Statistics show that more than one billion people in the world are living with some type of disability. This amounts to almost 15 percent of the world’s population. Being disabled could lead to several challenges that are only exacerbated in new and unfamiliar situations. This especially applies to those traveling or living overseas.Social security benefits while living overseas
Millions of people in the US are dependent on social security benefits, with most of the payouts going to retired individuals and their families. Of the approximately 59 million Americans who will receive social security benefits this year, disabled individuals and their dependents make up nearly 11 million. Almost 11$ billion is paid to them in the form of payouts by the Social Security Administration (SSA).
Social Security utilizes both medical disability and non-medical criteria to determine if you qualify for Social Security disability (SSDI), which is based on work credits; or Supplemental Security Income (SSI), which is the low-income program. You must first be able to prove that you have a medical disability. To be found medically eligible, you will need to prove the following:
• The physical or mental condition must be severe enough to make a significant impact on your ability to perform basic work-related tasks
• By the time a disability determination has been rendered, the condition must have lasted one full year, or it should be possible to estimate that the condition will last one full year
• The condition must be severe enough to prevent you from working and earning a monthly income equal to substantial gainful activity (SGA). SGA is work that yields over a certain dollar amount every month. This amount is $1,170 in 2017 for non-blind disabled applicants and $1,950 for blind applicants. Individuals who are making more than these amounts are not considered disabled, as the SSA assumes that they “are able to engage in competitive employment in the national economy”. The SSA does not take into account any income from non-work sources such as investments, interest or gifts.
The SSA also takes into consideration work credits based on which you will be deemed ‘insured’ under the SSDI program. Or your assets must be low enough to qualify for the SSI program.
US citizens who are eligible for SSDI can receive benefits even if they live overseas. But there are some countries to which the SSA cannot mail benefit checks. Also, the payments cannot be processed and sent to anyone other than you. The full list of countries to which the SSA cannot send benefit payments can be found on the SSA’s website. There are some exceptions, but you will need to the visit the US consulate or embassy to find out if you are approved as an exception. Remember that one of the rules to qualify for an exception is that you agree to pick up your benefit payments in person at the US embassy or consulate every month. SSD payments cannot be sent to individuals residing in North Korea or Cuba, and there are no exceptions to this. Keep in mind that payments that are withheld while you are residing in another country are available to you once you leave the country in which the restrictions are applied.
The SSA periodically sends questionnaires while you are residing overseas and failure to return the filled in questionnaires within the specified duration may cause your disability benefits to stop.
It is advisable to report to the SSA any changes in address, disability, work status, marital status, income statues, etc., in order to prevent disruption of the benefits or penalty charges.
Is it possible to live on disability benefits alone?
An important point of deliberation is whether it is possible to live on disability benefits alone. In many countries, this is possible, but what about the quality of life? If you need a caretaker, a maid or have special dietary requirements, Social Security Disability Insurance (SSDI) may not be enough, and you may have to look for another income source. There may be local jobs available, but keep in mind that the wages may be much lower than you are used to back home.
Which country should you move to?
The countries that are easily accessible for the disabled also tend to be quite expensive. Apart from the US, these include Australia, Canada, Germany, the UK, Japan, New Zealand, Norway, Singapore and Sweden. If disability benefits account for your only source of income, you may experience the same financial challenges in any of these countries as you do in your home country. Therefore there is little benefit to be gained from moving to any of these places. But there are dozens of other permitted countries for SSDI across the world where your dollar is worth a lot more. These countries range from the Latin and South American countries to Southeast Asia and Europe.
If you speak Spanish or are willing to learn it, you can narrow the list of countries to those in Central America, such as Costa Rica, Guatemala, Mexico, Nicaragua and Panama. These countries are a mere two hours from mainland America by flight. This makes it convenient to fly back often for medical care, disability reviews and visiting loved ones.
If you are looking for countries where English is widely spoken and the cost of living is affordable, you may want to consider the Philippines or Belize. The Philippines is also known to have a friendly population, which is an added benefit.
If hot, tropical climates do not suit you, you can opt for countries in Eastern Europe such as Poland, Ukraine or Lithuania. It is important to bear in mind that some destinations are not very accessible for the disabled, which makes it difficult to settle in.
In the United States, it is easy to take for granted the solid, well-maintained infrastructure. Everything from the water and electricity to the highways and tunnels are highly developed. You will need to ensure that the country you are moving to has enough sidewalks and wheelchair accessible buses and trains.
