The Basics of Social Security Disability

Social Security programs can be difficult to deal with. There are a multitude of programs that help a variety of different groups. So the question is, which groups do you fit into? Do you qualify for any social security programs? We know it’s confusing, so allow us from Social Security Disability Advocates USA break down the SSI and SSDI basics.

To begin, Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) are two entirely different programs. Qualifying for one program does not necessarily mean you will qualify for the other. There are different standards that you must meet for both programs. Let’s go over the differences.

Social Security Disability Insurance

Social Security Disability Insurance is a program that the Social Security Administration (SSA) oversees and funds. SSDI provides assistance to disabled individuals and their families. You pay into this program when you work via FICA taxes. There are a variety of requirements that you must meet before you qualify for SSDI.

SSDI Prerequisites

• Meet the Definition: You must meet the SSA’s definition of disabled. Partial or temporary disabilities do not qualify. You must have a disability that 1) prevents you from doing the work you did before, 2) has lasted or is expected to last for no less than one year, or is expected to result in death, and 3) prevents you from doing other types of work in addition to the work you did before you became disabled. This means that your disability must interfere with everyday activities, e.g. standing, walking, etc., to the point that you cannot make a living.
• Documents: When you apply for SSDI, you must submit 1) your social security number, 2) your birth/baptismal certificate, 3) names, addresses, and phone numbers of doctors who took care of you, 4) names and the dosages of all medicines you take, 5) medical records and test results, 6) a summary of your work duties, and 7) a copy of your most recent W-2 form.

SSDI Basics

Once the SSA determines you meet their definition of disabled, they forward your case to the Disability Determination Services (DDS) office in your state. There, you must submit all medical records for review if you want to qualify for SSDI. Disability specialists will ask your doctors about your condition, when your medical condition began, how your medical condition limited your activities, information regarding test results, and what treatment you received. They will also ask your doctors a multitude of other questions that we cannot list here.

• Work: One of the key requirements for SSDI is work. You must have worked enough and earned enough work credits to qualify for SSDI. Generally, 10 years is the minimum number of years you need to work. This is because you receive one work credit for every $1,320 in 2018, up to 4 a year. If you earn the maximum number of credits a year for ten years, you will have 40 work credits, which is generally the minimum amount. Younger people do not need as many work credits. The number of required work credits goes up with age. Working credits allow that you are “insured” under FICA regulations. In addition, your monthly SSDI benefits are based on how much you earned during your working years. Also, if you are working, you cannot earn above the Substantial Gains Activity (SGA) monthly limit. If you do earn above the SGA, you probably won’t qualify for SSDI.
• Age: You must be younger than your full retirement age. If you reach your full retirement age (generally around age 65-67), your benefits will automatically convert to retirement benefits.

The Social Security Administration will send a letter to you after a decision has been made regarding your case. If you disagree with the ruling, you can appeal it. Keep in mind, applications for SSDI take approximately five months to look over, and an application to appeal a decision can take another five months to review.

Supplemental Security Income

Supplemental Security Income is another program that the SSA oversees. However, SSI aids only individuals with low income who are blind, suffer from disabilities, or are age 65 or older. There are other important differences to take note of.

SSI Requirements

• Meet the Definition: To qualify for SSI, you must have limited income resources and be blind, disabled, or age 65 or older. In addition, you must reside in the United States or the Northern Mariana Islands, not be absent from the country for a full calendar month or more or for 30 consecutive days or more, and be either a U.S. citizen or national or a qualifying non-citizen.
• Documents: You will still need to prove to the SSA and to your state’s DDS office that you are in fact disabled and qualify for benefits.
• Work: Unlike SSDI, SSI is need-based, so work credits are not required. Because of this, though, your monthly benefit is not calculated based on your earnings. You may therefore receive less than you would if you had qualified for SSDI. Some individuals may qualify for both SSDI and SSI.
• Age: The age range is more flexible, as you can receive SSI benefits even if you are 65 or older.

With the requirements out of the way, let’s go over some other basic characteristics.

Medicaid and Medicare

Generally, people who qualify for SSI immediately qualify for Medicaid, a joint federal-state healthcare program. Medicaid is a very comprehensive health care coverage program. People who qualify for SSDI, on the other hand, qualify for Medicare two years after they qualified for SSDI. Medicare is a health care insurance program that covers most hospital visits and most primary medical care. Medicare is generally not as comprehensive as Medicaid, as there are insurance “gaps” that can be filled by purchasing supplemental coverage plans. An individual may qualify for both Medicare and Medicaid, and they will both work to make doctor’s visits and hospital bills as little as possible.

Family Benefits

Individuals who qualify for SSI do not have their benefits extended to their family. However, people with SSDI may have family members who can qualify for benefits, too. If you have SSDI, your family may qualify for benefits if 1) Your spouse is age 62 or older, 2) Aforementioned spouse is caring for your child who is under age 16 or disabled, 3) Your unmarried child (or in some cases a grandchild or step-child) is under age 18, or under age 19 if still in school, 4) Your unmarried child who is 18 or older acquired a disability for age 22.

The total disability benefit for your family is approximately 150% – 180% of your monthly disability benefits. For example, if the monthly limit is 150% of your benefit and you have two children, each child would receive 25% of your monthly benefits. This is because you receive 100% of your monthly benefits, and each child receiving 25% makes up for the remaining 50% of the limit.

Have Questions About Social Security?

If you still have questions about the SSI or SSDI basics, contact Social Security Disability Advocates today! We are available 24/7, and we are happy to answer all your questions. Call us at 602-952-3200, or contact us online and check out our LiveChat feature.

This is attorney advertising. SSDA, LLC is a group of attorneys that pursues claims for Social Security Disability benefits on behalf of its clients against the Social Security Administration. SSDA, LLC is in no way a part of the Social Security Administration. Further, the information on this blog is for general information purposes only. Nothing herein should be taken as legal advice. This information is not intended to create, and receipt or viewing does not constitute, a representative-client relationship.