Illinois Law
Illinois Elder & Social Security Law
- Elder & Social Security Law
Elder & Social Security Law
This attitude is changing rapidly. As the average age of Americans rises, society is becoming increasingly aware of the unique problems facing elderly people, as well as the professional opportunities available in serving them. Governments have responded with a wide array of state and federal programs designed to guarantee financial and physical well-being for the elderly and to fight age-based discrimination. As senior citizens take a more active role in asserting their rights, an increasing number of the elderly have sought legal representation from lawyers sensitive to their needs.
Elder law is not a well defined area of legal specialization. Elder law includes many other areas of law such as health, probate, estate planning and trusts, civil rights, consumer protection and Social Security. Social Security Law is discussed in depth later in this chapter.
Age Discrimination in Employment
Seniors in Illinois have two basic meansone state, one federalwith which to counter age discrimination in the workplace: the Illinois Human Rights Act and the federal Age Discrimination in Employment Act of 1967.
Illinois Human Rights Act
The Illinois Human Rights Act (IHRA) is a comprehensive antidiscrimination law prohibiting labor organizations, employers and employment agencies from discriminating based on age (over the age of 40), ancestry, arrest record, citizenship, color, disability, marital status, national origin, race, religion, sex or unfavorable military discharge. Under IHRA, it is illegal in most instances for an employer to use a person's age as a basis for decisions regarding hiring, recruitment, pay, promotion, transfer, discharge, discipline or privileges. For example, an employer cannot replace an older worker with a younger worker simply because the employer wants a young work force. Involuntary retirement before the age of 70 generally is prohibited. IHRA does permit an employer to offer various insurance plans or other fringe benefits to an employee based on age as long as the cost to the employer is reasonably equivalent for all employees.Any person who feels victimized by a violation of IHRA may bring a civil action directly against the employer or may file a charge with the Illinois Department of Human Rights. If a person files a charge of discrimination with the Department of Human Rights, he or she must do so within 180 days of the discriminatory act. For example, if an older person is fired and believes the motive was age discrimination, the charge must be filed within 180 days of the employer's notice of termination.
Any individual who files an employment discrimination lawsuit must show:
- That he or she is a member of the protected class (in this case, the protected age group)
- That he or she is qualified to do the job
- That he or she was rejected for the job or was fired from the job despite being qualified
- That the employer filled the job with someone with similar qualifications
Age Discrimination in Employment Act of 1967
The federal Age Discrimination in Employment Act of 1967 (ADEA) also prohibits age-based discrimination by labor organizations, employers and employment agencies. Under ADEA, employers are prohibited from using age as a basis for making hiring, firing, promotion or compensation decisions or from limiting, segregating or classifying employees in any way that would deprive or tend to deprive an individual of employment opportunities or otherwise adversely affect his or her status. ADEA specifically prohibits the use of job advertisements that specify an applicant should be "young," a "recent graduate," or that use terms such as "retired" or "over 65."ADEA has five major exceptions to its coverage. Employers accused of violating ADEA usually invoke one or more of the following exceptions as a defense for their actions:
- Tenured Faculty Members: Until recently, ADEA did not prohibit compulsory retirement at age 70 for tenured faculty members at institutions of higher learning. This exception expired on December 31, 1993, making compulsory retirement ages for tenured faculty no longer permissible
- Executives and Policy Makers: A small number of high-level employees with substantial executive authority are not covered by ADEA and can be subjected to compulsory retirement at age 70. This exception is a very narrow one and does not allow for compulsory retirement policies for mid-level managers
- Good Cause: An employer is permitted to discharge an employee for "good cause," a catch-all category that includes many different forms of failure to do a job adequately
- Occupational Requirement: In certain narrowly defined situations, an action otherwise impermissible under ADEA may be legal if the employer's action is "reasonably necessary to the operation of the business" or is based on "reasonable factors other than age." For example, employers may have mandatory retirement policies for firefighters and airplane pilots
- Bona Fide Seniority Systems and Employee Benefit Plans: Generally, it is permissible for an employer to adopt a bona fide seniority system or employee benefit plan as long as the system or plan is not intended to evade the purposes of ADEA.
