Social Security may provide you disability benefits if you suffer a medical condition that prevents you from working full-time, whether the condition is physical or mental in nature.
The eligibility requirements, application process, and appeals process can be confusing. We are here to guide you through the process and provide you with the information you need to make an informed decision.
There are several federal programs that assist individuals with disabilities, but Social Security Disability Insurance and Supplemental Security Income are by far the largest. These two programs are administered by the Social Security Administration. Under either of these programs, only those with disabilities and those meeting certain medical criteria can receive benefits.
What are the two programs?
Social Security Disability Insurance (SSDI) provides benefits to you and certain members of your family. These benefits are paid for if you have been paying in social security taxes and have worked long enough.
Supplemental Security Income (SSI) pays benefits based on an individual’s financial needs.
Who qualifies for SSDI?
Funding for the SSDI program is through the Social Security Fund, to which all workers are required to contribute throughout their working years. The amount of the contribution to FICA (Federal Insurance Contributions Act) that is deducted from your income depends upon how much you earn, so everyone makes different contributions.
To qualify for payments under SSDI for yourself and certain family members, you or your spouse must have made contributions to FICA. If you are a minor, you may qualify for SSDI if one or both of your parents’ made contributions to Social Security. There are however age requirements that define the eligibility of minor and adult children. If a disabled adult's disability began before the age of 22 and their parents were receiving retirement or disability benefits, they might be entitled to benefits.
There are important details of the required “work” contribution to qualify for SSDI benefits. For example, there is a system of "work credits" that depends upon how much you earn in a given year from which FICA contributions are deducted. How many credits you need to qualify for SSDI, and how much work earns you a credit, changes year by year and also depends upon your age when you became disabled. In general, however, you need 40 work credits, with 20 of them earned in the 10 years preceding the year that your disability began. Younger workers may need fewer credits to qualify.
The other necessary qualification is your disability or blindness itself. These are Social Security's "disability criteria." What is called the Social Security "disability determination process" requires current and complete medical evidence and other information for the evaluation of your claims.
Generally speaking, SSDI is available if you have physical and mental impairments that prevent you from working in your normal occupation or doing any other "substantial work."
Who qualifies for SSI?
Supplemental Security Income is a federal program funded by general tax revenues not social security taxes. This program provides benefits to adults and children with disabilities or blindness, who also have financial limitations. You can also receive benefits if you are 65 and older without a disability and meet the financial qualifications. The benefits received by qualifies individuals are meant to cover basic needs such as food, clothing and shelter. Based on your living arrangements and income, your monthly payments will vary.
Comparing SSDI and SSI
Some additional notes on SSDI benefits
- Medicare provided hospital insurance (Part A), supplementary medical insurance (Part B), Medicare Advantage (Part C) and Prescription drug benefits (Part D) are also included. Here is more information on Medicare.
- The monthly amount of your payment is based on the lifetime average earnings upon which you or your spouse made Social Security payments.
- SSDI may reduce your monthly payment if you are collecting Workers' Compensation payments or public disability benefits.
- Your other financial resources do not reduce what you receive monthly.
- If you reach retirement age and are still receiving SSDI disability benefits, they convert to retirement benefits automatically and the amount doesn't change.
Some additional notes on SSI benefits
- Your application for benefits must provide information on your income and your degree of disability. We can assist you with making these determinations and submitting the required forms.
- The medical benefit is Medicaid, the health insurance program for those with limited income and other resources. It covers children in certain circumstances and the aged, blind, and disabled. To be eligible, you must meet requirements to receive federally assisted income-maintenance payments.
- The law allows a state to decide on eligibility standards and types of services under Medicaid. But evaluation of your disability qualification for SSI is the same as qualification for SSDI payments.
How do I apply for SSDI or SSI?
A physician will need to examine you to meet the requirements of evidence of disability.
You are not required to be represented by a lawyer to obtain SSDI benefits. Many people handle their own application, supported by a site like this.
You do have a right to be represented, though, in dealing with the Social Security Administration. It does not need to be a lawyer. Any disability advocate who is not a lawyer must meet certain Social Security Administration requirements. The SSA will work directly with your representative. Using guidance available on this site, most people can prepare and file their own application to SSDI, SSI, or both. A lawyer becomes more important if the SSA makes a decision on your initial claim with which you disagree and you need to prepare an appeal.
If you are applying for both SSDI and SSI, called "concurrency," then help may be more important. Find additional information on this site and ask for help.
Help with the application process
The site Social Security Disability.com lists these steps to take in the application process:
- You begin by indicating your intent to file by filling out an application online or obtained from your local Social Security office.
- You verify that your FICA contributions qualify you for benefits. Usually, your employer can do this.
- You prove your disability. The SSA has a "Bluebook" listing adult conditions and childhood conditions that are qualifying.
- You get from your doctor records of your medical condition.
- SSDI responds to your claim within 30 to 90 days of submitting your claim. If it is approved, you should start receiving benefits in 90 days.
- If your claim is denied, you can appeal the decision at a hearing. This is the step at which a disability attorney can be important.
For information and assistance with any questions about SSDI—you can turn to My Eligibility Resource for accurate, current information on programs to meet the needs of you and your family and how to apply successfully and overcome any unexpected problems.
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