My family and I are currently enjoying The Inbestigators (indicating the best investigators) as our evening escapism. The Australian TV series features four fifth graders whose powers of observation and quick deduction skills—as well as extreme persistence—allow them to solve cases that baffle both their peers and adults. As with any great detective from the iconic Sherlock Holmes on down, the secret to the children’s success lies in their attention to detail.
Social Security generates mysteries in the same way our computers generate pop-up ads—mostly spontaneously, continuously and sometimes as a result of something we’ve entered somewhere. Unlike clickbait, though, there is always a lag time between your action and the Social Security Administration’s mysterious and sometimes-mistaken reaction. Before taking an action that has the potential to impact your own social security, then, it is critical to find out what the Administration thinks it knows about your situation, and then compare it to what you DO know. There may be a gulf the size of the Grand Canyon between your view and theirs. I am by no means maligning the agency or its staff. They work hard, provide a valuable service, and process enormous volumes of data every day. More than 169,000 people a day receive services from one of 60,000 workers in more than 1,200 field offices.
If you are receiving Social Security disability benefits, either Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) or both, one of the biggest steps you can take is going to work or increasing the amount you earn from work, by taking on more responsibilities or a new job. Social Security has a whole suite of work incentives that can support your transition, but to use them to the best effect, you need to know what Social Security has on record for various characteristics of your claim.
The first page of the Benefits Planning Query (BPQY) reports what type(s) of cash benefits the Social Security Administration believes it is paying you and in what amount. While this sounds obvious—of course they know what they are paying me and I know what they are paying me—there are subtleties. For example, you may be receiving both SSI and SSDI. This is important to confirm because earning from work will impact each of these benefits differently. Any SSI payment you receive will be reduced by 50 cents on the dollar for any work earnings over $85/month. Whereas SSDI benefits will not be affected until you reach a level, where you are performing Substantial Gainful Activity (SGA), by earning $1,220/month (2019). SSI has a resource limit of $2,000 in one’s own name, which you may run up against if you save some of your work earnings. SSDI does not have this. Moreover, if you have SSI, your Medicaid eligibility will be linked to it, which provides you access to programs that extend Medicaid eligibility for people who work. Also, certain items may be deducted from your check such as Medicare part B premiums, delinquent child support, or overpayment repayment.
For those receiving SSDI, your BPQY will also tell you whether anyone else is being paid on your work record. Again, it may seem like this should be obvious, but it is not always, particularly when the primary beneficiary is divorced. Your minor children or adult children with disabilities may be getting paid on your work record, as might an ex-spouse who is caring for them. If your benefits cease because you go back to work at a certain level, their benefits will cease also. The BPQY will also tell you whether Social Security thinks they have overpaid you, how much they believe this amount is, and whether they are withholding any amount from your benefit check to address the overpayment. Although the Administration sends out a copious number of letters, you may still be surprised to find you have an overpayment, or that it is larger than you think. Do not assume their figures are correct. If you use your records of any monthly earnings you reported to the SSA and your record of any benefit checks your received in months when you worked, you can calculate whether or not you should have an overpayment and what size it should be. Also, do not assume you have no recourse. If they have miscalculated or even if they are right and repayment is a hardship, there are ways to appeal and request a waiver.
The second page of the BPQY tells you whether you are receiving Medicare and which parts. Usually, it does not tell you much about Medicaid, as that is state-determined. Page two also records whether you have any SSI Work Exclusions, which are amounts that the SSA deduct before they count how much income you have from work. Effectively reducing your countable income minimizes the impact that working will have on the amount of your benefits. An example of this is the Student Earned Income Exclusion, which allows a student under age 22 to earn up to $1,870/month up to a yearly maximum of $7,550 (2019) BEFORE the 50 cents on the dollar reduction to the SSI kicks in. This is HUGE. If you are a full-time student and below the age threshold and this exclusion is NOT documented in your BPQY, you need to make clear your status before you go to work.
For those receiving SSDI, page 2 of the BPQY records whether you have used up a Work Incentive (particular to SSDI) called the Trial Work Period (TPW). The first month after starting your SSDI in which you earn more than $880/month (2019) is a Trial Work Month (TWM). When you have accumulated 9 such months, in a rolling 60-month (5 year) period, you have completed the first step towards going off your SSDI benefits. Therefore, it is VERY important to know whether Social Security thinks you have started that rolling 60-month TPW and, if so, how many TWMs they think you have used up already. During TWMs, you get paid your full SSDI check as usual, so you may not even be aware that you are accumulating these markers.
Following the TWP, you enter the Extended Period of Eligibility (EPE), during which you receive a check in any month in which you earn less than the SGA level ($1,180 for 2019) but you do not receive a check in any month in which you earn more than that. If you are paid hourly and have variable hours, your checks may be on-again/off-again during the 36 months of your EPE. You can see that if Social Security has miscalculated when your TWP and hence your EPE was supposed to have started and when it is supposed to end the agency might well end up paying you for months when they should not be. This will result in an overpayment, so it is certainly something that you want to address if you find a discrepancy in TWP months accumulated or start date. I have seen situations where the dates recorded for someone’s TWP are off by more than a year, resulting in a large potential liability to the claimant.
On page 3 of the BPQY, you will find a table of how much in gross wages Social Security has recorded for each month that you worked, subsequent to starting SSDI benefits. This table is perhaps the most important aspect of the whole report. If, for example, Social Security does not have a record of any SSI exclusions, but you have or should have such exclusions, then the recorded earnings will be higher than they should have been. The SSA’s calculation of your use of SSDI Work Incentives such as TWMs and the EPE likewise follow from this table. It is tedious, but it can be highly informative to review this table to determine 1) whether Social Security correctly recorded your earnings for each month, 2) in how many if any months you earned more than the Trial Work Period level, and 3) in how many if any months you earned above the SGA level. Keep in mind that both the TWP and SGA levels generally increase a little each year, so you will have to look on the SSA website to find the correct amount for each prior year.
The Inbestigators always get their answer within a couple of days in TV land and in 15 minutes in real time. And they seldom need a paper trail. Solving your Social Security mysteries won’t be as easy. But the BPQY is an invaluable source of clues.