Relationship Between IHRA and ADEA
The relationship between IHRA and ADEA is complex, primarily because ADEA was not intended to supersede or replace existing state regulations regarding age-based discrimination. Both laws cover age discrimination in employment. An aggrieved person may file a charge with the Illinois Department of Human Rights for relief under IHRA or with the federal Equal Employment Opportunity Commission (EEOC) based on discrimination in employment under the ADEA. However, there are rules concerning the relationship between the state and federal systems. Because of the complex interplay between the two laws and because each has a different statute of limitation, a lawyer or representative of the EEOC or Illinois Department of Human Rights can advise a victim of age discrimination how, when and where to proceed against an employer.Health Care Decisions and Protective Arrangements
Living wills and powers of attorney for health care are two written documents covering decisions in elder law. If people do not create these documents, their health care decisions may be covered by the Illinois Health Care Surrogate Act. Under this act, a surrogate or a guardianusually a family membermay be appointed to make important decisions about a person's health care if he or she becomes unable to do so. When a patient becomes unable to make a decision about life-sustaining treatment and is diagnosed with a condition that will require such a decision, the health care provider must inquire about the existence of a living will or power of attorney for health care. If neither of these documents exists, the physician is authorized to rely upon a surrogate to make the decision. The patient must be informed that a surrogate has been appointed and who the surrogate is. Any decision made by the surrogate should be made in accordance with the patient's wishes.
Living Will
Despite its name, a living will is not actually a will at all. A living will is a document spelling out how much and what kind of medical care its writer (declarant) wants if he or she becomes terminally ill and incapable of communicating his or her wishes. "Terminally ill" means the person has an incurable or irreversible condition and the use of medical procedures only delays and prolongs the dying process. Living wills are controversial and, although many states refuse to recognize them, they are recognized in Illinois.Any competent adult can make a living will. Although many people have living wills drafted by their lawyers at the same time they have traditional wills drafted, living wills do not need to be drafted by lawyers. Illinois has a suggested living will form that people can use if they wish. Many people seek advice from a doctor before drafting a living will so they can describe their wishes specifically, taking into account the kinds of medical technology currently available to them. It is also useful for a person who signs a living will to inform his or her doctor of what the living will says. The most important point about a living will is that the individual decides how much and what kind of health care he or she wants.
| Living Will Declaration This declaration is made this . . . . . . . day of . . . . . . . . . (month, year). I, . . . . . . . . ., being of sound mind, willfully and voluntarily make known my desires that my moment of death shall not be artificially postponed. If at any time I should have an incurable and irreversible injury, disease or illness judged to be a terminal condition by my attending physician who has personally examined me and has determined that my death is imminent except for death-delaying procedures, I direct that such procedures that would only prolong the dying process be withheld or withdrawn, and that I be permitted to die naturally with only the administration of medication, sustenance or the performance of any medical procedure deemed necessary by my attending physician to provide me with comfort care. In the absence of my ability to give directions regarding the use of such death-delaying procedures, it is my intention that this declaration shall be honored by my family and physician as the final expression of my legal right to refuse medical or surgical treatment and accept the consequences from such refusal. Signed . . . . . . . . . . . . . . . . City, County and State of Residence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The declarant is personally known to me and I believe him or her to be of sound mind. I saw the declarant sign the declaration in my presence (or the declarant acknowledged in my presence that he or she had signed the declaration) and I signed the declaration as a witness in the presence of the declarant. I did not sign the declarant's signature above for or at the direction of the declarant. At the date of this instrument, I am not entitled to any portion of the estate of the declarant according to the laws of intestate succession or, to the best of my knowledge and belief, under any will of declarant or other instrument taking effect at declarant's death, or directly financially responsible for declarant's medical care. Witness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Power of Attorney for Health Care
Living wills can be used only for terminal illnesses. Treatment decisions for nonterminal illnesses can be addressed by the creation of a power of attorney for health care. A power of attorney for health care is a document that one person (principal) signs in order to give another person (agent) authority to make health care decisions if the principal becomes incapacitated. Unlike a living will, a person's health condition does not have to be terminal for a power of attorney for health care to be effective.The power of attorney for health care sets out exactly what the agent will do if the principal becomes unable to make health care decisions. It may state that the agent has complete authority to make health care decisions based on what the agent believes is best, or it may state specifically what the health care decisions should be. For example, the principal may declare that every measure should be used to keep him or her alive or that medical treatment should be stopped under certain circumstances.
