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The United States Social Security Administration (SSA) administers four basic programs to provide financial assistance to people who cannot work because of a disability. While there are some similarities between these programs, each one is aimed at assisting a particular type of disabled person and has its own set of requirements and conditions.

We’ve answered some questions people frequently ask us about disability benefits below.

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Types of Disability Benefits

The four basic disability programs administered by the SSA are:

 

  • Social Security Disability Insurance (SSDI)
  • SSDI Benefits for Disabled Adult Children
  • SSDI Benefits for Disabled Widows and Widowers
  • Supplemental Security Income (SSI)

This program aims to help adults who worked and paid FICA taxes before becoming disabled. As an “insurance” system, SSDI benefits (sometimes called DIB) are generally only available to people who have contributed to the Social Security System. This program is often referred to as SSDI or DIB. Individuals who became disabled due to a physical and mental injury can benefit from this program.

An adult who became disabled before age 22 may be eligible for SSDI benefits based on their parent’s earnings record.

If a worker who has paid FICA taxes passes away, their disabled widow, widower, or surviving divorced spouse may be eligible for SSDI based on the deceased spouse’s earnings record.

This “needs-based” program, which is also governed by the Social Security Administration, aims to provide benefits to individuals who have little to no income or assets. You can receive SSI even if you never paid FICA taxes.

The three primary difference between SSDI and SSI are:

 

  • SSDI is for workers who have paid FICA, while SSI does not require a work history.
  • SSI is for extremely low-income/ low-asset individuals, while SSDI has a higher income limit.
  • SSDI is funded from the Social Security trust fund, while SSI is funded by general taxes.

Eligibility for Disability Benefits

To qualify for SSDI benefits, you must meet the following requirements:

 

  • You have worked recently enough and long enough to earn the required amount of “work credits”.
  • You are “disabled” based on the SSA’s definition of disability.
  • If you are working, you are not earning more than $1,260 a month (in 2020).

Work credits are based on the amount of money you earn and pay Social Security taxes on. You can earn up to four credits each year. The amount of money you need to earn to receive a work credit can change each year. In 2020, you earn one work credit for every $1,410 in earnings.

 

To be eligible for disability benefits, you must have worked recently enough and long enough to earn the required amount of work credits. The number of work credits required depends on the age you became required.

 

You can determine the number of work credits you need to qualify for SSDI benefits using the SSA’s Benefits Planner.

Under the SSA’s definition of disability, you must meet the following requirements to be considered disabled:

  • You have a severe medical condition that significantly limits your ability to do basic work such as lifting, standing, walking, sitting, and remembering for at least 12 months.
  • Your medical condition prevents you from completing “substantial gainful activity”.
  • Your medical condition is documented by a physician and included in the SSA’s current list of disabling medical conditions.

The term “substantial gainful activity” refers to both the level of activity work requires and the amount of earnings it provides. Work is considered “substantial” if it involves significant physical and/or mental activities.

 

Work is considered “gainful” if it is any of the following:

  • Performed for pay or profit
  • Of a nature that is generally performed for pay or profit
  • Intended for profit, whether or not a profit is realized.

The SSA maintains a list of medical conditions for each of the major body systems that it considers severe enough to prevent a person from completing substantial gainful activity. If your condition is not on the list, the SSA will  decide if it is as severe as a medical condition that is on the list

 

You can review the SSA’s current Listing of Impairments, also called the Blue Book, to see if your medical condition is included. There are separate listings for adult and childhood impairments.

To qualify for SSDI benefits for Disabled Adult Children, you must meet the following requirements:

 

  • Your parent is deceased or starts receiving SSDI retirement or disability benefits.
  • You are “disabled” based on the SSA’s definition of disability.
  • You became disabled before the age of 22.
  • You are at least 18 years old.
  • You are unmarried.
  • If you are working, you are not earning more than $1,260 a month (in 2020).

To qualify for SSDI benefits for Disabled Widows and Widowers, you must meet the following requirements:

 

  • You between the ages of 50 and 60.
  • You are “disabled” based on the SSA’s definition of disability.
  • You became disabled before or within seven years of your deceased spouse’s death.
  • You were either still married to your spouse at the time of death or you were divorced but had been married for at least 10 years.
  • If you are working, you are not earning more than $1,260 a month (in 2020).

