420-3 OTHER COMMONLY AVAILABLE BENEFITS

420-3 OTHER COMMONLY AVAILABLE BENEFITS FOR WHICH AN APA APPLICANT OR RECIPIENT MUST APPLY

An APA applicant or recipient who appears to be eligible for a benefit from another program must apply for that program. The individual must file for benefits payable at the earliest month and in the highest amount available based on the earliest month.

420-3 A. PRIVATE SECTOR PENSIONS AND ANNUITIES

Private sector pensions and annuities may be available to an individual if the individual or a deceased spouse worked for a private employer, or was a member of a union, with a pension or annuity plan. An applicant or recipient who has a work history (or has a deceased spouse with a work history) which indicates potential eligibility for a pension or annuity must apply for and pursue the benefit.

In most cases, clients will already be receiving any pensions or annuities to which they are entitled. Case workers must, however, explore the possibility of potentially available benefits and make referrals if appropriate.

420-3 B. PUBLIC SECTOR PENSIONS AND ANNUITIES

The federal government operates pension plans for federal civilian employees and for members of the uniformed services. Most state and local governmental employees are also covered by pension plans. Foreign governments may also provide pensions for retired employees.

With some exceptions, state and local government and federal civilian employees must work a minimum of five years before vesting rights in the pension plan are established, and withdrawal of employee contributions to the pension plan will cause a loss of all vesting rights. Military retirement benefits generally require a minimum of 20 years' service. (See section 420-3E for VA pensions.)

Any APA client who is not already receiving a pension, annuity, or retirement payment for which he or she appears eligible must be referred for application, unless the client provides convincing evidence that he or she is not eligible for the benefit in question.

420-3 C. SOCIAL SECURITY ADMINISTRATION ( SSA ) INSURANCE

The Social Security Administration makes payments under the retirement, survivors, and disability insurance ( RSDI ) program to retired workers and their family members, survivors of deceased workers, and disabled workers and their families under Title II of the Social Security Act. In the interest of brevity, this manual refers to Social Security Insurance Benefits as " SSA " benefits.

To be found eligible for benefits for themselves, their survivors, or their dependents, individuals must have worked a minimum number of calendar quarters in "covered" employment. Covered employment is any employment that involves payment of Social Security taxes. The number of quarters needed to qualify for benefits varies between 6 and 40 depending on the applicant’s age and situation.

Although SSA payments are not needs-based, certain limits are imposed on the amount an individual under age 70 may earn while receiving benefits. After the earnings maximum is exceeded, benefits are reduced by $1 for each $2 earned over the annual exempt amount for individuals under age 65. When an individual reaches the age of 65, benefits are reduced by $1 for each $3 earned over the annual exempt amount. Benefits are not reduced by earnings for individuals who reach age 70.

The amount of a worker's SSA benefit is based on a calculation which takes into account the worker's average covered earnings and the amount of time he or she worked or could have been expected to work. For persons who reach 62, become disabled, or die after 1978, the actual earnings are indexed - updated to reflect increases in average wage levels in the economy. Auxiliary and survivor benefits are based on a percentage of the worker's benefit.

SSA benefits are potentially available to individuals in the following categories:

Retirement benefits are payable at age 62 to a retired insured person and to the spouse of a retired worker when the spouse reaches age 62. These benefits are permanently reduced if claimed before full retirement age (between age 65 and 67, depending on the individual’s date of birth).

Unreduced benefits are payable to the spouse of a retired worker at any age if the spouse has in his or her care a child under the age of 16, or disabled, who is entitled to benefits on the earnings record of the worker.

Child's benefits are paid to the retired worker's unmarried child under age 18, or from age 18 to 19 if the child is a full-time student in elementary or secondary school. They are also paid regardless of age if the child has been disabled since before reaching the age of 22.

Survivor benefits are payable to a widow or widower at age 60, or, if disabled, at age 50, and to a widow or widower at any age if she or he cares for a child who is either under age 16 or is disabled and entitled to benefits on the earnings record of the worker.

Survivor benefits are payable to unmarried children under age 18, or from 18 to 19 if in elementary or secondary school. They are also available at any age if the child has been disabled since before reaching the age of 22.

