SSDI questions using totalizators agreement, any help appreciated!
March 4, 2023 8:38 AM
Okay! This is confusing. I stopped working in 2013 in the UK and went off work in 2007 in the USA on FMLA in 2007 and have a psych consult in the UK in 2009 and was off work there for 2 years 2009-2010. Now I am in Germany and a housewife and haven’t worked since 2013 but am registered since last year severely disabled with chronic migraine and am about to be hospitalized for PTSD.
I would like to maybe come home someday and am trying to work out how this might be possible.
I have 27 full credits. The last credit I got was in 2005. I need to get the broken down record but I think I only have 16 credits from when I was 21-31 which was when I last worked. I worked full time in the UK through 2012 and would have turned 31 that year. So I guess I don’t have the recent experience.
My doctor from 2007 would probably write a statement for me but since I kept working after that I suppose it’s not a help. But do they ever accept an onset date if the person has worked after?
I don't need the ssdi, BUT I am very keen to be eligible for Medicare because of my chronic migraine and because of the ptsd hospitalization I can picture that my health insurance privately would be pretty expensive… and it seems like they go hand in hand (ssdi and Medicare before 65). I guess I can only opt to pay for Medicare before 65 IF I am getting SSDI.
It looks like I can theoretically get SSDI if I use my National insurance contributions record up to 2013 but can I do that if Im not living in the UK anymore? Does that mean I wouldn’t get my little UK pension?
Is this something I should come home and do with a lawyer? What documents should I work to get now?
Also on the totalitarian agreement it says that it doesn’t cover Medicare. But if I used it to get ssdi, come home and get Medicare then would it switch to social security but I still wouldn’t get Medicare?
Is it possible to work under the gainful employment hours and still earn credits to work my way up to 40? My last job I enjoyed was working in a bookstore in my early 20’s, I could probably manage that if it still existed!
Ive looked for lawyers in Europe and cant find any and called in the United States but ran out of steam after the first two said that they didn’t work with people overseas.
Thank you for your help.
I would like to maybe come home someday and am trying to work out how this might be possible.
I have 27 full credits. The last credit I got was in 2005. I need to get the broken down record but I think I only have 16 credits from when I was 21-31 which was when I last worked. I worked full time in the UK through 2012 and would have turned 31 that year. So I guess I don’t have the recent experience.
My doctor from 2007 would probably write a statement for me but since I kept working after that I suppose it’s not a help. But do they ever accept an onset date if the person has worked after?
I don't need the ssdi, BUT I am very keen to be eligible for Medicare because of my chronic migraine and because of the ptsd hospitalization I can picture that my health insurance privately would be pretty expensive… and it seems like they go hand in hand (ssdi and Medicare before 65). I guess I can only opt to pay for Medicare before 65 IF I am getting SSDI.
It looks like I can theoretically get SSDI if I use my National insurance contributions record up to 2013 but can I do that if Im not living in the UK anymore? Does that mean I wouldn’t get my little UK pension?
Is this something I should come home and do with a lawyer? What documents should I work to get now?
Also on the totalitarian agreement it says that it doesn’t cover Medicare. But if I used it to get ssdi, come home and get Medicare then would it switch to social security but I still wouldn’t get Medicare?
Is it possible to work under the gainful employment hours and still earn credits to work my way up to 40? My last job I enjoyed was working in a bookstore in my early 20’s, I could probably manage that if it still existed!
Ive looked for lawyers in Europe and cant find any and called in the United States but ran out of steam after the first two said that they didn’t work with people overseas.
Thank you for your help.
This is way way way too complicated for Mefi to tackle. You have to take this to a(n appropriate) lawyer. Possibly more than one, given your multinational (?) earnings history and the multiple systems interacting here.
