Can a disabled Teacher qualify for Medicare (Health Insurance) before age 65?
Probably not, turning 65 is one way to qualify for Medicare and so is getting SSDI – Social Security Disability for two years and then getting Medicare. Medicare Interactive.org
Social Security pays benefits to people who cannot work because they have a medical condition that is expected to last at least one year or result in death. (ssa.gov) However, as a teacher and a member of CalSTRS you don’t pay into Social Security so you probably wouldn’t get SSDI. Check with CalSTRS, Medicare or Attorney’s.
You might qualify under your spouse’s Social Security benefits??? Auxilary Benefits as a spouse of an insured worker – Nolo Excerpt
CalSTRS Publications & Medicare & Social Security
The CalSTRS Disability Benefits Guide states that you may qualify for long-term disability benefits if you have a medical condition that will prevent you from working for at least a year. STRS Member Handbook Your CalSTRS retirement benefit or Medicare benefit will not be reduced because of these provisions in Social Security law Nolo’s Guide to Social Security Disability
Social Security, CalSTRS and You
Our Webpage on Social Security Disability
What is the three pronged test for Disability Eligibility?
To meet the definition of disabled as established for CalSTRS in the California Education Code, you must have a medically determined physical or mental impairment that is permanent or expected to last at least 12 continuous months. The impairment must prevent you from performing:
- Your usual duties with or without reasonable accommodation from your employer.
- Duties of a comparable level to your usual duties, which you are qualified for or can become qualified for in a reasonable period of time with education, training or experience.
- Employment at a comparable level at which you can earn at least 66 2/3 percent of your final compensation. Cal STRS Disability Benefits * Calstrs.com *
This looks to me, and of course please go ahead and check with competent legal counsel to be a 3 prong test. See the Miller 3 prong Test for Obscenity. That is to be disabled you must meet all 3 of the above requirements. That is, if you can make more than you earned before, but voluntarily elect not to, then your not disabled.
Links & Resources
California Education Code Disability Retirement [24100 – 24119]
* 24103. (a) The member shall provide medical documentation substantiating the impairment qualifying the member for the disability retirement under this part.
calstrs.com/disability-benefits
calstrs.com/disability_guide 2019
calstrs.com/your_disability_benefits from member handbook 2012
How does one live on 2/3 rds of their prior income
or a max of $31,500 earned + the Disability Benefit?
You can earn income after you begin receiving a disability Coverage B benefit. You can teach under certain employer conditions, but you are not allowed to earn CalSTRS service credit or contribute to CalSTRS while receiving a disability retirement benefit. Your earnings from all types of employment, including self-employment, are subject to an earnings limit, unless you are participating in an approved CalSTRS rehabilitation plan.
CalSTRS retirement benefits will be reduced dollar for dollar by the total amount of earnings from all employment in excess of the 12-month calendar year limit. You will be required to provide CalSTRS with an annual report of your gross earnings from all employment. The Employment Development Department and your employer will verify your reported earnings.
The 2019 calendar year earnings limit is $31,500. The limit is determined early each calendar year. This amount is different from the service retirement earnings limit. Member Handbook Page 110 *
You’ll find that there is a limit to how much you can get while disabled.
The Insurance Companies don’t what you home, if you can work. It’s adverse selection – moral hazard to sell you too high a benefit.
If you’re disabled, you don’t have to drive to work, buy lunches out, nice clothes, etc.
You generally don’t need the same level of income when you are disabled as you did when you were working. In fact, you can typically only purchase disability insurance for about 60% of your predisability income.
Consider the following reductions in spending that you could make if you became disabled:
- Commuting expenses. If you drive to work, you can probably assume it costs you $0.50 per mile.
- Workday lunches and breaks. If you eat out every day and buy the occasional latte, you could easily save $10 to $30 per day when you are not working.
- Work clothes. Being unable to go to work can save thousands of dollars per year in clothing expenses.
- Discontinued activities. It’s sad, but life on disability may not include the vacations you’re used to. On the bright side, you’ll have fewer expenses. You may even generate income from selling those jet skis, ATVs, and other toys.
- Downsizing. Most of us can make cuts in our budget if we have to. Moving to a smaller, perhaps one-story house may even be a good idea. Motley Fool.com
Insurance – Disability #Calculator
Click here to calculate your chances of being disabled and how much income loss there might be?
Medicare and You 2021 (PDF) #10050
Everything you want to know
Don’t like computers?
