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Social Security denied my spousal benefits repeatedly - won in court but stuck with reduced payment due to late enrollment penalty

I'm beyond frustrated with the Social Security Administration after fighting them for YEARS over my spousal benefits. I tried to apply when I turned 65 (while still covered by my employer's health insurance). Three different SSA representatives told me I wasn't eligible for spousal benefits OR Medicare at that time. I knew something was wrong, so I applied THREE TIMES and got rejected each time! Finally found an attorney willing to take my case to court. The judge reviewed my paperwork and immediately ruled in my favor! But here's the kicker - even though I tried to apply at 65, they're only giving me 1.5 years of retroactive payments instead of the full 4 years I'm owed. The attorney took 40% of that backpay. Worse yet, they're penalizing me for "late enrollment" - something completely caused by THEIR ERROR. My monthly benefit is now less than $410 instead of the $925 I should be receiving. I've appealed this decision 3 times. The last response basically ignored my main argument that I was given incorrect information by SSA employees. Does anyone know if there's any recourse left? I've always trusted people in authority positions and had no reason to think SSA reps would give me wrong information that would cost me thousands of dollars. Any advice appreciated.

Ravi Malhotra

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I'm so sorry this happened to you. Unfortunately, this is more common than you might think. The SSA has something called "administrative finality" which limits how far back they can correct errors. Even when it's their mistake, they often stick to their rules. For your specific situation, you should consider requesting an "equitable relief" review. This is specifically for cases where an SSA employee gave incorrect information that caused financial harm. You'll need to file Form SSA-795 (Statement of Claimant) explaining exactly what happened, which employees you spoke with, and when. Also, there's a difference between the retroactive payment limitation (usually 6 months for retirement benefits) and the late enrollment penalty (which reduces your benefit permanently). Those are separate issues you might need to address differently.

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Thank you for this information! I've never heard of "equitable relief" before. Is this something I can request even after multiple appeals? And do I need legal representation again to file this form? I'm hesitant to pay another lawyer after losing so much of my backpay the first time.

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WOW this is CRAZY!! The same thing happened to my sister-in-law last year!!! They told her she wasnt eligible for widows benefits then 2 yrs later they said she WAS eligible the whole time but she lost money because of THEIR mistake!!!! The whole system is rigged against us seniors I swear

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Omar Farouk

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Oh great, reading this makes me nervous. I'm turning 65 next month and I've been planning to file for spousal benefits while my husband continues working until 67. Now I'm wondering if I should record my conversation with the SSA rep or get something in writing...

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Chloe Davis

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This is definitely a frustrating situation, but there are a few options you can still pursue: 1. Contact your Congressional Representative's office. They have staff dedicated to helping constituents with federal agency issues, including Social Security. They can sometimes cut through red tape that seems impossible for individuals. 2. File a complaint with the SSA Inspector General about the misinformation you received. 3. Request a meeting with the District Manager at your local SSA office (not just a claims representative). Bring all documentation showing your original application attempts. 4. If your last appeal was to the Appeals Council and was denied, the next step would technically be Federal Court, though that's expensive and time-consuming. Regarding the late enrollment penalty - there's a specific process for requesting penalty relief due to government misinformation. This is separate from your benefit amount appeal.

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I hadn't thought about contacting my Congressional Representative. That's a great idea. My last appeal was to the Appeals Council, and they basically said that since I couldn't provide names and exact dates of the SSA employees who gave me wrong information 4 years ago, they couldn't verify my claim. How am I supposed to remember their names after all this time? I didn't know I needed to document everything back then!

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AstroAlpha

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I went through something similar with SSA and spent WEEKS trying to get through to someone who could actually help. The phone lines were always busy or I'd wait for hours only to get disconnected. Finally I found this service called Claimyr (claimyr.com) that got me through to a live agent in under 5 minutes. They have a video demo at https://youtu.be/Z-BRbJw3puU showing how it works. Once I finally got to speak with a knowledgeable agent, they helped me file for equitable relief and I was able to get part of my penalty removed. Definitely worth getting through to someone senior who can actually review your case properly instead of just the frontline reps who keep denying you.

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Diego Chavez

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is this legit? sounds 2 good 2 be true i been calling ss for 3 days straight and cant get anyone

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AstroAlpha

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Yes, it's legitimate. I was skeptical too, but it worked for me. The key is that once you get through to an actual person, you need to ask for a supervisor or someone who specializes in appeals and equitable relief specifically. Most regular reps won't know how to handle complex cases like this.