Note that you have not mentioned purchasing insurance in the U.S. on the appropriate state exchange, and I'm not sure why you're not considering that an option. Those payments are based on household income, not on preexisting conditions.
posted by praemunire at 10:53 AM on March 4, 2023
Note that you have not mentioned purchasing insurance in the U.S. on the appropriate state exchange, and I'm not sure why you're not considering that an option. Those payments are based on household income, not on preexisting conditions.
posted by praemunire at 10:53 AM on March 4, 2023
I didn’t know about that so I will check into it. Im having trouble finding the right lawyer. I think as I find time and articles that cover the topics that seem to affect me that I will see if I can find one. But yeah, it is complicated! On the totalization it just says you can just go and apply yourself at the consulate but since I know so many claims are denied I was trying to father my arrows and see the best way around.
posted by pairofshades at 11:13 AM on March 4, 2023
posted by pairofshades at 11:13 AM on March 4, 2023
And thank you for the tip!
posted by pairofshades at 11:16 AM on March 4, 2023
posted by pairofshades at 11:16 AM on March 4, 2023
Also! If you don't know the exact answers but you are smart and resourceful, and any kind of idea pops to mind of a route to follow to find a good path on how to apply that would most welcome!
posted by pairofshades at 11:19 AM on March 4, 2023
posted by pairofshades at 11:19 AM on March 4, 2023
I didn’t know about that so I will check into it.
This option didn't exist when you left the U.S., I think. It is flawed, but still better than what it replaced. You can pick a likely state and estimate an income and most states will offer a rough idea of how much premiums would cost for varying levels of coverage. However, I just noticed that the NY state one is geoblocked, so you may have to get an American friend to help you with that.
posted by praemunire at 11:29 AM on March 4, 2023
This option didn't exist when you left the U.S., I think. It is flawed, but still better than what it replaced. You can pick a likely state and estimate an income and most states will offer a rough idea of how much premiums would cost for varying levels of coverage. However, I just noticed that the NY state one is geoblocked, so you may have to get an American friend to help you with that.
posted by praemunire at 11:29 AM on March 4, 2023
I believe you can make an account with SSA.gov to check your credits to see what the SSA says that you have right now.
I have no idea if you will qualify. If your household is low income & end up with just SSI, you will qualify for Medicaid, which does have some behavioral health coverage but it is difficult to access and the quality can be very poor, especially for PTSD.
You also need to take into account the application process, which can take literal years. I'm not sure if there is a residency requirement in the US for application, however from the time you apply to the time you are approved can average multiple years (I think in IL it's about 3ish, or it was when I was actively following peoples cases) depending on the jurisdiction you apply in. Some jurisdictions are faster than others, so you may want to research that prior to application. Most people who apply are denied the first time around and have to appeal. There are two different appeals. The 2nd appeal is when you get the chance to go in front of a judge this is where most people get approved.
posted by AlexiaSky at 12:02 PM on March 4, 2023
I have no idea if you will qualify. If your household is low income & end up with just SSI, you will qualify for Medicaid, which does have some behavioral health coverage but it is difficult to access and the quality can be very poor, especially for PTSD.
You also need to take into account the application process, which can take literal years. I'm not sure if there is a residency requirement in the US for application, however from the time you apply to the time you are approved can average multiple years (I think in IL it's about 3ish, or it was when I was actively following peoples cases) depending on the jurisdiction you apply in. Some jurisdictions are faster than others, so you may want to research that prior to application. Most people who apply are denied the first time around and have to appeal. There are two different appeals. The 2nd appeal is when you get the chance to go in front of a judge this is where most people get approved.
posted by AlexiaSky at 12:02 PM on March 4, 2023
Also, Medicare does have a lifetime limit on inpatient psychiatric hospitalization of 190 days. If you feel that your mental health needs may exceed that, it may be prudent to seek that care outside of Medicare if at all possible such as in the country you are in now.
posted by AlexiaSky at 12:05 PM on March 4, 2023
posted by AlexiaSky at 12:05 PM on March 4, 2023
Social worker here, this is my best understanding of your situation based on this document:
If you earned at least six credits during your time in the UK, the US will count them towards your total balance. If your US + UK credits add up to 40, then you would qualify for SSDI but at a reduced rate based on the proportion of US to UK credits; that benefit would be reduced further if you qualify for a pension from the UK. However, you will not qualify for Medicare Part A as they do not count credits earned outside the US towards Medicare. In my state everyone on SSDI receives both Medicaid and Medicare, however Medicaid qualifications are going to vary by state so may depend on where you are planning to move.
