Claysphere Rivera asked:

General public opinion had generated the belief that Social Security is designed exclusively for retirement. Contrary to this misconception, Social Security System offers a variety of programs that cater not only benefits for retiring individuals but also programs providing assistance for the disabled including their dependents.

This article focuses on Social Security program, particularly survivor’s benefits. More specifically, the article gives a thorough exposition of the fundamentals of Social Security survivor’s benefits claims.

Foremost, a brief discussion about Social Security survivor’s benefits is worthwhile.

Social Security survivor’s benefits are designed to provide the much-needed income to the surviving family members of a qualified decedent making their lives sustainable at least.

Not just anybody can apply for this kind of benefits. The Social Security Administration had provided constitutive requirements for a survivor benefit claims.

The survivor’s eligibility is gauged based on the decedent’s earning record showing his work, payment of social security taxes and earned work credits. The work credits are crucial in this respect because it would be made the basis for the survivor’s entitlement of this particular kind of social security benefit.

Worthy to note however, under a special rule, if you are only “currently insured” at the time of your death and relatively have only 6 credits in the 13 quarters prior to your death, your children and your spouse can still receive this benefits.

On the other hand, if you have determined your qualifications for benefits it would be wise to apply promptly, especially if you are not yet a recipient of social security benefits. This is for the reason that the benefits are paid from the time of application and not from the time that the worker died.

The application for benefits generally requires relevant information such as the following:

• the proof of death;

• Social Security number of the applicant as well as the deceased worker;

• marriage certificate if applying as a divorced widow or widower;

• dependent children’s social security numbers if available including their birth certificates;

• deceased worker’s W-2 forms or federal self-employment tax return for the most recent year; and

• the name of the bank and account number of the applicant so that the benefits can be deposited directly in the account

Some of the requirements mentioned above can be dispensed with especially to those who have already received Social Security benefits. However, it is essential to report the death with the Social Security office so that update and changes of payment would be made.

With reference to the amount of survivor’s benefits, the same relatively depends on the earnings of the person who died. The more the worker paid into Social Security, the greater your benefits will be.

Take notice that, there is a limitation to the payment of benefits to the survivor members each month. The limit varies, but is generally between 150 and 180 percent of the deceased’s benefit amount.

More so, reduction of benefits can be halted on the following situations:

• To those who get a pension from work that was not covered by Social Security, like the federal civil service, your Social Security benefit may be reduced.

• Those who are working and have been receiving Social Security survivor’s benefits and are younger than full retirement age, the benefits may be reduced if your earnings exceed certain limits.

However, the reduction of benefits affects only the survivor concerned and not the benefits of other family members.

A special rule applies to those who remarry. Generally, widow or widower’s benefits are not given to those who remarry before age 60.

However, remarriage after age 60 (or age 50 if disabled) will not hold the survivor from getting benefit payments based on the latter’s former spouse’s work.

At age 62 or older, the survivor may get benefits based on his/ her new spouse’s work, if the benefits are higher.

Like any other claim under the whole spectrum of Social Security, claimants are given the right to dispute the findings or decision of the Social Security Administration.

An appeal, to be specific, is given to the claimants. The latter process entails complex situations that need another careful elaboration.

The key thing in all types of claims is the right of the claimant to confer with a Social Security lawyer of their choice.

For credible information and expert representation on your survivor benefits claim, log on to our website and seek the assistance of our Los Angeles Social Security attorneys.

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Attorneys who represent Social Security disability claimants generally do so under a “contingency fee agreement.” That is, the client does not pay the attorney unless and until the case is resolved and Social Security benefits have been awarded. A representative who wants to charge or collect a fee from a claimant for services provided in any proceeding before the Social Security Administration (SSA) under the Social Security Act (the Act), must first obtain SSA’s authorization. To do so, a representative must use one of two mutually exclusive fee authorization processes: the fee agreement process or the fee petition process. Under the fee agreement process, an attorney can collect no more than 25% of of back benefits recovered, or $5,300, whichever is less. If the attorney is unsuccessful in obtaining benefits, there is no charge.

Fee Agreement Process Before SSA decides the claim, the representative or the claimant may file a fee agreement. Generally, SSA will approve an agreement (under § 206(a)(2)(A) of the Act) if the other statutory conditions are met and no exceptions apply. If SSA approves the fee agreement and no one requests administrative review, the fee specified in the agreement is the maximum fee the representative may charge and collect.

Fee Petition Process After the representative’s services in the case have ended, he or she may petition for a fee. SSA reviews the fee petition and authorizes a “reasonable” fee (under §206(a)(1) of the Act) for the specific services provided.

A fee agreement is a written statement signed by the claimant and his or her appointed representative specifying the fee the representative expects to charge and collect, and the claimant expects to pay, for services the representative provides in pursuing the claimant’s benefit rights in proceedings before the Social Security Administration (SSA). For SSA to approve a fee agreement, the representative must submit it before the date of the first favorable determination or decision SSA makes on a claim after the representative’s appointment. If the representative does not submit a fee agreement by that date, SSA assumes the representative either will file a fee petition or waive a fee.