A principal must be at least 18 years old in order to create a power of attorney for health care. Illinois has a suggested short form power of attorney for health care, or a principal may write his or her own power of attorney for health care as long as it contains certain information required by law. The power of attorney for health care must name the agent, describe the power the agent will have, and be signed and dated by the principal while he or she is still able to make decisions.
Guardianship
The Illinois Guardians for Disabled Adults Act provides that a court may appoint a guardian if a person (ward) becomes mentally or physically incapable of making personal or financial decisions. The guardian may be appointed as a guardian of the person or guardian of the person's estate, or both. The purpose of guardianship is to promote the well-being of disabled adults and to prevent abuse, neglect and exploitation.To create a guardianship, any person can petition the court, whether that person is a potential guardian, a potential ward or a third person. Usually a petition is made by a family member or close friend concerned about the person's competence to manage property or make personal decisions. A petition must include the name and other information about the person, the value of the person's property and the name and other information about the proposed guardian. It also must set forth the reasons why guardianship is needed. The petitioner has the burden of proving the ward's incapacity and the court applies a standard of the best interest of the ward in making its decision.
A ward can be restored to capacity by petition to the court. Anyone can bring a petition and must show by a preponderance of the evidence that the ward no longer is incapacitated and is able to make provisions for personal care or management of his or her property.
For many families, guardianship causes a drastic change in the family relationship, especially if not all family members agree that a petition for guardianship should be filed. Some of this potential stress can be avoided if an aging person creates a living will or power of attorney for health care and property while still legally competent.
Commitment to a State Institution
There are three ways an individual can be committed to an institution for mentally ill persons in Illinois. Commitment sometimes becomes an issue for elderly people.Voluntary Commitment
A person 18 years of age or older in Illinois may request voluntary admission to a mental health facility. This voluntary admission may be done informally without application. The facility director will deem the individual suitable to be admitted after an examination. Voluntary admission also may be requested formally by filing an application with the facility director. Any person admitted voluntarily to a mental health facility must be informed of his or her right to be discharged. Persons admitted informally may be discharged at any time during normal day-shift hours starting from the first day after admission. People who are admitted by way of the formal voluntary admission procedure must apply for discharge in writing and will be discharged within five days of the request.Emergency Hold
Any adult may petition the director of a mental health facility to admit someone on an emergency basis. The hospitalization must be necessary to protect the admitted person from hurting himself or herself or others. The petition must be accompanied by a certificate from a physician or a clinical psychologist, and it must state the reasons why the person should be admitted involuntarily. The person held under an emergency admission has the right to a medical examination within 24 hours and a right to a hearing within five days.Judicial Commitment
Any adult may petition a court for judicial admission of another individual to a mental health facility. The person petitioning for involuntary judicial admission must file the petition in the county where the person sought to be admitted resides. The petition must state the facts that make commitment necessary and the names and addresses of witnesses to these facts. Upon the filing of a petition for commitment, the court will set the matter for hearing or, if the petition does not contain physicians' certificates, will order an examination. The proposed patient receives notice of the hearing and a written summary of his or her rights. No involuntary admission may be made unless the court finds that the person is unable to care for himself or herself or that the person is a danger to himself or herself or others. A judge may involuntarily commit someone to a state institution for an initial period of up to 180 days. After that period, the patient is entitled to periodic review of his or her case and possible release.Social Security Law
The Social Security Act
The public benefit programs started by the Social Security Act and its amendments are financed generally by taxes levied on workers. Employers automatically deduct a portion of each worker's paycheck and match that amount with money from their business or organization. As of 1995, 7.65 percent of the employee's gross salary goes to Social Security. This deduction is usually labeled "FICA" for the Federal Insurance Contributions Act, which authorizes the payroll tax. A person's employer also is required to contribute 7.65 percent of the employee's gross salary to Social Security. Self-employed workers are responsible for paying the entire amount themselves. If a person is self-employed, he or she pays 15.3 percent of his or her taxable income to Social Security, but half of that is deductible from federal income tax as a business expense.
Of the money received from Social Security payroll taxes, the largest portion goes to pay retirement benefits; smaller portions pay disability benefits and Medicare. As of 1995, there were approximately 141 million people paying into Social Security.