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my uncle had something like this happen but with disability not spousal benefits. he also had to get a lawyer. the whole system is just designed to make us give up i think. good luck fighting them

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Ravi Malhotra

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One more suggestion that might help: specifically request a "Good Cause" determination for the late enrollment penalty. Under certain circumstances, SSA can waive penalties if you can show it wasn't your fault. Being given incorrect information by an SSA employee qualifies as "good cause." Also, have you checked whether you're entitled to benefits on your own work record? Sometimes people focus so much on spousal benefits they don't realize they might qualify for more on their own record. For the retroactive benefits limitation, unfortunately the law only allows 6 months of retroactive payments for retirement claims filed after FRA (Full Retirement Age), so that part might be harder to fight unless you can prove you actually completed applications earlier that they lost or improperly processed.

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Thank you for mentioning the "Good Cause" determination - I'll definitely look into that! Regarding my own work record, I did check that first. I mostly worked part-time jobs while raising our children, so my own benefit would only be about $320/month. My husband was the primary earner, which is why I applied for the spousal benefit (50% of his). And yes, the retroactive payment situation is what really upsets me. I don't have physical proof of my earlier applications because they were done in person at the SSA office. It's my word against theirs, and apparently my word counts for nothing even though the judge agreed I was eligible all along!

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i dont understand why medicare is tied to ss anyway! its so confusing my husband got medicare at 65 but they said he couldnt get SS til 67 but then my friend got both at 65??? make it make sense!!!

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Chloe Davis

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Medicare eligibility starts at 65 for most people, regardless of when you claim Social Security. You can get Medicare at 65 even if you delay taking Social Security until later (66, 67, or even 70 to maximize benefits). Your husband's Full Retirement Age (FRA) for Social Security is probably 67 (for anyone born in 1960 or later), which is why they told him that. Your friend might have an earlier FRA, or might have chosen to take reduced benefits early. It's confusing because the programs are connected but have different eligibility rules.

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Omar Farouk

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I'm curious - did your attorney explain why they could only go back 1.5 years for your retroactive benefits? There's usually a clear rule about this, and your attorney should have explained the limitation. Also, for the late enrollment penalty - did you have creditable health insurance coverage through your employer the entire time? If so, you shouldn't face a Medicare Part B penalty at all. That's a separate issue from the reduced Social Security benefit amount. For the reduced Social Security benefit, was this because they're saying you filed at age 69 instead of 65? If so, that doesn't make sense - filing after your Full Retirement Age should give you delayed retirement credits, increasing your benefit, not reducing it. Something doesn't add up in how they calculated your benefits.

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You're right that something doesn't add up! My attorney explained that for retirement benefits (including spousal), they can only pay 6 months of retroactive benefits. Even though I tried to apply at 65, since they didn't accept those applications and only counted my successful application at age 69, I only got 6 months of back payments. Regarding Medicare - yes, I had employer coverage the whole time, but since they claimed I never properly applied for Medicare at 65, they're charging me the late enrollment penalty on my Part B premium. And you're absolutely right about the delayed retirement credits - that's what makes this so infuriating! Instead of getting an increased benefit for filing at 69, I'm getting a reduced benefit because they're saying I failed to enroll in Medicare on time, which is affecting my Social Security payment. It feels like I'm being punished from every direction for their mistake!

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Diego Chavez

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this is why i tell everyone to record phone calls with ss or get everything in writing!!! they mess up all the time and then we're the ones who suffer

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Ravi Malhotra

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Based on your additional information, I think you're dealing with two separate issues that might be getting confused: 1. Social Security spousal benefits: If you filed at 69, you should actually get MORE than 50% of your husband's benefit due to delayed retirement credits, not less. The 6-month retroactive payment limitation is correct, unfortunately. 2. Medicare penalties: This is likely a separate issue. The late enrollment penalty for Medicare Part B adds 10% to your premium for each 12-month period you could have had Part B but didn't. However, if you had creditable employer coverage, you should have qualified for a Special Enrollment Period with NO penalty. I suspect the $410 vs $925 difference isn't just about penalties - it might be that they calculated your benefit incorrectly or applied the wrong formula entirely. At this point, I strongly recommend requesting a detailed benefit calculation explanation from SSA in writing. Ask specifically for a breakdown of how they arrived at $410 instead of $925. Once you have that, the error might become clearer and easier to appeal.

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Thank you so much for breaking this down. I think you're right that I'm dealing with multiple issues that got tangled together. I'll request that detailed benefit calculation explanation ASAP. One clarification - my husband was already receiving his benefits when I applied, so I wasn't sure if the delayed credits would apply to spousal benefits in that scenario. The SSA rep said something about my benefit being reduced because I didn't file for Medicare on time, even though I had employer coverage. This whole process has been so confusing. I really appreciate everyone's help and suggestions!

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