If the representative submits a fee agreement before the date SSA makes a favorable decision, SSA will approve the fee agreement at the time of the favorable decision if the statutory conditions for approval are met and no exceptions to the fee agreement process apply. Once SSA approves the fee agreement, the fee specified in the agreement is the maximum fee the representative may charge and collect for all services in the claim.

A fee petition is a written statement signed by a claimant’s representative requesting the fee the representative wants to charge and collect for services he or she provided in pursuing the claimant’s benefit rights in proceedings before the Social Security Administration (SSA).

SSA presumes that the representative will either file a fee petition or waive his or her fee if the representative does not file a fee agreement before the date SSA makes the first favorable determination or decision. A representative who elects to use the fee petition process generally files the petition after his or her services in the case have ended. Based on this petition, SSA will authorize a reasonable fee for the specific services provided.

The fee agreement and fee petition process are not interchangeable. However, if a representative elects the fee agreement process but SSA does not approve the agreement, or if an SSA reviewing official upholds a disapproval of a fee agreement on administrative review, the representative must file a fee petition if he or she wants to charge and collect a fee for their services.

The Social Security Act and SSA regulations prohibit representatives from charging or collecting any fee for representational services that SSA has not authorized, or that is more than the maximum amount SSA authorized. Any representative found to have charged or collected an unauthorized fee may be suspended or disqualified from practice before SSA and will be barred from appearing before SSA until full restitution is made. The representative also is subject to fines and imprisonment

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Types of Social Security Disability Benefits

The Social Security Administration has established a number of different types of disability programs. Although the medical rules are similar under each program, the technical rules on eligibility set each program apart. What program you may be eligible for depends on a number of factors, including your work history, age, household income and marital status. You may be eligible for more than one type of benefits, but generally SSA will pay you the higher benefit amount of any one program you may be entitled to.

Disability Insurance Benefits: This program, also known as “DIB” or Title II benefits, awards benefits to individuals who, because of a physical or mental impairment, are unable to work at a “substantial” gainful level, and their condition has existed or is expected to exist for at least a 12 month period. By “substantial,” SSA means the claimant would be unable to earn over $900.00 per month because of their disability. This dollar amount increases slightly every year. To be eligible for DIB, a claimant must have worked long enough and paid enough into Social Security through their FICA taxes to be “insured.” As a general rule, if a claimant worked at least five of the last 10 years, he would be “insured” for purposes of DIB. How much a claimant receives each month if found disabled and entitled to DIB is based on how much he “paid into” the system during his working life. Generally, the longer someone has worked and the higher his earnings, the more he would be paid if found disabled. Individuals found disabled and entitled to DIB benefits may be awarded retroactive benefits. Retroactive benefits can only go back one year from the date of the initial application. There is a five-month waiting period from the date the claimant is determined to be disabled until entitlement to DIB benefits begin. To illustrate this, if a claimant files a claim for DIB on January 1, 2006 alleging disability as of February 2005, and SSA determines he is disabled and his disability began February 1, 2005, he would be eligible for retroactive benefits starting in July 2005. In addition to receiving individual DIB benefits, your minor children may also qualify for auxiliary benefits based on your disability. These benefits are granted in addition to any benefit you receive. To ensure any minor children are awarded any benefits they may be entitled to, it is important you furnish the names and Social Security numbers of any minor children you have to SSA. The children do not have to live in the same household to be eligible for auxiliary benefits.

Supplemental Security Income: This program, also known as SSI or Title 16 benefits, is a “needs-based” program in which individuals with little or no resources or assets may receive disability benefits. The medical criteria for SSI eligibility is the same as that used for DIB — a physical or mental impairment which prevents you from working at a “substantial” gainful level, and the condition has existed or is expected to exist for at least a 12 month period. Effective January 2007 the SSI payment for an eligible individual is $623 per month and $934 per month for an eligible couple. There is no retroactive eligibility for SSI benefits: benefits can go back only to the month in which your claim was filed. Unlike DIB, there is no five-month waiting period for entitlement to SSI, so your eligibility would begin the month in which you filed your claim or were determined to be disabled, whichever is later. A claim for SSI benefits can also be filed on behalf of any minor children with a disability; however, as with Adult SSI claims, to be entitled to SSI benefits the household income must be below certain limits.

Disabled Adult Child: This program provides disability benefits to adult children of deceased or disabled parents. In addition to the medical requirement that you have a physical or mental impairment which prevents you from working at a “substantial” gainful level, and the condition has existed or is expected to exist for at least a 12 month period, you must also show that your condition has existed and has been disabling since before your 22nd birth date. In addition, you must be the adult child of a parent who is currently receiving DIB benefits, or the Adult child of a parent who is deceased and was “insured” for purposes of eligibility for DIB benefits. It is not necessary that the adult child ever worked because benefits are paid on the parent’s earnings record. The adult child must not have worked and earned “substantial earnings” for an extended period at any point after turning 22; however, certain expenses the adult child incurs in order to work may be excluded from these earnings. An adult child already receiving SSI benefits should check to see if benefits may be payable on a parent’s earnings record. Higher benefits might be payable and entitlement to Medicare may be possible.