If your existing UK + US credits do not add up to 40, then I'm afraid you're SOL - all of your previous credits expire if you haven't worked in ten years. Social Security will automatically convert your SSDI application into a SSI application if you don't have enough work credits so you would still receive benefits, just a lower amount (currently $914/mo).
You should definitely start collecting your medical records as Social Security will want to see them but they will only be used to determine whether you have a qualifying disability, not SSDI vs SSI eligibility as that is solely based on work credits earned.
Frankly the easiest way to get this sorted out is to apply for SSDI and see what Social Security tells you. They deny most people's initial applications anyway so I wouldn't let that dissuade you. The biggest challenge with the application process tends to be getting them to agree that you have a qualifying disability. Not sure what kind of resources you'll be able to access outside the US but there will likely be some kind of low to no cost social service and legal assistance with your application in your area after you move back.
posted by fox problems at 12:15 PM on March 4, 2023
If you earned at least six credits during your time in the UK, the US will count them towards your total balance. If your US + UK credits add up to 40, then you would qualify for SSDI but at a reduced rate based on the proportion of US to UK credits; that benefit would be reduced further if you qualify for a pension from the UK. However, you will not qualify for Medicare Part A as they do not count credits earned outside the US towards Medicare. In my state everyone on SSDI receives both Medicaid and Medicare, however Medicaid qualifications are going to vary by state so may depend on where you are planning to move.
If your existing UK + US credits do not add up to 40, then I'm afraid you're SOL - all of your previous credits expire if you haven't worked in ten years. Social Security will automatically convert your SSDI application into a SSI application if you don't have enough work credits so you would still receive benefits, just a lower amount (currently $914/mo).
You should definitely start collecting your medical records as Social Security will want to see them but they will only be used to determine whether you have a qualifying disability, not SSDI vs SSI eligibility as that is solely based on work credits earned.
Frankly the easiest way to get this sorted out is to apply for SSDI and see what Social Security tells you. They deny most people's initial applications anyway so I wouldn't let that dissuade you. The biggest challenge with the application process tends to be getting them to agree that you have a qualifying disability. Not sure what kind of resources you'll be able to access outside the US but there will likely be some kind of low to no cost social service and legal assistance with your application in your area after you move back.
posted by fox problems at 12:15 PM on March 4, 2023
If your US + UK credits add up to 40, then you would qualify for SSDI but at a reduced rate based on the proportion of US to UK credits
There is also a recency requirement on the credits for SSDI; no idea if that is affected by the UK aspect. That's part of how complex this all is. Meanwhile, SSI requires that your household (appears OP has a partner?) is very low-income and has very few assets, which does not appear to be the case here if OP is comfortable enough to look at SSDI as a bonus rather than the major means of support.
posted by praemunire at 1:26 PM on March 4, 2023
There is also a recency requirement on the credits for SSDI; no idea if that is affected by the UK aspect. That's part of how complex this all is. Meanwhile, SSI requires that your household (appears OP has a partner?) is very low-income and has very few assets, which does not appear to be the case here if OP is comfortable enough to look at SSDI as a bonus rather than the major means of support.
posted by praemunire at 1:26 PM on March 4, 2023
I'm pretty sure you have to wait two or three years to get US Medicare if you're approved for SSDI, which is in itself a crapshoot, they seem to reject almost everyone and force them to appeal. I'm on phone, can't add links. Medicaid is related to income and those income caps vary by state.
posted by mareli at 2:29 PM on March 4, 2023
posted by mareli at 2:29 PM on March 4, 2023
OK, it's 24 months.