The most disability-friendly destinations in the world
An increasing number of countries in the world are passing accessibility laws for individuals with disabilities. Any disability-friendly city must have wide sidewalks, public transportation that is easily accessible, and easy access to public attractions and stores.
Berlin in Germany won the EU City Access Award in 2013 for its efforts to build a barrier-free environment, and for its easily accessible transportation system. Most theatres and museums in this city are accessible, and so are many restaurants and bars.
The lesser-known city of Gydnia in Poland is renowned for its efforts to make public transit accessible to all. The majority of the city buses are accessible for those with disabilities. Gydnia also has an information system that includes Braille signposts. The information boards in the city are also easily accessible to people in wheelchairs, and most restaurants have parking for wheelchair users.
Milan in Italy, the winner of last year’s EU Access City Awards, has improved its transportation system, overcome its architectural and sensory barriers, and committed itself to fully engaging with its disabled residents.
Another destination that has made considerable improvements to become fully accessible to disabled individuals is Tel Aviv in Israel. Nearly all of its intercity bus lines are wheelchair friendly and also equipped with technology for the visually-impaired, such as buses that announce their line number over speaker. The city also has strict building codes that ensure that all new construction is wheelchair-friendly. Nearly all stores in Tel Aviv are equipped with ramps.
Countries with the best healthcare
One of the main concerns of disabled individuals looking to move abroad is the quality of healthcare. Is it possible to get healthcare services as good as those available in the United States? Yes, it is possible and in some cases, the quality of healthcare is even better than what it is in the US, and more affordable too. Based on cost and quality, the 2017 Global Retirement Index scored 24 countries.
One of the countries that made it to the top three was Malaysia, a country where the medical tourism industry is rapidly picking up pace. Some of the reasons for this are a stronger US dollar and affordable air travel. The rising healthcare costs and long waiting times in western countries has also led to more and more individuals choosing Malaysia as their healthcare destination. This country has some of the best doctors in Asia, many of who were trained in the US and speak fluent English. Several hospitals in the cities of Penang and Kuala Lumpur have received the United States’ prestigious Joint Commission International certification.
Costa Rica is another such destination where the low costs of medical treatment and high quality of healthcare make it an ideal destination to move to. Expats in Costa Rica pay only a fraction of the fees they paid in the US for doctors’ visits, surgical procedures and prescriptions. Expats have access to two medical systems. The first is universal healthcare, called Caja Costarricense de Seguro Social or Caja, which is available to citizens and legal residents. In this system, expats pay a monthly fee based on the income reported on their residence application. The second system is the private healthcare system where expats can pay cash to see private healthcare providers. Insurance can also be used to pay for these services. Most of the private hospitals in Costa Rica have an international patient department that assists in arranging financial matters for expats. There are reputable facilities throughout the country, but the best hospitals and specialists, both in the public and private systems, are based in San José.
Colombia too has affordable, high quality healthcare. In fact, Colombia’s healthcare system was ranked 22 out of 191 countries reviewed by the World Health Organization (WHO), outperforming Canada and even the US, which ranked at 37. Most hospitals are staffed by medical professionals that speak English or have a certified translation department. Even those with pre-existing conditions can avail themselves of government health insurance.
Mexico is another destination that offers high quality healthcare at a fraction of the costs in the US. Even the medium-sized facilities provide top-notch medical services. Legal residents can access the government-run system that offers high quality basic care at low prices, and the private healthcare system, for which expats can pay in cash or insurance.
Helping children with disabilities make the transition
Moving abroad is a major change for any child, but for those with disabilities it can be even more stressful. In order to make the transition as smooth as possible, there are some things parents can do. Firstly, the individual needs of your child must be assessed thoroughly to make sure that those needs can be met at their new school. Every child has their own unique needs and a school may be able to cater to one special need, but not another. Before moving abroad the child must have a detailed medical or psycho-educational evaluationor an Individualized Education Plan, if coming from an American public school.
In the US, the Individuals with Disabilities in Education Act (IDEA) stipulates that every child should be educated in the least restrictive environment. But international schools, even the ones that have the word ‘American’ in the name, are not bound by this act and hence do not always have to provide services to children with disabilities. Nonetheless, there are a number of schools overseas that are willing to admit special needs children and work with them; the problem is that their services may be inconsistent, not just between schools, but also within the same school. Instead of waiting until arrival, confirm in advance that the school has a place for your child, has reviewed the relevant documentation, and can provide the necessary services.