Disabled Widow’s/Widower’s Benefits: If you are a disabled widow or widower age 50 or older you may be able to receive benefits off your spouse’s (or former spouse’s) Social Security record. If you are a widow or widower from a spouse you were divorced from, to be eligible for benefits you need to have been married to your spouse for 10 years or longer and your disability must have started before age 60 and within seven years of the date in which the worker died. If you were married to your spouse when they passed away, Social Security does not require that you were married for 10 years. In either case, you will need to provide proof of relationship in the form of your marriage certificate or divorce decree, along with your spouse’s death certificate when you file for benefits. If you file a claim for Disabled Widows/Widower’s benefits and DIB or SSI benefits, you will receive only the higher monthly benefit amount of the two programs.

Medical Insurance: Once you are found disabled and entitled to Social Security disability benefits, you will also be eligible for medical insurance though Medicare or Medicaid. If you filed a claim for DIB, Disabled Adult Child or Disabled Widow’s/Widower’s benefits, you may be eligible for Medicare. However, eligibility for Medicare does not start until you have been disabled for 25 months. If you are approved for Social Security benefits under any of the above-listed programs, SSA will contact you approximately two months before your eligibility for Medicare begins. If you have already been disabled for 25 months, be sure to keep a record of all medical bills as you may be reimbursed by Medicare for these expenses. There is no waiting period for Medicaid; however, your income and resources must be very low to qualify. If you have applied for and have been approved for SSI you probably qualify for Medicaid. You may think that Medicaid and Medicare are the same, but actually they are two different programs. Medicaid is a state-run program that provides hospital and medical coverage for people with low income and little or no resources. Each state has its own rules about who is eligible and what is covered under Medicaid. Some people qualify for both Medicare and Medicaid. For more information about the Medicaid program, contact Social Security or your local social services or welfare office.

This article has been written to give you a general overview of the Social Security disability programs and the disability process. As this article may not address all questions you might have, please contact us for further information.

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Social Security Fraud refers to the act of dishonestly claiming of benefits. Due to the increasing number of fraudulent claims, the US government enacted a law that will protect individuals from these illicit conducts.

What constitutes Fraud under the Social Security Act?

The Social Security Act provides an outline for actions that are considered fraudulent. Some of those acts are the following:

• Knowingly and willfully makes or causes to be made any false statement or representation of material facts in the application for benefits under this title;

• Knowingly and willfully makes or causes to be made any false statement or representation of a material fact for use in determining any rights to the benefits;

• Having knowledge of any event affecting

o His  or her right to the benefit

o The initial or continued right to the benefit of other individual in whose behalf he or she has applied for or is receiving benefit

o Having made an application to receive any of such benefits for the use and benefit of other and having receive it, knowingly and willfully converts the benefits for the use other than for what is intended

Information needed in filing Social Security Fraud

When planning to file a Fraud complaint, you need the following data:

• Name

• Address

• Social security number of the person you are reporting.

• Description of potential fraud incident

In cases where the Social Security number is not known, you need to secure his or her date of birth, age and the name of the parents. However, if you are reporting a concealed activity you need the name of the employer and its address and phone number.

How to report Social Security Fraud incident

The Social Security Administration takes seriously any report regarding Social Security Fraud. The Office of the Inspector General is the one who investigates incidents of Social Security Fraud. If you have any knowledge regarding these incidents, you can report it immediately by:

• Calling the Social Security Office hotline number

• Use the on line fraud reporting form

• Write to Social Security Office.

Yet, if you have been the actual victim of a fraudulent act, seeking legal assistance from a competent Social Security Fraud attorney is advisable. An attorney with sufficient in handing these cases can help you prosecute the law violators.

What is the Office of the Inspector General?

The Office of the Inspector General is the one directly responsible for meeting the statutory mission promoting economy, efficiency and effectiveness in the administration of Social Security programs. It is also responsible for preventing and detecting fraud, waste, abuse and mismanagement in such programs and operations.

OIG also searches and reports systematic weaknesses in SSA programs and operations and make recommendations for improvements and corrective actions.

Penalties for the violation of the Act

Any person found guilty for Social Security Fraud shall be:

• Fined under the United States Code

• Imprisoned for not more than five years or both

The federal court in sentencing the defendant may in addition to any other penalty order restitution.

When can there be restitution?

The court orders restitution in any of the following instances:

• The Commissioner of Social Security order payment that should not have  been made

• An individual suffers financial loss due to defendant’s violation of this Act.

Our Los Angeles attorneys are proven experts in handling Social Security Fraud cases. For free evaluation of your case, log on to our website and contact our legal staff.

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