The three largest programs within the Social Security Act are Retirement, Survivors and Disability Health Insurance (RSDHI); Supplemental Security Income (SSI); and Medicaid. RSDHI is the name of the federal government's benefits program for workers and retirees, and contains three separate programs to cover retirement, disability and health insurance (Medicare).
Although these three programs are extremely complex, a general familiarity with them is helpful for understanding one's entitlements.
Benefits for Retirees
Retirement and Survivors Insurance
Despite the fact that Retirement and Survivors Insurance (RSI) is only one branch of RSDHI, which in turn is only one branch of the Social Security Act, when most people refer to "Social Security" they actually mean RSI. Payments from RSI are the Social Security checks that millions of Americans receive each month. RSI was not intended to be a person's sole source of income, but to supplement other income sources such as pensions, insurance, savings, and investments. However, for many, RSI is their only source of income.A worker gains RSI coverage by performing covered employment for a certain amount of time. The term "covered employment" means most types of work, including full- or part-time wage or salaried work, self-employment, farm work, membership in the United States Armed Services, employment in private nonprofit organizations, most domestic work, and most federal, state, and local government employment. The only major exceptions are railroad employees separately covered by the Railroad Retirement System, federal workers hired before 1984, and certain religious workers. The rules of eligibility and benefit amount are quite complex and provide limited coverage for spouses, children, and survivors.
Generally, a person begins receiving RSI benefits at age 65; however, a worker has the option of initiating benefits at age 62. All benefits are based on what is called the primary insurance amount (PIA): the amount a worker is entitled to if he or she retires exactly at age 65. The amount of the monthly check varies depending on how much the worker made each year. The higher his or her pay, the higher the benefits, up to a maximum dollar amount. A person who initiates benefits at age 62 receives a reduced monthly amount equal to a percentage of his or her PIA. This is a permanent reduction that amounts to approximately seven percent of the PIA for each year a person receives benefits before age 65. Postponing the receipt of benefits until after age 65 can entitle a worker to receive higher monthly amounts. Cost-of-living increases are built into the system so that the monthly amount automatically increases each year as the national cost of living rises.
Family members receive benefits based on the worker's retirement benefits. The spouse of an eligible worker draws spousal benefits on the worker's accountusually one-half of the worker's Primary Insurance Amount (PIA)if the spouse is at least 62 years old or cares for a child eligible for child's benefits on the worker's account. Other bases for family eligibility are:
- Spousal benefits for a divorced spouse if he or she was married to the insured worker for at least ten continuous years and has not remarried
- Full benefits for a surviving widow or widower of a fully insured worker from age 65
- A one-time death benefit (currently $255) for surviving relatives of fully insured workers who apply within two years of the worker's death
- Benefits for the child or grandchild of an insured worker if he or she was dependent on the worker when benefits began, is unmarried, and
- is 18 years old or younger
- is 19 years old or younger but enrolled as a full-time elementary or secondary school student
- is older than 18 years but became disabled before reaching age 22
Railroad Retirement System
The Railroad Retirement System is a federal income insurance program specifically for workers in the railroad industry. This system was originally independent of the Social Security Administration, but in 1974, the two programs' provisions were integrated. The integration was not entirely smooth, however, which has led to complex and confusing rules that are often the source of errors in awarding benefits.Most of the rules for Railroad Retirement closely parallel those for RSI. A retired railroad worker is eligible for monthly benefits if he or she worked for a railroad employer for at least ten years before reaching age 65. As with RSI, a worker can opt to retire earlier, at age 62, but will receive reduced benefits. Anyone with fewer than ten years' employment in the railroad industry is ineligible for railroad benefits, but the years of railroad employment can be added to years of non-railroad employment for purposes of calculating RSI benefits.
Some railroad workers who retired before January 1, 1975 are entitled to draw full RSI benefits and full Railroad Retirement benefits. Most other workers, however, have their RSI benefits reduced by the amount of the Railroad Retirement benefits.
Disability Benefits
The federal government has two disability benefit programs administered by the Social Security Administration for qualified applicants: RSDHI Disability Insurance and Supplemental Security Income (SSI). These two programs are similar and are governed by many of the same rules. An individual who qualifies for one program occasionally can receive benefits simultaneously from both programs.Both RSDHI and SSI programs define disability as "inability to engage in any substantial gainful activity by reason of any medically determined physical or mental impairment that can be expected to last for a continuous period of not less than 12 months." The physical or mental disability must be "of such severity" that an applicant not only is unable to do the work he or she did previously, but is unable to engage in any kind of gainful work.