Prefer a printed version be mailed to you?
Audio MP 3
Use our scheduler to Set a phone, Skype or Face to Face meeting
Intake Form – We can better prepare for the meeting
Related Pages in Social Security » Social Security Disability – SSI, SSDI Section
I’m sure I’m disabled and can’t go back to work! How do I show? know if my problems are enough to convince the “board” that I can’t go back to work?
The information you sent us privately, is really beyond our pay grade. See page above, there are attorney’s that specialize in disability claims.
Here’s Social Security’s Factors in Evaluating Disability
Listing of Impairments
Mental Disorders
Musculoskeletal System
See page 110 for limitations and more detail on the maximum you can earn
https://www.calstrs.com/sites/main/files/file-attachments/member_handbook_2019.pdf?1550275010
It’s difficult to live on the disability pension and an earnings limit of $31,500. I’ll be on Medicare soon. Would that pay for my mental health needs?
Mental Health is an essential benefit under ACA/Healthcare Reform aka Obamacare, it should be covered now.
Here’s how mental health is covered by Medicare.
Did you or your husband pay into Medicare?
What might trigger an investigation into if I can work and earn more that 2/3rds of my prior salary?
How are investigations done?
Check these links:
https://saffwein.com/how-to-avoid-being-accused-of-social-security-disability-fraud/
https://oig.ssa.gov/report-fraud-waste-or-abuse/what-can-oig-investigate
You Tube VIDEO undercover investigation into Disability Fraud
My wife is a paraplegic and was on SoonerCare, she has Medicare disability and Medicaid disability, she got a form from social security saying do you want Part B Dr. Visits coverage as of February 1st, she returned the form and told them no, but someway she got put in some company for part D Prescriptions, she didn’t sign with any company and didn’t want plan D coverage, so now Sooner Care tells her she has no drug coverage with them, and Sooner care is so much better than private coverage,
how could she have been put on a private insurers plan for D coverage when she knew nothing about it?
She has not been able to even find out which company she fraudulently got enrolled in.
How can something like this happen and what can she do to correct this and get her drug coverage back from Sooner Care?
The letter you got, was that for Part D Prescriptions or Part D Doctor Visits?
We don’t get paid to help people with California Medi Cal or National Medicaid
Here’s information on the Oklahoma Health Care Authority about Sooner Care
http://www.okhca.org/individuals.aspx?id=548&menu=42
Go there and you can download a member hand book. We will email you one privately. The way OK set up the link, we can’t really cut and paste it here.
It’s our understanding that if you have Medicaid or Medi-Cal, you can change your Part D plan anytime.
https://www.medicare.gov/Pubs/pdf/11109-Your-Guide-to-Medicare-Prescrip-Drug-Cov.pdf
If you don’t join a drug plan, Medicare will enroll you in one to make sure you don’t miss a day of coverage. If you decide you want another plan, you can switch to another plan at any time.
https://www.medicare.gov/drug-coverage-part-d/how-part-d-works-with-other-insurance
Go to this page on our website and it will show you how to shop and compare Part D Rx Plans. From there you should be able to enroll in Sooner Care, if that’s what you want.
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My wife just was informed that she will be on permanent disability from CalStrs. She has Young Onset Parkinson’s. She is 54 years old. Her payments will start on Sept 15th. She worked for close to 10 years in something outside of teaching so she must have close to the 40 quarters and also she paid into Medicare in each of her checks as a teacher.
Is she eligible for Medicare?
***This is all quite complex… Here’s the page on Social Security’s website about how many quarters you actually need. Check our webpage on Social Security Disability and we’ve linked to attorney’s that can help you sort through this confusion. Please also visit your local CalSTRS office. Here’s their office locator.
If you are not getting employer paid medical coverage and want to check out the individual & family market, including ObamaCare Subsidies, click here.
Try this Medicare eligibility calculator.
It is difficult to figure all this out. We have heard that she will be eligible for Medicare after two years of being “officially disabled.” We have heard that she would be eligible for Medicare if she was eligible for Social Security disability.
***Yes, that is correct, if one qualifies for Social Security Disability.
Social Security Disability Benefits Publication # 10029
Our Webpage on Social Security Disability – I don’t see that you have anything to lose by applying. If you do get benefits, they would offset what you are getting from STRS per page 7 of the STRS manual.
The Question in your situation, is can she get both Medicare and CalSTRS disability?
