Social Security

Social Security Continues Discriminating Against Same Sex Married Couples By Making Them Pay Thousands of Dollars for Agency Mistake

By | BLOG, HOMEPAGE, LGBT, LITIGATION, Supplemental Security Income | No Comments

Hugh Held and Orion Masters of Los Angeles, California have been together for more than 20 years. When marriage to a person of the same sex became legal in California for a brief period in 2008, they were excited to ‘take the plunge’ and exercise a right they did not expect they would ever have when they first met. Little did they anticipate that their marriage would one day put them in economic peril.

hugh-orien

Hugh and Orion are an extremely low-income couple and both receive federal Supplemental Security Income (SSI) to cover their basic needs. SSI is a program that provides extremely poor seniors and people with disabilities with a federal benefit of $733 a month for a single person and $1,100 a month for an eligible married couple. In some states, such as California, the benefit is enhanced slightly by a state supplement. Since, for a married couple, the income and resources of a spouse are counted when determining eligibility, an SSI recipient who gets married will always see their benefits decrease.

From the outset, when Hugh went to the SSA office to apply for SSI and on subsequent visits, he was accompanied by Orion. Later in March, 2013, in the course of a routine redetermination, after they learned that the Supreme Court was going to decide a challenge to the Defense of Marriage Act (DOMA), they asked whether their marriage would affect their benefits. They were told not to worry, that it would have no impact on their benefits. Then, on June 26, 2013 the Supreme Court struck down Sect. 3 of the Defense of Marriage Act (DOMA) as unconstitutional; that’s when it became illegal to deny federal benefits to individuals who were married under the laws of their state. After the Windsor decision, Hugh went back to SSA to ask if the new decision would impact his benefits. This time he was told it might impact his benefits, but that they did not know how. Again, he was told not to worry. The SSA would be in touch. Until then, he would get his benefits just as he always had.

Fast-forward one year later to June 2014: Hugh was hit with a $6,205 bill from the SSA with no explanation. The notice also detailed a reduction in his benefits from $877.40 a month to $308.10. After months of calls and confusion, Hugh found out that the SSA had now decided to recognize his marriage to Orion—one year after DOMA was struck down and six years after their wedding day. The real kicker, however, is the $6,205 bill. After more than a year of inaction and discrimination, the SSA is demanding to be repaid for the time period during which they themselves didn’t recognize Hugh’s marriage and had continued to issue benefits as if he was single. They expect Hugh – who now must survive on a monthly benefit of $308.10 per month—to come up with $6,205 to correct the overpayment from SSA’s discriminatory mistake. Hugh and Orion already struggle to make ends meet as is, making an unexpected $6,205 bill an extreme financial hardship. As an alternative to paying back his alleged debt in an impossible lump sum, the SSA told Hugh he could repay in monthly increments of $20, which would put him in the clear just in time for his 81st birthday.

Hugh had done his due diligence in reporting his marriage to the SSA and relies on every SSI dollar for monthly expenses. This is not only unfair, it’s unlawful. The SSA’s own policy regarding overpayment is that it can be waived if a recipient was overpaid through no fault of their own and the repayment would be unfair.

To stop this discrimination against aged SSI recipients and those with disabilities simply because of who they are married to—we filed a class action against the SSA. The lawsuit we filed, along with our partners at Gay & Lesbian Advocates & Defenders (GLAD) and Foley Hoag LLP, seeks to end SSA’s pursuit of overpayments due to its delayed recognition of same-sex marriages. The class action is on behalf of Hugh, Kelly Richardson-Wright—a plaintiff in Massachusetts, and hundreds of other SSI recipients married to someone of the same sex in or before June 2013. It’s really pretty simple: “The victims of that discrimination should not be the ones to pay for the agency’s mistake,” said Gerald McIntyre, one of the Justice in Aging attorneys on the case. The complaint, filed March 10, can be viewed here. or at GLAD.org.

ISSUE BRIEF: SSA’s Failure to Process SSI Appeals Requests

By | Alerts, Appeals Process, Income Network Alert, REPORTS, Supplemental Security Income | No Comments

January 2014 — An  issue brief from the National Senior Citizens Law Center says that the Social Security Administration needs a uniform system in place to input and track appeals by Supplemental Security Income (SSI) recipients and to ensure that all requests for reconsideration are logged in upon receipt in a district office. It provides an overview of how those who have a legitimate basis for challenging benefit suspensions and reductions.

ISSUE BRIEF: Why SSI Needs An Appeal Process That Works

By | REPORTS, Supplemental Security Income | No Comments

September 2013 — An NSCLC issue brief, Why SSI Needs an Appeal Process That Works, provides an overview of how Supplemental Security Income (SSI) recipients are harmed when the Social Security Administration decides to stop or decrease their benefits, and they have a legitimate challenge to that decision but have no effective means of presenting their side of the case.

If SSI recipients are going to have their benefits reduced or suspended for financial or other non-medical eligibility reasons, the Social Security Administration (SSA) must notify them, and by law, they have a right to appeal the agency’s decision.

Unfortunately, SSA too often does not follow required due process safeguards in cases involving appeals to non-disability determinations. For example, they may lose the paper work, fail to continue benefits for someone even when they filed a timely appeal, and delay case reviews and conferences.

The issue brief is part of a series of reports that will reveal specific problems with the SSI non-disability appeals process.