The applicant for either RSDHI disability or SSI has the burden of proving by medical evidence that he or she is disabled or blind. Most applicants must wait five full months before their benefits begin. Each applicant's case is reviewed periodically to determine whether his or her condition has improved to the point that he or she is able to resume working.
RSDHI Disability Insurance
RSDHI Disability Insurance provides benefits for workers with substantial work histories in covered employment who are unable to continue work because they became disabled before reaching age 25. The term "covered employment" includes most types of work. The disabled worker and his or her dependents usually are eligible for RSDHI disability benefits. In some cases, disabled survivors of an insured worker can receive benefits.Supplemental Security Income
SSI is a nationwide income maintenance program designed to help persons with limited income and assets who are elderly, blind or disabled. Although SSI is administered by the Social Security Administration, it is not funded by Social Security taxes. Unlike Social Security, SSI is based on need. A person's work record is not relevant in determining eligibility for SSI. Thus, a disabled person under age 65 who has not worked a sufficient amount of time to qualify for RSDHI disability may be eligible to receive SSI disability benefits.To receive SSI, a person must be 65 years of age or older, be blind or disabled and have financial need. The formula for determining SSI eligibility and benefits takes into account income level and assets. When calculating a person's income, the government includes earnings, Social Security benefits, payments from pensions, any non-cash items like food, clothing or shelter, and items that the individual may own. Some things, however, are exempt from consideration, such as:
- A person's home (regardless of its value)
- Household goods and personal property (worth less than $2,000)
- One car (worth less than $4,500)
- Income tax refunds
- The value of food stamps
- A portion of monthly earnings
When the federal government created SSI, it replaced many state-administered welfare programs for the elderly, blind and disabled. The State of Illinois chose to continue its own program to supplement SSI benefits. This program is known as State Supplemental Payments (SSP). SSP provides additional assistance to qualified elderly, blind and disabled persons, including those whose income levels are above the SSI standards. The purpose of SSP is to help very poor Illinois residents who are unable to work but whose needs are not met by other federal or state programs.
Medicare
Medicarealso called Medical Assistance in Illinoisis a federal program administered by the Social Security Administration designed to cover some basic medical and health care costs of eligible individuals over age 65, as well as many people with disabilities. Medicare has become an enormous federal program, providing billions of dollars in coverage every year.Medicare should not be confused with Medicaid. Medicaid is a program administered by the Social Security Administration to pay doctor and hospital bills of people with limited income and assets. Medicare benefits are available to qualified individuals regardless of financial need. Because Medicare is closely linked to RSI, Disability Insurance and Railroad Disability benefits, a basic understanding of the eligibility requirements and application procedures for those programs is helpful for an understanding of Medicare.
Medicare Parts A and B
Medicare has two basic divisions called Part A and Part B. Medicare Part A, commonly known as Hospital Insurance, covers medically necessary hospital and related health care. Included in Part A are costs for such expenses as inpatient hospital care necessitated by acute illness, skilled nursing home care, certified hospice care for the terminally ill, inpatient psychiatric care and care in the home by a certified home health care provider. People qualify for Hospital Insurance when they turn 65 or if they are covered by Social Security or Railroad Retirement benefits.Medicare Part B, commonly known as Medical Insurance, is a voluntary health insurance program designed to cover some of the costs not covered by Medicare Part A, such as outpatient hospital services, outpatient physical therapy, speech pathology services, necessary ambulance service and medical equipment. Unlike Part A, which is paid for out of Social Security taxes and is free to anyone who qualifies, Part B is an optional program that carries a monthly premium of under $50.
The federal government contracts with private insurance companies to handle routine claims processing, payment and other functions under Parts A and B. Medicare recipients have the right to choose how they will receive hospital, doctor and other health care services covered by Medicare. One option is the traditional fee-for-service system. Under this system, the recipient visits a hospital or doctor of his or her choice and pays a fee for any services provided. Medicare will pay a percentage of that fee, but the recipient is responsible for certain deductible and coinsurance payments. Most people covered by a fee-for-service Medicare plan also have private insurance (commonly called Medigap) to supplement their Medicare coverage.