***Appears to be yes, as there is an offset – reduction see citation above. What medical coverage does she have now?
She went on Medical leave on Feb 1st.
We want to stick with the CalStrs disability payments since they are larger.
***That’s fine, it’s just an offset.
How much can I earn before I lose my disability benefits?
Let me review these publications and the disability video above.
https://www.calstrs.com/sites/main/files/file-attachments/intro-to-calstrs-disability-benefits.pdf
https://www.calstrs.com/sites/main/files/file-attachments/disability_guide.pdf
Your questions isn’t as simple as one might think. Also, it’s not the right question. See this new page for the 3 prong test for Cal STRS disability eligibility.
I am temporarily disabled because I have
Crps https://www.mayoclinic.org/diseases-conditions/complex-regional-pain-syndrome/symptoms-causes/syc-20371151
Complex regional pain syndrome (CRPS) is a form of chronic pain that usually affects an arm or a leg. CRPS typically develops after an injury, a surgery, a stroke or a heart attack. The pain is out of proportion to the severity of the initial injury.
Complex regional pain syndrome is uncommon, and its cause isn’t clearly understood. Treatment is most effective when started early. In such cases, improvement and even remission are possible.
on my dominant hand/arm.
I’m a teacher.
Can I get state disability payment?
Did you have SDI deducted from your pay check?
What district do you work for?
Check our webpage on SDI
SDI Eligibility Requirements
In order to be eligible for DI benefits, you must:
Be unable to do your regular or customary work for at least eight days.
Be employed or actively looking for work at the time your disability begins.
Have lost wages because of your disability.
Have earned at least $300 from which State Disability Insurance (SDI) deductions were withheld during your base period. For additional information visit, Calculating Benefit Payment Amounts.
Be under the care and treatment of a licensed physician/practitioner or accredited religious practitioner within the first eight days of your disability. The date your claim begins can be adjusted if it does not meet this requirement. You must remain under care and treatment to continue receiving benefits.
Complete and submit your claim form (DE 2501) no earlier than nine days after your first day of disability begins but no later than 49 days after your disability begins or you may lose benefits.
Have your physician/practitioner complete the medical certification portion of your disability claim.
A nurse practitioner may certify to a disability within his/her scope of practice; however, he/she must perform a physical examination and collaborate with a physician or surgeon.
A licensed midwife, nurse-midwife, or nurse practitioner may complete the medical certification for disabilities related to normal pregnancy or childbirth.
If you are under the care of a religious practitioner, request a Claim for Disability Insurance Benefits-Religious Practitioner’s Certificate (DE 2502), from an SDI office. Certification by a religious practitioner is acceptable only if the practitioner has been accredited by the Employment Development Department.https://edd.ca.gov/Disability/Am_I_Eligible_for_DI_Benefits.htm
My spouse has cancer. G-d forbid, when she passes away can I draw disability from her retirement?
I have been on disability since 2011.
Am I allowed to receive her Strs retirement?
Are you on SSI Supplemental Security Income or SSDI Social Security Disability?
I don’t believe that SSDI would have an issue, check our page on that.
We need to check if the two plans “co-ordinate” with each other.
We – and that includes YOU, will need to review these publications from STRS:
Member Handbook
https://www.calstrs.com/calstrs-member-handbook
Retirement Guide
https://www.calstrs.com/publication/your-retirement-guide
Introduction to Disability
https://www.calstrs.com/sites/main/files/file-attachments/intro-to-calstrs-disability-benefits.pdf
Disabilty Benefits Guide
https://www.calstrs.com/sites/main/files/file-attachments/disability_guide.pdf
Survivor Benefits
https://forms.calstrs.com/CalSTRSOnlineFormRequestWebUI/Root/Pages/OpenAttachment.aspx?FormId=050f379a-de29-425a-b233-d04dba05714b
Social Security & Cal Strs
https://www.calstrs.com/sites/main/files/file-attachments/socialsecurity2019.pdf
Cal STRS Survivor Benefits
https://forms.calstrs.com/CalSTRSOnlineFormRequestWebUI/Root/Pages/OpenAttachment.aspx?FormId=050f379a-de29-425a-b233-d04dba05714b
If you die before retirement or while receiving a Coverage A disability benefit:
• With a preretirement election of an option, your beneficiaries will receive a lifetime monthly benefit based on a percentage of the reduced benefit that would have been paid if you had retired on the date of your death.
• Without a preretirement election of an option, your survivors, including your spouse or registered domestic partner and dependent children, may be eligible for a monthly survivor benefit.
