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July 24, 2005
Send Personal Stories of Success about Social Security Benefits
The Consortium for Citizens with Disabilities - a coalition of over 100 national consumer, provider & advocacy organizations - needs information to help protect the future of Social Security. As you know, there is a lot of discussion about changing Social Security. This is a very serious concern for people with disabilities and their families because changes in the program will have a huge impact on everyone who gets benefits not just people who retire. If you or a family member gets Social Security benefits, we want to hear from you! By giving us information, you may remain anonymous OR you may share your name with us. If you do share your name, please indicate below if you would appear at a public meeting to talk about the importance of Social Security benefits for you and/or your family.
What we need are stories about Social Security benefits only, not about Supplemental Security Income (SSI) benefits. If you receive only SSI benefits, please do not use this form. But if you get both Social Security and SSI benefits or if you are not sure which benefits you get, please share your story by completing this form.
YOUR PERSONAL STORY
___ I get a monthly Social Security check. ___ Someone else in my household gets a monthly Social Security check. This person is [describe relation to
you] _____________________
I get Social Security because [check answer that applies to you]: ___ Its my own disability insurance because I can no longer work due to a disability.
___ Its disability insurance from one of my parents or my spouse. ___ Its my own retirement insurance because I no longer work. ___ Its retirement insurance
from one of my parents or my spouse. ___ Its survivors insurance from one of my parents or my spouse who are now dead.
Are you a disabled adult child under the Social Security rules? [This means that you have a severe disability that began before age 22; are not married;
and are unable to earn more than a certain amount of money each month] Yes ___ No ___ ___ I wish to remain anonymous. I live in _________________
[state].
___ I am willing to share anonymous private and confidential information about my personal/family story, including how we use the Social Security benefits,
with public officials who are deciding the future of the Social Security program.
___ I am willing to have others publicly share my personal/family story, including how we use the Social Security benefits, and identify me/my family
by name.
___ I am willing to speak at public meetings before public officials in my own state to share my personal/family story, including how we use the Social
Security benefits.
For each person in your household who gets Social Security benefits, please answer the following questions: If you are the person who gets Social Security:
Age ____ Amount of monthly check ____ Received benefits for how long? ____
If one of your parents gets Social Security: Age ___ Amount of monthly check ____ Received benefits for how long? ____
If one or more of your children gets Social Security: Age(s) _________ Amount of monthly check(s) __________ Received benefits for how long? ____ What
is your disability or the disability of your family member?
How long did you (or your family member) work before receiving Social Security benefits? What was your job?
Please explain briefly why the Social Security benefits are important to you and your family.
Its helpful to know how most people spend their Social Security benefits. Please check any items listed below that you use the money for and place a star
[*] next to the 3 items where you spend the most money.
___ Rent or mortgage payment ___ Food ___ Utilities ___ Special food for person with disability in household ___ Clothing ___ Car payments/gasoline ___ Transportation
___ Medical bills ___ Prescription drugs ___ Respite care ___ Special services for person with disability in household ___ Education or job training
___ Others [please list]
If you did not get this money from Social Security, what would you do? Could you get help from any other public or private agency?
When you hear about the Presidents proposals to change Social Security, what concerns do you have?
Your name:
Address:
Phone number: Email address:
You can help people better understand the risk of losing Social Security guaranteed benefits for eligible people with disabilities and their family members.
Please return this form by any of the following methods: Mail: Disability Policy Collaboration, Social Security Task Force, 1660 L Street NW, Suite 701,
Washington DC 20036
Fax: 202-783-8250
E-mail: info@c-c-d.org
Posted by Karen Thomas at July 24, 2005 08:51 PM