" Administrative burdens" placed on people with disabilities in US.
More on denials of SSDI.
posted by mareli at 4:43 PM on March 4, 2023
" Administrative burdens" placed on people with disabilities in US.
More on denials of SSDI.
posted by mareli at 4:43 PM on March 4, 2023
And if you haven't worked in the US in the last ten years you likely aren't eligible for SSDI anyway.
posted by mareli at 4:54 PM on March 4, 2023
posted by mareli at 4:54 PM on March 4, 2023
Thank you all for your answers. I was of the understanding that there are situations where some people do attempt to show the disability started earlier (during a time the person was insured) and there is a legal basis for that. So hopefully I’ll be able to get enough documents from my doctors over the years to be able to show my story. I never when back to my career after 2009. Ive never been on benefits in any country and I get pension credits for being a mom here but I don’t think they count as work credits. Also im not concerned with needing psychiatric hospital stays. This is more of a therapeutic stay to get a break from my noisy house, its more my migraine medications are expensive and that’s my worry. Thank you everyone for your help.
posted by pairofshades at 10:31 PM on March 4, 2023
posted by pairofshades at 10:31 PM on March 4, 2023
It is a common misunderstanding that “most people” get awarded disability benefits by Social Security Administration ALJs At the hearing level.
In 2022, 1,765,032 people applied for disability benefits; 670,712 were awarded benefits. 459,925 filed for reconsideration and 68,988 of them were found disabled. That is a total of 739,700 claimants approved at the first two steps of the process.
235,462 claimants requested a hearing and, of those, 120,085 were awarded benefits. So, far more people are awarded benefits at the first two levels of review.
To the OP:
Other posters are correct, unless you have ALS or end state renal disease, Medicare benefits start 24 months after the start of your disability benefits.
Did you ever get a mySSA account, as advised the last time you asked a similar question? As explained then, your earnings record would explain your insured status better than anyone here can. And as I explained then, it is hard, but not impossible, to establish disability with a remote date last insured. It is wrong to say that your credits “expire” after ten years.
It is theoretically possible to work below SGA levels to extend your insured status, as it takes far less money to earn a quarter of coverage. However, remember that the 20 quarters of coverage have to be in 40 quarter period, so if older quarters are too far removed in time, you will not be able to string together enough now to meet the 20/40 test.
Also, working after alleged onset is always tricky. While not necessarily fatal to a claim by any means, it does raise issues as the severity of the impairments.
posted by pasici at 5:55 PM on March 6, 2023
In 2022, 1,765,032 people applied for disability benefits; 670,712 were awarded benefits. 459,925 filed for reconsideration and 68,988 of them were found disabled. That is a total of 739,700 claimants approved at the first two steps of the process.
235,462 claimants requested a hearing and, of those, 120,085 were awarded benefits. So, far more people are awarded benefits at the first two levels of review.
To the OP:
Other posters are correct, unless you have ALS or end state renal disease, Medicare benefits start 24 months after the start of your disability benefits.
Did you ever get a mySSA account, as advised the last time you asked a similar question? As explained then, your earnings record would explain your insured status better than anyone here can. And as I explained then, it is hard, but not impossible, to establish disability with a remote date last insured. It is wrong to say that your credits “expire” after ten years.
It is theoretically possible to work below SGA levels to extend your insured status, as it takes far less money to earn a quarter of coverage. However, remember that the 20 quarters of coverage have to be in 40 quarter period, so if older quarters are too far removed in time, you will not be able to string together enough now to meet the 20/40 test.
Also, working after alleged onset is always tricky. While not necessarily fatal to a claim by any means, it does raise issues as the severity of the impairments.
posted by pasici at 5:55 PM on March 6, 2023
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posted by pairofshades at 9:20 AM on March 4, 2023