When in Doubt, File a Claim

September 9, 2020 Updated: September 14, 2020

I’m going to start this column at the bottom! Or, rather, with the bottom-line message I want to deliver today: Whenever you think you might be due any kind of Social Security benefit, insist on filing a claim for that benefit. You have every right to do so. Before I clarify that message, let me give you some background.

For part of my 32-year career with the Social Security Administration, I was a claims intake person. In other words, it was my job to help people file claims for various kinds of Social Security benefits. Many times, a person’s potential eligibility for benefits is fairly cut and dried. For example, if you were 62 years old and not working and showed up at my desk to file for retirement benefits, I would have immediately whipped out the retirement application and helped you fill it out.

But other times, a person’s eligibility for benefits is questionable. As an example, let’s say a 55-year-old guy showed up at my desk and said he had a couple of sore knees and wanted to file for disability benefits. A part of me would have wanted to say this to the guy: “Listen, buddy, the law says you have to be severely disabled to qualify for disability benefits. And I can tell you from experience that a couple of bum knees isn’t going to pass muster. You’d be wasting my time and your time filing for disability benefits because your claim is going to be denied.”

But I never did that. I always helped him file a claim. Why? For two reasons. It was drilled into me from the start of my career that people always had the legal right to file for any kind of Social Security benefit. Besides, for all I knew, the guy might have also had a bad heart or high blood pressure or other physical maladies that might have helped him qualify for disability benefits.

And the second reason I would have taken his claim was more self-serving. I knew that Social Security office staffing was doled out based on the number of claims the office took. In other words, the more claims I took, the better chance there was that our office would get the extra staff we always felt we needed. So, I always thought that taking claims was a win-win for both the client and my local SSA office.

But I’ve been retired for 15 years now, and I wonder if things are different at the SSA today. I’ve been hearing troubling stories from readers about their experiences when they inquired about their possible eligibility for benefits. Here are some examples.

Q: Even though my husband and I lived together for 20 years, we didn’t actually get married until two years ago. Sadly, he died last month. When I contacted Social Security to file for widows benefits, the clerk told me we had to be married at least 10 years, so she said I wasn’t due anything. She helped me file for the $255 death benefit, and that’s all I got. What should I do?

Q: I am 62 years old. I called Social Security’s 800 number and told them I wanted to file for my Social Security benefits. I run my own business but plan to turn it over to my wife and pay myself a salary of $18,000 per year so I will be under the Social Security earnings limit and thus eligible for my monthly checks. The telephone rep I talked to told me I was not eligible for benefits and terminated the interview. Do I have any recourse?

These questions help me illustrate the point I made at the beginning of this column: You have every right to file for whatever Social Security benefits you think you might be due. So, whenever there is any doubt about your eligibility, always demand to file a claim.

By doing so, you accomplish two things. One, you will get a legal decision about your eligibility for benefits, not just one Social Security rep’s opinion (or one Social Security columnist’s opinion). And two, you will have appeal rights. In other words, if your claim is denied and you still are not satisfied, you can ask that your claim be reviewed. You could take it all the way to the Supreme Court if you wanted to!

That last comment is a little far-fetched (although feasible). However, the basic point I am making is very valid. If a Social Security agent just says no and you later learn you were due benefits, you generally won’t be able to do anything about it but gripe—and then file a claim with no retroactivity. But if you actually file a claim the first time and it is denied, and you later are able to prove your eligibility, you will get full retroactive benefits to the date you filed the claim.

So, that is the overall message to everyone reading this column: Always demand to file a claim for benefits if you think you might possibly be due them—no matter what a Social Security rep tells you.

And now let me give my opinion to the two people whose emails I included in this column.

Unless I am missing some of the facts, the widow who was married for a couple of years before her husband died was given bum advice by the Social Security rep to whom she spoke. The 10-year duration of marriage rule applies only to divorced spouses. So, assuming this woman was still married to her husband when he died, is old enough for widows benefits, and is not getting higher benefits on her own Social Security account, she should be getting widows benefits and should file a claim immediately.

The guy with the business is treading a fine Social Security eligibility line. In the past, the rules were pretty stringent: He would not have been able to simply turn the business over to his wife on paper and pay himself a minimal salary and then expect to collect Social Security retirement benefits. But recently, the SSA has eased up on these rules, and he may be eligible. Again, the only way he will find out for sure is to file a claim.

Now that I’ve made my “insist on filing a claim” point, I should clarify that that advice cannot be taken to an extreme. For example, you can’t show up at a Social Security office at the age of 55 and demand to file a claim for retirement benefits. The rules clearly state you must be at least 62 to be eligible. But again, if you are pretty sure you are due a Social Security benefit, make sure you file a claim for those benefits to keep your legal rights open.

Tom Margenau worked for 32 years in a variety of positions for the Social Security Administration before retiring in 2005. He has served as the director of SSA’s public information office, the chief editor of more than 100 SSA publications, a deputy press officer and spokesman, and a speechwriter for the commissioner of Social Security. For 12 years, he also wrote Social Security columns for local newspapers. If you have a Social Security question, contact him at thomas.margenau@comcast.net.