Statement by NSCLC’s Paul Nathanson on the Chained CPI

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WASHINGTON — President Obama’s budget proposal released today includes an unacceptable change to Social Security’s cost of living adjustments (COLAs).

A switch to the chained CPI formula to determine Social Security COLA benefits is a stealth benefit cut. It  will mean that several years out, the change will negatively impact Social Security beneficiaries, especially the very old, women because they live longer, as well as people with disabilities and Asian- and Hispanic-Americans because they have higher life expectancy. Read More

The Fiscal Cliff Deal: What Does It Mean for Low-income Older Adults?

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ANALYSIS

The Fiscal Cliff Deal: What Does It Mean for Low-income Older Adults?

On Tuesday, January 1, 2013, by a vote of 257-167, the House of Representatives agreed to approve the Senate amendments to H.R. 8, the American Taxpayer Relief Act of 2012, also known as the “fiscal cliff deal.”  The President has agreed to sign it. The focus of the deal is the extension of the Bush-era tax cuts for most Americans; however, tucked inside the legislation are a few provisions that may impact health care for low-income older adults. These include extending the funding for low-income outreach programs, the establishment of a Commission on Long-Term Care and the extension of the Qualified Individual program and Special Needs plans.

Extension of funding for low-income outreach programs:

Congress agreed to extend funding outreach and assistance for low-income programs.[1]  The Medicare Improvements for Patients and Providers Act of 2008 and the Affordable Care Act (ACA) initiatives to provide outreach and enrollment assistance to low-income beneficiaries were set to expire on January 1.  Many aging and disability groups advocated for their extension, and the fiscal deal extended funding for the following programs in 2013:

  • State Health Insurance Programs: $7.5 million
  • Area Agencies on Aging: $7.5 million
  • Aging and Disability Resource Centers: $5 million
  • National Center for Benefits and Outreach Enrollment: $5 million

Long-term Services and Supports:

The fiscal deal repeals Community Living Assistance Services and Supports (CLASS) Act.[2]  While the Obama Administration halted implementation of the ACA provision to create a voluntary, national long-term care insurance program a year ago, the legislation officially removes CLASS from the ACA.

In a subsequent section, the deal establishes a Commission on Long-Term Care.[3]  The purpose of the Commission is to thoughtfully evaluate the current long-term services and supports (LTSS) landscape and craft a plan to establish, implement and finance a coordinated LTSS delivery system.  The deal’s creation of this Commission marks the first time Congress has committed to a comprehensive evaluation of LTSS since the Pepper Commission over twenty years ago.[4]

The 15 member Commission will provide recommendations after: 1) analyzing how LTSS currently operates in Medicare, Medicaid, and long-term care insurance, 2) exploring other health programs that interact with LTSS, and 3) examining issues related to the LTSS workforce.

The Commission will consult with MedPAC, MACPAC, the National Council on Disability and relevant consumer groups.

The following individuals will each appoint three members to serve on the commission: the President, the Senate majority leader, the Senate minority leader, the Speaker of the House and the House minority leader. The members must be appointed within one month of the day the law is enacted.  The members must represent: consumers of LTSS, older adults, individuals with cognitive and functional limitations, caregivers, the health care workforce, private long-term care insurance, employers, state insurance departments, and state Medicaid agencies.

The commission has the power to hold hearings, commission studies by the Government Accountability Office and the Congressional Budget Office and receive information and technical assistance from federal agencies.

Six months after the Commission is appointed, the Commission must vote on a comprehensive long-term care plan.  Any legislative recommendations or proposals included in the plan will become the “Commission bill.”  If a quorum of members approve the Commission bill, then ten days after its approval, the Commission will submit the bill to the President, Senate and House.  After submission, the Senate majority leader, or one of his or her designees must introduce the bill the next day the Senate is in session.   The Commission bill follows the same process in the House, as the majority leader of the House or one of his or her designees must introduce the bill on the next legislative day.

Extension of QI and SNPs

The deal extends the Qualifying Individual (QI) program through December 31, 2013.  The QI program pays Medicare Part B premiums for individuals with incomes between 120 and 135 percent of the federal poverty level and resources below $6,940 for an individual and $10, 410 for a couple.[5]  With this extension, low-income older adults who may have lost their Part B coverage due to significant out-of-pocket costs should be able to maintain coverage.

In addition, the deal extends Medicare Advantage Plans for special needs individuals (Special Needs Plans) through 2015.  This is particularly significant for the dual eligible demonstration, as there have been questions among advocates about the interaction between existing SNPs and plans selected to participate in a demonstration.

The deal still leaves many questions about the health-care future for low-income older adults unanswered.  While the deal delays the sequester for two-months, future negotiations over the sequester, spending and the debt-ceiling may signal additional changes to Medicare and Medicaid.

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[1] H.R. 8, The American Taxpayer Relief Act of 2012, Section 610, Extension of Funding Outreach and Assistance for Low-Income Programs (January 1, 2013).

[2] H.R. 8, Section 642.

[3] H.R. 8, Section 643.

[4] Howard Gleckman, “Fiscal Cliff Deal Repeals CLASS Act, Creates Long-Term Care Commission,” (January 1, 2013) available at www.forbes.com/sites/howardgleckman/2013/01/01/fiscal-cliff-deal-repeals-class-act-creates-long-term-care-commission.

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