From a recent report by Social Security's Office of Inspector General:
... An SSI recipient may be eligible for CDB [Child Disability Benefits -- Disabled Adult Child Benfits or DAC is what they're usually called] as a disabled child on a wage earner’s record [the father or mother] under the OASDI [Old Age, Survivors and Disability Insurance] program when the recipient meets the criteria for benefits. To conduct our review, we identified 1,017 SSI recipients who were potentially eligible for CDB from 1 of 20 segments in SSA’s system. From this population, we selected a random sample of 50 recipients for review.
... [W]e identified SSI recipients who were eligible for CDB. Our analysis of 50 SSI recipients identified 22 who were potentially eligible for, and 15 potentially technically entitled to, CDB. This occurred because SSA did not always (1) develop and dispose of leads related to CDB and/or (2) identify SSI recipients eligible for CDB during reviews of their non-medical eligibility factors and SSI payment amounts. Separate from our review, SSA has conducted projects, which identify SSI recipients who were potentially eligible for CDB. Based on the results of our review, we estimate 8,140 SSI recipients were potentially eligible for CDB and may be due underpayments totaling approximately $18.5 million. If SSA does not take action, we estimate the 8,140 SSI recipients may lose an additional $3.6 million over a 12-month period. ...
In my experience there are two types of benefits that are very frequently missed: Disabled Adult Child and Widowers benefits. Parents benefits are usually missed but there are very, very few entitled to Parents benefits. I always discuss the possibility of DAC benefits with young disability claimants. Even if they're not eligible now because neither of their parents is on Social Security benefits or retired, they'll need the information for later. I also make a point of asking both older male and older female clients about their marital status so I don't miss Widows and Widowers claims.
We have seen several DAC claims within the past 6 months where the client has been on benefits since age 18 but the DAC is denied because SSA says there is insufficient evidence to establish disability prior to age 22. These are cases where the DAC claim is being taken 10-15 years later so obtaining old evidence from medical providers is extremely difficult. SSA is never able to locate the prior file when we request it despite the client having been on continuous benefits since age 18. Seems rather self-serving for SSA to lose files and to give no credence to its own determination of disability.
ReplyDeleteSSA? Self-serving? Nah, can't be.
ReplyDeleteHad some of these adult child claims. One just approved and having a dickens of a time getting attorneys fees on it. Does only one person in the office know how to process this type claim?
ReplyDelete8:45. In the past people who were allowed SSI as an adult were almost always allowed CDB benefits once they were eligible. However since they changed the mental listings a while back we are told collateral estoppel no longer applies for those allowed under the mental , HIV and some other but not all Listings that were changed.
ReplyDelete10:29. Not self serving because actually more people are allowed or continued because prior folder was lost or destroyed. No idea why they were allowed so continue or allow under expedited reinstatement because it is not possible to show improvement even with people who earned three times the SGA level for many many years
ReplyDeleteThe years SSA comes up with drives me crazy. Why? Like why must prove disability between 18 and 22. The disabled widow or widower's must prove within 7 years of the spouse's death. The 5-year waiting period for Medicare. The 5-month waiting period.
ReplyDeleteJust never got a good explanation how they came up with these arbitrary numbers. My family and I have a strong science background. So maybe it is the science in me why the SSA comes up with these numbers.
2:36, SSA doesn't come up with these numbers--they are in the law. Congress came up with them.
ReplyDeleteIn many cases, it was the process of a political negotiation: if one party wanted 5 years and one wanted 10, the law wound up with 7.
@236--because the numbers sometimes make sense. Paying benefits to a DAC-disabled adult child-makes sense if the age is fairly young because the person would have been dependent on their parents for support at the time they became disabled.
ReplyDeleteDitto for the 7 year period for disabled widows. If the widow doesn't become disabled during this time period, which can be extended if the widow was receiving benefits for a child in his or her care, maybe the thinking is that such person had time to work and become insured on their own.
There is a two year waiting period for Medicare. That one and the 5 month waiting period are just choices Congress decided on. Perhaps you should ask your Congress person or Senator for that.
I know a case where someone got paid DAC benefits but wasn't entitled due to marriage. The marriage was documented but overlooked. He was asked to pay back $100000. He filed an appeal and eventually won. Asking the ARCMOS to sign off wasn't fun.
ReplyDelete