Generally, in order to be considered disabled, your medical condition must prevent you from not only doing your old job, but from doing any work at all. However, if you are 50 or older and have always worked physically demanding jobs, you can still be considered disabled if you are only able to do sedentary work because of your medical condition. Similarly, in certain situations, people between the ages of 55 to 59 can be considered disabled even if they are able to perform light work, people between age 60 to age 64 may be considered disabled even if they can perform medium work.

To qualify for SSI, you must meet the following requirements:

 

  • You have very limited income and financial resources.
  • You are “disabled” based on the SSA’s definition of disability.

 

Your age is not a barrier to qualifying for SSI. Both minors and adults can qualify.

Applying for Disability Benefits

Before you can apply for SSDI or SSI benefits, you will need to gather the following information:

 

  • Your Social Security Number.
  • Your birth certificate.
  • DD-214 Form if you are a military veteran.
  • The names, addresses, and telephone numbers of doctors, hospitals and clinics, social workers, and therapists that took care of you or gave advice about your condition.
  • A detailed history of your medical treatments and examinations, with dates, where necessary.
  • A list of the medicines you are using and their dosages.
  • Medical records regarding your condition.
  • Provide Laboratory test results if you have them.
  • Give a summary of where you have worked before and the type of works you have done.
  • Provide a copy of your most recent W-2 Form or your tax return from the past year if you are self-employed.

 

If you are unable to obtain some of the items, the SSA may be able to help you.

You can start the application process for SSDI or SSI by calling 1-800-772-1213 to schedule an interview. Before your interview, you will receive a disability starter kit in the mail. This kit contains the forms and information meant to guide and prepare you for the interview. You should review your starter kit as soon as possible to better prepare for your upcoming interview.

 

You can also apply online, or in person at the nearest SSA office in your state.

The time it takes to get a decision on your application for disability benefits will vary depending on:

 

  • The nature of your disability.
  • How quickly the SSA can obtain medical records from your doctor or other medical source.
  • Whether a medical examination is necessary.
  • Whether the SSA conducts a quality control review of your application.

If your application is not approved, there are several levels of appeals offered to  you. The various levels of appeal include:

 

1. Reconsideration

A second disability claims examiner will examine your file and make a new decision.

2. ALJ Hearing

You will have a hearing before an administrative law judge (ALJ) to identify how disabling your medical condition is.

3. Appeals Council

The Appeals Council will review the ALJ’s decision and do one of the following:

  • Reverse it and grant an approval.
  • Order a second hearing be held.
  • Issue another denial.
  • Dismiss the case.
    4. Federal Court

You can file a case in federal court and continue to appeal to the Supreme Court of the United States.

Receiving Disability Benefits

Most of the benefits are based on your income when you were paying Social Security taxes before you became disabled. Your benefit amount will be based on your average indexed monthly earnings for the time you were working. This same principle is applicable for calculating the benefits for Disabled Adult Children, except the records of their parent’s contributions to the Social Security system will be used instead. Likewise, the disbursed amount for Disabled Widows and Widowers benefits is calculated based on the spouse’s contribution to the Social Security system.

 

The SSA always sends you a statement with an estimate of your disability benefits if you contribute to the Social Security system. If you do not have your statement, it can be requested from the Social Security Administration by calling 1-800-772-1213.

If you are eligible for SSI program benefits, the basic monthly payment is $698 for an individual or $1,048 for qualified couples.

If the SSA determines that you are eligible for Social Security disability benefits, there is a five-month waiting period before your benefits can begin. You can receive your first benefit payment for the sixth full month after the date your disability began

Yes. You are not prohibited from receiving payments from both programs. If you are approved for SSDI but receive low monthly payments, you may be eligible to receive both.

No, you cannot earn both at the same time. If you are receiving SSDI benefits, they will automatically convert to retirement benefits when you reach full retirement age.

Disability benefits are just one of the many government assistance programs available for disabled and low-income people. If you are eligible for disability benefits, you may also be eligible for additional local, state, and federal government assistance programs. However, in some cases, the other benefits you receive can affect financial eligibility for SSI or the monthly amount of your SSDI and/or SSI benefit payments.

Yes. The SSA has special rules that allow you to get back to work without jeopardizing your benefits. You may also be eligible for a trial work period for nine months to test if you are able to work.