If your survivors are not eligible for a monthly benefit, your accumulated Defined Benefit contributions will be paid to your one-time death benefit recipient in a lump-sum distribution. If you did not name a recipient, CalSTRS must make the payment to your estate.
Retirement Guide
Your Retirement Decisions
You’ll need to make decisions regarding both your Defined Benefit pension and your Defined Benefit Supplement account funds.
Defined Benefit Retirement
When you’re eligible to retire, you’re entitled to a guaranteed, lifetime retirement benefit. Your retirement benefit is based on a formula that provides a fixed percentage of your final compensation determined as of the age you retire and your years of service:
Service Credit x Age Factor x Final Compensation = Your Retirement Benefit
Member-Only Benefit:
The Member-Only Benefit is the highest monthly benefit you can receive in retirement. It does not provide a monthly lifetime benefit to anyone when you die after retirement.
Modified Benefit:
The Modified Benefit provides a reduced monthly benefit to you for your lifetime plus a monthly benefit to your beneficiaries after your death. You’ll need to choose an option and one or more option beneficiaries.
Get the Book Nolo’s Guide to Social Security
If you are a disabled widow or widower or the spouse of someone getting disability benefits, your Social Security payments may be reduced if you worked for a government agency where you did not pay Social Security taxes and you receive a pension from that agency. Notify the SSA if you begin to
receive such a pension or if the amount of that pension changes.
Your question is beyond my pay grade. Check with Social Security, Cal STRS or an Attorney see listings above.
Fact Sheet Social Security Disability # 10570
I was a teacher I applied for SSDI through Allsup. https://www.allsup.com/ Disability Services
I was approved as 100 percent disabled but was only awarded Medicare ( which I do not want! Because I had Tricare military benefits which are great but would then become secondary to medicare ).
Can I refuse Medicare?
I guess you didn’t get a monthly monetary award as you were a teacher?
I don’t see a problem with Tricare being secondary. See our page on Medicare and dual benefits#page=24.
TRICARE may pay second if you have TRICARE For Life coverage. You pay the costs of services Medicare or TRICARE doesn’t cover.
You’re lucky, it normally takes 2 years to get Medicare after an SSDI award.
The problem is that I need to find out if I can receive SSDI. I taught in NY for ten years ( other employment prior). I have all SSA credits. Then I taught in CA from 2006-2018. Can I collect SSDI assuming I qualify medically for it ( which has been determined to be the case.
How many years did you work in non teaching?
Try this SSDI calculator
As a California public school educator, you do not contribute to Social Security, so you will not
receive a Social Security benefit https://www.calstrs.com/sites/main/files/file-attachments/socialsecurity2019.pdf
if one gets disability thru the Maryland teachers retirement are they eligible to get Medicare
I doubt it. See above. Did you pay into Social Security or Medicare? Even if you got SSDI, it would be a 2 year wait. I’m only licensed in CA. IMHO the best place to check would be your Teachers Retirement Plan.
http://www.sra.state.md.us/participants/members/downloads/benefithandbooks.aspx
I have 10 years of service and am receiving Ca lStrs Disability.
I worked 20 years prior to teaching
Can I also collect state disability?
We will examine the requirements for SDI State Disability Coverage on this page.
I teach in California but I worked and paid into SS fo more than 20 years. Would I be able to collect SSDI at all?
Excellent Question, Here’s my research:
If you have worked in both the public and private sector, you may be eligible for both a state disability benefit and Social Security disability. In fact, if you are eligible for both, once OPERS approves you, you must apply for Social Security disability benefits within 90 days of the board approving your benefits.
Note: If you are eligible for both SSDI and STRS or OPERS, your state benefits will offset your SSDI, as per a provision called the Windfall Elimination Provision (WEP). https://www.calstrs.com/post/windfall-elimination-provision The formula the government uses for calculating benefits under these circumstances is complex. Speak to a disability lawyer for more information. gallonlaw.com/blog/difference-opers-disability-strs-ssd/
If you expect to receive a Social Security check through your spouse or other employment, two federal rules—the Windfall Elimination Provision and the Government Pension Offset—could leave you with a smaller Social Security check or no check at all. https://www.calstrs.com/social-security
See also https://www.calstrs.com/sites/main/files/file-attachments/socialsecurity2018.pdf
Scroll down this page for more attorneys https://socialsecurity.healthreformquotes.com/disability/