Another option is to use a health maintenance organization (HMO). HMOs offer a wide range of health care services in exchange for a fixed premium paid in advance. Medicare recipients enrolled in an HMO rarely require additional Medigap insurance because the HMO plan itself supplements Medicare. One drawback of an HMO, however, is that health care services can only be provided by a member of the HMO's health care network. Medicare recipients lose the freedom to consult any health care provider of their choice.
Costs Not Covered by Medicare
Medicare never was intended to provide comprehensive coverage for all medical needs of America's elderly population, but rather, was intended to supplement private resources. Many health services are not covered by Medicare. For example, Medicare does not pay for:- Custodial care provided by someone without medical training and intended to help the patient with his or her daily living needs, such bathing, walking or exercising
- Dentures or routine dental care
- Eyeglasses, hearing aids and examinations to prescribe or fit them
- Nursing home care (except skilled nursing care)
- Prescription drugs
- Routine physical checkups and related tests (except for some screening procedures, such as Pap smears and mammograms)
- Most immunization shots
- Services outside the United States
- Personal comfort items
Medicaid
Medicaid should not be confused with Medicare. Despite their similar names, the two programs are different. While Medicare is funded and administered entirely by the federal government to provide health care to elderly persons and people with disabilities, Medicaid is a cooperative program funded partly by the federal government and partly by the individual states. The federal government's role in Medicaid is quite limited. It pays a percentage of the cost of each state's health care program for indigent people and ensures that every state's program complies with various federal requirements. The amount of money a state receives from the federal government is called the Federal Financial Participation (FFP). Each state's FFP is determined by a formula based on the state's per capita income and the amount of medical services the state chooses to provide to needy people within the state. Many people qualify for Medicaid, Medicare and other forms of assistance that often are administered in an overlapping or cooperative fashion.Each state has wide latitude to decide how Medicaid operates within the state. In Illinois, Medicaid is administered by the Illinois Department of Public Aid. To receive Medicaid, a person must have countable assets with a low value and very low income, as determined by a complex formula. In Illinois, a person generally cannot have more than $2,000 in assets or more than $591 in income per month and have medical bills exceeding his or her monthly income, although there is a complex formula applied that considers the applicant's unique situation. There are several assets the formula does not count. Assets not counted include:
- Homestead
- Automobile necessary for employment or otherwise to produce income, to receive health care or essential for transporting a person with disabilities
- Income-producing property
- Household goods and personal effects
A person whose income is above Medicaid limits might be able to qualify for Medicaid under a spend-down provision. The spend-down is equal to the amount a person's income is over Medicaid limits. Medicaid occasionally agrees to cover the amount that a person's medical bills exceed a patient's spend-down.
Restructuring assets to qualify for Medicaid can be an especially attractive option for senior citizens, even if they already qualify for Medicare. Medicaid coverage is better for persons living in nursing homes because Medicaid pays for a wider variety of nursing care services and for a longer period of time than does Medicare. Lawyers specializing in Medicaid have experience in advising clients how to restructure their assets and income to qualify for Medicaid.
Other State Assistance
In addition to SSP described above, the Illinois Comprehensive Health Insurance Plan is a state program offering additional financial assistance to Illinois residents. This program was intended as an alternative to traditional health insurance. It benefits Illinois residents who are refused health insurance by private health insurance companies or who can obtain insurance but only at an excessive rate. The Comprehensive Health Insurance Plan provides coverage for medically necessary treatment such as hospital services.In Illinois, two additional programs help older people and people with disabilities pay for their Medicare coverage. In order to be eligible for these programs, an individual must have assets of no more than $4,000 and must live in Illinois. The Qualified Medicare Beneficiary Program (QMB) assists those who have Part A Hospital Insurance and whose income is at 100 percent or less than the federal poverty level. The Specified Low-Income Medicare Beneficiary Program (SLMB) covers Part B Medical Insurance for individuals with incomes between 100 percent and 110 percent of the poverty level. These programs are run by the Illinois Department of Public Aid.
