Understanding the Complexity of Social Security Benefits

“What am I entitled to?” That’s the question many people ask when approaching Social Security—and the answer is rarely straightforward. A single individual could potentially qualify for many different benefits, depending on disability, work history, and even personal life events such as marriages or tragedy.

In this newsletter, I walk through a case example, citing the governing Policy Operations Manual System (POMS) references, to show why careful screening is essential—and why too many people unknowingly leave benefits on the table.

The Human Side of Entitlement

Over my career, I’ve met countless individuals at turning points in their lives—retiring, coping with disability, or surviving the loss of a spouse. Each one had a story. And each one’s unique circumstances shaped their possible Social Security entitlements.

What always stood out to me were the cases where customers missed out on benefits simply because they didn’t know what to ask for. That’s the driving reason for sharing this case example: real situations can become surprisingly complex under Title II law.

Case Example:

Customer profile

Age 61, stopped work 4 months ago due to back pain.

Marital history: First marriage: 5 years (ended in divorce).

Second marriage: lasted 6 months and ended tragically due to a car accident.

Later remarried the first spouse: 6 years (ended in divorce).

Former spouse (first): Age 63, remarried, has not yet filed for benefits.

The question: “What am I entitled to?”

Five Possible Benefit Paths

1. Disability Insurance Benefits (DIB), POMS Reference: DI 00015.000ff

Must meet disability insured status and have an impairment severe enough to last 12+ months and prevent substantial work.

If approved, Medicare eligibility begins in the 25th month of entitlement, starting before age 65 (HI 00801.146).

2. Retirement Insurance Benefits (RIB), POMS Reference: RS 00201.001

Eligible at age 62 for reduced retirement benefits based on their own earnings record.

Retirement benefits can be collected while pursuing disability; if disability is later approved, payments are adjusted upward (only reduced by the retirement payments already received).

3. Independently Entitled Divorced Spouse’s Benefits, POMS Reference: RS 00202.005

Requirement: marriage must last 10 years.

If remarriage occurs to the same spouse within the following calendar year after divorce, the two marriages are combined.

Here, 5 years + 6 years = 11 years → qualifies for divorced spouse benefits, regardless of the ex’s current entitlement or marital status.

4. Widow’s Benefits, POMS Reference: GN 00305.100 (exception rules)

Widow benefits usually require 9 months of marriage, but exceptions apply if death was accidental.

The individual could thus be eligible for widow’s benefits from the second marriage.

Per GN 00204.020, they may compare widows vs. retirement benefit rates and elect to start whichever best suits them and receive the other at a later date.

5. Disabled Widow’s Benefits (DWB), POMS Reference: RS 00615.170

If disability is pursued, the individual may qualify for special survivor benefits under a different computation that can pay a higher rate than standard widow’s benefits.

Additional Notes

This example does not address Supplemental Security Income (SSI). SSI is a needs-based program, but SSA screens for it at each initial application.

Actual entitlement depends heavily on documentation and the adjudicator’s review of evidence.

Why This Matters

This one case illustrates eligibility for five different Social Security benefits. Most people assume there’s a single straightforward answer, but in practice, life history + timing + exceptions all shape what you can receive.

Without guidance—or the knowledge to reference POMS—many people risk losing benefits they’ve earned.

Conclusion

The key takeaway: when it comes to Social Security, don’t just ask “Am I eligible?” Instead, ask “What am I entitled to?”

  • File early to protect your claim.
  • Ask about all possible benefit types.
  • Don’t hesitate to advocate for yourself—even POMS references can support your case.

 

Be sure to talk with an experienced Social Security representative or a certified Social Security expert. Awareness and persistence can mean the difference between receiving the minimum and securing your best entitlement.

Maryellen Eckert EDPNA