Many people with disabilities depend on Social Security, Supplemental Security Income (SSI), or Social Security Disability Insurance benefits and related health coverage.
Here is the scoop on those:
Social Security was established in 1935 and has evolved over the years. Presently, these benefits are as follows:
Social Security is an earned benefit with dedicated funding from payroll contributions paid by workers and their employers. Benefits are based on the worker’s earnings history and can be accessed as early as age 62 for a portion of the full benefit or at full retirement age for the full benefit. If you wait longer, the social security amount you receive is higher.
Supplemental Security Income provides basic income support for low-income seniors and people with disabilities, to protect against extreme poverty and help recipients meet basic needs. SSI is reserved for people with very low income and very limited assets (e.g., can have savings of no more than $2,000 for an individual or $3,000 for a couple). Unlike Social Security, SSI has no requirement for a prior work history or prior contributions.
Social Security Disability Insurance (SSDI) assists workers with qualifying disabilities, their children, and spouses. When a worker qualifies for this benefit, the worker’s spouse and child(ren) also may be eligible for monthly benefits.
Many people with disabilities and their families receive Social Security benefits based on the earnings record of a parent or spouse who is deceased (“survivors’ benefits”) or who is receiving Social Security retirement or disability benefits. Benefits are up to 50 to 75 percent of the worker’s full benefit; if several individuals receive these family or “ancillary” benefits, total benefits are subject to a family maximum that is generally 150 to 180 percent of the worker’s full benefit. Children of retired, disabled, or deceased workers may also receive benefits if they are a minor child under the age of 18, a high school student under the age of 19, or an adult who qualifies as a Disabled Adult Child.
Disabled Adult Child benefit assists many people with disabilities to live independently and can be a critical source of support for families caring for an adult child with a disability. Although only adults can qualify for DAC benefits, the benefit is considered to be a type of Social Security child’s benefit because it is paid based on the earnings record of a parent. To qualify a person must be age 18 or older, be unmarried (or married to another Social Security beneficiary), and have a disability that started before age 22 and meets the definition of disability under the Social Security Act.
The above descriptions were taken from the Social Security Administration.
Understanding SSDI-DAC Benefits and Medicaid Eligibility
In the past, recipients of Supplemental Security Income (SSI) had to navigate a separate process to apply for the Disabled Adult Child (DAC) benefit under Social Security. While this still holds true in many states, there’s a nationwide shift toward automatically transitioning eligible individuals from SSI to SSDI-DAC. Let’s delve into the details.
1. What Is SSDI-DAC?
- SSDI-DAC stands for Disabled Adult Child benefits. Unlike SSI, which is an entitlement benefit, SSDI-DAC is an insurance benefit partially funded by prior contributions.
- Eligibility: To qualify, an unmarried adult child must have a disability that began between ages 18 and 22 and continues beyond age 22. Importantly, the benefit is based on the parent’s earnings record, not the disabled adult child’s own work history.
2. Income Considerations:
- Recent inflation increases have impacted overall payments, potentially pushing SSDI-DAC benefits above the monthly income limit required for Medicaid eligibility.
- Medicaid’s income limit varies by locality and is generally calculated at 300% of the poverty level.
3. Navigating Protections:
- The Social Security Act shields those who switch from SSI to SSDI-DAC from losing Medicaid benefits.
- However, additional income sources (even as little as $10 from employment or another small pension) combined with SSDI-DAC benefits can erode this protection.
- Uneven application and lack of awareness contribute to challenges faced by beneficiaries.
- Some individuals have been forced to quit vital jobs due to these complexities.
- Parents worry that their child might lose essential Medicaid waiver services upon their passing.
4. Virginia’s Revenue-Neutral Approach:
- Kristin worked in tandem with the Autism Society of Central Virginia and many other constituents to advocate for clarity in the state. Due to their advocacy, the Virginia legislature passed a bill instructing the Department of Medical Assistance Services (DMAS) to exclude SSDI-DAC income when calculating Medicaid waiver eligibility.
- Revenue Impact Assessment: To ensure revenue neutrality, the bill enacts a two-year period during which DMAS will disregard SSDI-DAC income for eligibility purposes. DMAS will then evaluate the revenue impact during the next general session.
- This approach aims to maintain Medicaid coverage while addressing financial concerns. Advocates are poised and ready to continue advocating to make sure this bill becomes permanent.
5. Federal Advocacy and the Path Forward:
- Beyond Virginia, Kristin is taking her advocacy efforts to Capitol Hill in Washington, DC. Meeting with federal legislators, she aims to discuss the same issue.
- Federal Legislation: While states have grappled with this issue, a federal bill could provide consistent guidelines. The Center for Medicare and Medicaid Services (CMS) has allowed states to selectively disregard certain income types while maintaining federal funding.
- Impact on Families: A federal law would alleviate concerns for families of individuals with developmental disabilities. It ensures that work history or a parent’s passing won’t jeopardize essential home and community-based services.
- Empowering Employment: By removing barriers, such legislation encourages employment within the community.
6. Ongoing Advocacy:
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- Our passion for advocating for the community continues. Advocating for disability-related issues, income equality, and employment opportunities, we are looking to build a better future for all.
Source: SSA.gov