Applying for Benefits
- Social Security card or number
- Birth certificate
- Tax information, such as his or her most recent W-2 form or tax return
- Information about his or her home, such as a real estate title
- Income and ownership information, such as payroll slips, bank books, insurance policies and vehicle registration
- Marriage certificate, spouse's birth certificate and spouse's Social Security number (if spouse is applying for benefits)
- Children's birth certificates and Social Security numbers (if applying for children's benefits)
- Military discharge papers
Right to Appeal
There are three steps to the administrative appeals process. The first step is reconsideration. An administration representative (someone other than the person who made the original decision) reconsiders the matter and issues an opinion. If, on reconsideration, the decision is negative again, the second step is a hearing before an administrative law judge. At this stage, the claimant has the right to subpoena and cross-examine witnesses, present evidence and read relevant files. After listening to both sides, the administrative law judge issues a decision. In most cases this will end the matter, but if the decision is negative and the claimant wishes to press his or her claim, the third and final step is the Appeals Council. If the Appeals Council decides to review the case (its jurisdiction is discretionary), it conducts a "paper" review of the entire matter. This means it issues a decision based on the files accumulated in the two previous steps. There is no additional opportunity to testify, although the appellant may submit additional documentation if necessary.
It is important to know that there are time limits in which to make an appeal. If a person is interested in appealing a decision regarding benefits, he or she should not delay in contacting the nearest Social Security Administration Office.
Resources
Illinois Attorney General, Senior Citizens Advocacy, phone: (800) 252-2518.
Contact the Illinois Department of Human Rights, State of Illinois Center, 100 Randolph Street West, Suite 10-100, Chicago, IL 60601, phone: (312) 814-6200, TDD: (312) 263-1579 or 222 College South, Suite 101, Springfield, IL 62706, phone: (217) 785-5100, TDD: (217) 785-5125, for information on age discrimination or to file a charge.
Contact the Illinois Department of Public Aid, Division of Medical Programs, Prescott E. Bloom Building, 201 South Grand Avenue East, Springfield, IL 62763, phone: (217) 782-2570, toll-free: (800) 252-8635, for information about Medicaid, Medicare, SSI, or SSP.
Contact the Illinois Department on Aging, Division of Older American Services, 421 Capitol Avenue East, Suite 100, Springfield, IL 62701-1789, phone: (217) 785-3356 or (312) 917-2630 or (800) 252-8966 for information about elder services and protective services or to order the free pamphlet, Partners in Aging: A Guide to Programs, Services and Advocacy Organizations Serving Older Adults in Illinois, 1993-94, or other publications.
The Illinois Secretary of State, Department of Human Services, Senior Citizen Division, 450 Howlett Building, Springfield, IL 62756, phone: (800) 252-2904 (voice or TTY) offers services for seniors.
Illinois Securities Department, Secretary of State, Lincoln Tower, 520 Second South, Suite 200, Springfield, IL 62701, phone: (217) 782-2256. Call to order the free pamphlet, Senior Citizens Securities Fraud.
Illinois State Bar Association, Illinois Bar Center, Springfield, IL 62701-1779. Call (217) 525-1760 to order the free pamphlets, Estate Planning & Living Wills and Your Health Care: Who Decides?
United States Equal Employment Opportunity Commission, Chicago District Office, 930A Federal Building, 536 Clark Street South, Chicago, IL 60605, phone: (312) 353-2713.
The Social Security Administration operates a toll-free, 24-hour telephone service to provide information on Social Security and related government benefit programs, including estimates of retirement benefits. Most questions about Social Security should be addressed to the Social Security Administration. To reach a service representative, call (800) 772-1213 between the hours of 7:00 a.m. and 7:00 p.m. on business days.
The Social Security Administration also publishes a number of booklets, forms and pamphlets designed to explain different types of government benefits, all of which are available free of charge. They include the following:
Disability (Publication No. 05-10029)
Medicare (Publication No. 05-10043)
Retirement (Publication No. 05-10035)
SSI Supplemental Security Income (Publication No. 05-11000)
Survivors (Publication No. 05-10084)
The Appeals Process (Publication No. 05-10041)
Understanding Social Security (Publication No. 05-10024)
You May Be Able to Get SSI (Publication No. 05-11069)
These and other publications are available at any local Social Security Office or by calling the toll-free telephone number above.
For online information, visit the Social Security Administration's World Wide Web Site: http://www.ssa.gov