Borderline Age Rules

“If a claimant is within a few days to a few months of reaching a higher age category and using the chronological age would result in a denial, consider using the higher age category if it would result in a favorable determination . . . .”  The phrase, “a few days to a few months” is defined as a small number not to exceed 6 months.

POMS DI 25015.006(B)

2015 Data

The following is data obtained from the Social Security Forum, Vol. 38, No. 2 – February, 2016.  The data is for Fiscal Year 2015:

  • 67% of disability applicants are denied by the Social Security Administration when they apply.
  • 88% of appeals in the Reconsideration process are denied.
  • When a case goes to an Administrative Law Judge, about 45% of claimants are approved.
  • Appeals to the Appeals Council were denied at a rate of 83% in 2015.
  • Appeals to Federal Court resulted in denial or dismissal over 50% of the time.

 

Social Security Disability Fraud Investigations

The Social Security Administration uses Cooperative Disability Investigation (“CDI) Units to investigate potential fraud.  The CDI units work with the Office of Inspector General (OIG) as well as state and local law enforcement agencies.  Such investigations take place during the entire application process, and also during continuing disability reviews.  Investigations can be generated by state agency employees, SSA employees, private citizens, anonymous sources, and law enforcement agencies.  During the investigation, the CDI Unit can interview the application, interview third parties, conduct surveillance, and/or examine the claimant’s social media accounts.  It appears such investigations are expanding.

COLA

There will be no cost of living adjustment for Social Security and SSI beneficiaries in 2016.

SGA Threshholds

Substantial gainful activity thresholds – Non-blind

2016: $1,130/month

2015: $1,090/month

Substantial gainful activity thresholds – blind

2016: $1,820/month

2015: $1,820/month

Trial Work Period

2016: $810 per month

2015: $780 per month

SSI Amounts

Individual:

2015/2016: $733 per month

Couple

2015/2016: $1,100 per month

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