Survivor benefits are payable to a dependent parent at age 62. A parent is considered to be dependent if he or she received at least one-half of his or her support from the deceased worker.

A lump sum benefit of $255 is payable on the death of an insured worker to the spouse living with the worker at the time of death or eligible to receive benefits at that time. If there is no qualified spouse, the death benefit is payable to a child or children of the worker who are eligible for monthly survivor benefits.

Disability benefits are payable to a disabled worker who has not reached full retirement age after a waiting period of five full months. These benefits end if the worker recovers or returns to substantial work despite the impairment.

Benefits for the family members of a disabled worker are payable under the same conditions as for family members of retired workers.

Under certain circumstances, benefits may also be paid to the divorced spouse of a retired, deceased or disabled worker and to the remarried widow or widower of a deceased worker.

Case workers are not expected to understand the complexities of eligibility for SSA benefits. Clients are often unaware of their own eligibility for these benefits. In order to assure that all potential benefits are pursued, all APA applicants or recipients who are receiving neither SSA nor SSI benefits must be referred to a Social Security Administration office to apply for any benefits to which they may be entitled, unless documentation in the case file verifies that SSA benefits have been previously applied for and denied, and there is no reason to believe that the client has become eligible since the last denial.

Verification. Proof that a claim for SSA benefits has been filed is best obtained by viewing a referral letter from the Social Security office or correspondence from Social Security to the client. If such evidence is not available, the BENDEX interface is a possible alternative source, but the amount of time required for updated information to appear on the BENDEX generally means it is not usable for this purpose. State Verification Exchange System ( SVES ) responses will verify a current claim. If direct contact with the servicing SSA office is necessary, the manner in which this contact is routinely made must be coordinated by the managers of the DPA and SSA offices involved. In general, telephone contacts between case workers and Social Security claims representatives should be used only when the information needed cannot effectively obtained in some other way, or is so complex that personal contact is necessary.

420-3 D. UNEMPLOYMENT INSURANCE BENEFITS ( UIB )

Unemployment benefits may be available from the State of Alaska or another State where a client has recent employment history. Unemployment benefits may also be available in some cases from an individual's union or former employer.

Eligibility factors for unemployment benefits generally include a recent history of "covered" employment, and availability for work. Many APA applicants have recently-acquired impairments which may render them unavailable for work. Others, particularly the blind and the aged, may be able-bodied.

Any APA applicant or recipient who appears to have potential eligibility for unemployment benefits should be referred for application, unless evidence in the case file clearly documents a physical or psychological condition which, in the judgment of the case worker, makes the individual unavailable for work.

420-3 E. DEPARTMENT OF VETERANS AFFAIRS ( VA ) PENSION AND COMPENSATION BENEFITS

The VA administers numerous programs. Only VA pensions and VA compensation payments are prior resources to the APA program. Veterans have two major cash benefit programs:

1. VA compensation for service-connected disability or death

This program pays monthly cash benefits to veterans who are disabled as a result of an injury or disease incurred or aggravated by active military duty, whether in wartime or peacetime. The amount of monthly compensation depends on the degree of disability, which is rated by the percentage of normal function loss. Benefit rates above the 100% disability payment level are paid for certain specific severe disabilities. Veterans who have at least a 30% service-connected disability are entitled to an additional allowance for their dependents. VA compensation payments may also be made to dependent parents and to the widow(er) of a veteran who dies as a result of a service-connected illness or injury.

With one exception, VA compensation payments are not needs-based and are not reduced by a recipient's other income. Benefits for dependent parent(s) of a deceased veteran are based on need. A parent is considered to be dependent if he or she received at least one-half of his or her support from the deceased veteran.

2. VA pension payments

VA pension payments are made on the basis of a combination of wartime service and an age of 65 or over, a nonservice-connected disability, or death. With very rare exceptions, VA pension payments are based on need. The VA may take a veteran's dependent's needs into account in determining a pension, augmenting the amount of the basic pension.

420-3 F. WORKERS' COMPENSATION PAYMENTS AND OTHER DISABILITY BENEFITS

If an applicant or recipient indicates that he or she has been injured on the job or has what seems to be a work-related impairment, he or she must be referred for Workers' Compensation payments. Workers' Compensation payments may also be available to the survivor of an injured employee who died as a result of a work-related condition.