Someone who can’t work because they’re disabled may receive disability income from the federal government. The Social Security Administration (SSA) reviews and then grants disability income under the Supplemental Security Income (SSI) and Social Security Disability Income (SSDI) programs. If someone has a long-term physical or mental disability preventing them from working, they might qualify for benefits.
The application process is confusing and complicated, and it’s tough to get answers from local Social Security offices. That’s why people might opt to work with a lawyer.
Whether you work with a lawyer or you’re applying on your own, the following are six critical facts about Social Security Disability to be aware of.
1. Disability Benefits Basics
The Social Security Disability Insurance (SSDI) program pays benefits to individuals and certain family members if they’re insured. Being insured means that you have worked recently and long enough, paying Social Security taxes on what you earned.
The Supplemental Security Income (SSI) program pays benefits to children and adults with limited resources and income who also have disabilities.
The two programs are different but have the same medical requirements. If you meet non-medical requirements, you are paid monthly benefits if you have a medical condition that’s expected to last for at least a year or result in death.
Only around 38% of first-time applicants for SSDI are approved for benefits. The reasons they’re often not approved are because they don’t show sufficient proof of disability or they’re inaccurate in filling out forms.
You have to meet two criteria to qualify for SSDI benefits. First, you must have worked for a certain amount of time in a job covered by Social Security. The second criterion is that you have a medical condition that meets the definition of disabled from the Social Security Administration.
If you’ve worked jobs that Social Security covers, there’s a table available online that tells you for around how long you must have worked to meet the first condition. This is known as a test of the duration of work. There’s also a recent work test that is required for benefits.
Meeting the second part of the criteria to qualify—having a disabling condition—is much more difficult.
3. SSDI vs. SSI
If you’ve not worked enough to qualify for SSDI, you might qualify for SSI. The SSI program is to help people who are disabled, elderly, or blind and who aren’t working and haven’t worked for a long period of time. The medical requirements are the same. That means you must have a significant physical or mental condition preventing you from working.
There are differences in the programs.
SSI is needs-based if someone has limited income and resources. SSDI, by contrast, is based on work history.
The monthly benefit for SSI is capped at a relatively low amount, while SSDI benefits are based on how much you worked and your earnings.
In most states, an SSI beneficiary will also qualify for Medicaid. An SSDI beneficiary can receive Medicare after two years of disability payments.
4. Qualifying Medical Conditions
The Social Security Administration maintains a limited definition of disabled. The conditions are judged by state-operated agencies known as Disability Determination Services.
The conditions that have to be met for benefits include being unable to do the same work you did before you were disabled, being unable to do other jobs, and having a disability expected to last more than a year or lead to death.
SSDI pays just for total disability. You can’t get partial or short-term SSDI disability benefits.
When you apply, the SSA reviews your application to see if it meets the general requirements. Then, SSA sends the application to the Disability Determination Services office in your state. That office investigates whether your medical evidence supports your claim for disability. The DDS office will consider evidence from health care providers, tests, treatments, and your ability to do activities related to your work.
Once the evidence is reviewed, a state agency decides on qualification. If your claim gets approval, you’ll receive a letter that will tell you when your payments start and your amount of benefits. If you’re denied, your letter will tell you why. It will include instructions on appealing your denial.
5. Applying for SSDI
You can apply for SSDI online, in person at a local Social Security office, or by phone. You need to be well-organized if you’re doing it on your own because the application is tedious.
The first step is to get all the relevant medical and personal information related to your disability. You’ll need documents of your work history as well.
From there, you’ll complete a disability report. A disability report includes all of your treatment information with contact information for providers, and you’ll need a list of jobs you held for the 15 years before you became unable to work.
Once you get all of your information together, you can fill out your application and report online.
To improve your chances of approval, you might include more information than what’s required. For example, you can submit details on the physical and mental job requirements and how your condition limits you from these duties. You can also create a written report with anything you think is relevant to your case.
6. Receiving Benefits
If you’re approved for SSDI benefits, they’re supposed to replace a portion of your yearly salary. The more you earned when you were working, the higher your SSDI benefits up to a limit. If you’re approved, you receive a monthly check based on a formula taking into account how long you worked, your average earnings, and the age when you became disabled.
Checks that are paid monthly range from under $1,000 up to more than $2,400.
On average, monthly checks are around $1,111.
What you receive is also impacted by the credits you earned during your employment. You can receive up to four credits a year as a worker, based on your earnings.
Finally, most people, they’ll keep collecting benefits as long as they’re disabled. You could lose benefits if your health improves to a point where you aren’t disabled anymore or you begin to earn over a certain amount each month.