What you need to know when you get social security disability benefits?

Contents

Once I am approved, will I continue to receive disability benefits forever?

You have just been approved for Social Security Disability benefits and you finally let out a long sigh of relief. You have probably been through the ordeal of a Social Security Disability appeal and couldn’t be happier that the process is finally over. The question on your mind now is probably whether or not you will continue to receive those Social Security Disability payments indefinitely, or if they will stop at some point in the future. The answer isn’t the same for all Social Security Disability recipients.

When you are awarded Social Security Disability benefits, your case is categorized into one of three categories including Medical Improvement Expected (MIE), Medical Improvement Possible (MIP) or Medical Improvement Not Expected (MINE). Which of these categories your particular case falls into depends on when you will be receiving continuing eligibility reviews and how long your Social Security Disability benefits will continue.

If your case is labeled as MIE that means the SSA expects that your condition will improve and you will be given a continuing eligibility review in approximately six to eighteen months. If during that review it is determined that your condition has improved and you are able to return to work, your benefits will be discontinued. If your condition has not improved at the time of your review, your Social Security Disability payments will continue and you will receive another review in another six to eighteen months.

If your case is labeled as MIP, that means the SSA believes that it is possible that your condition will improve but is not likely. In this case, you will be given a continuing eligibility review in approximately two to five years. If, at the time of this review, your condition has improved and you are able to return to work, your benefits will stop. If you are unable to return to work and your condition has not improved, then you will continue to receive Social Security Disability payments and will be up for review again in another 2 to 5 years.

If your case is labeled as MINE that means that the SSA does not think your condition will ever improve. You will still undergo continuing eligibility reviews, but those reviews will be conducted approximately every 5 to 7 years. As long as your condition does not improve, you will continue to receive Social Security Disability benefits until you reach retirement age, at which point your disability benefits will convert over to Social Security Retirement benefits.

It is important to note that even if the SSA’s continuing eligibility review determines that you are able to return to work, you can appeal the decision. During this appeal you will be able to continue receiving your monthly Social Security Disability benefit payment. However, if the appeal results in the SSA determining that there was no validity to the appeal and you are denied, you may have to pay back the money you received from the SSA while you were undergoing the appeal process.

For those who suffer from severe and permanent disabilities, there is no “expiration date” set on your Social Security Disability payments. As long as you remain disabled, you will continue to receive your disability payments until you reach retirement age. At that point benefits convert to retirement benefits and are payable until death.

Does Disability Pay More than Social Security?

Applying for Disability benefits has a reputation as a time-consuming and inefficient process. Consequently, many people entering their 60s who could potentially qualify for disability benefits may opt to just elect for Social Security a couple of years early to avoid the hassle. However, this strategy has the potential to cost you a lot of money in the long run. Whether opting for disability would be the more remunerative strategy will depend on your age.

To be clear, when we say “Disability,” we mean Social Security Disability Insurance. If we say “Social Security,” we’re referring to Social Security Retirement Benefits. Additionally, the analysis presented here is based on the assumption that you are eligible to begin receiving either of these benefits, and therefore are at least 62 years old. If you’re younger than that, you’re not eligible to begin receiving Social Security benefits. In this case, your only option is to take disability.

Calculating Your Benefit Amount

The formula for calculating your Social Security benefits and your Disability benefits is exactly the same right up until the very end. We’ll get into how it diverges in the next section, but for now, we’ll focus on the shared process.

The first step is calculating your average indexed monthly earnings (AIME). The Social Security Administration (SSA) will take your 35 highest-earning years into consideration. For each of those years, it will index your income for inflation and include it up to the taxable maximum (the point at which you stop paying Social Security taxes). In 2019, this point is $132,900.

Next, the SSA will add up these totals and divide to get your AIME. If you have more than 35 earning years, your lowest years will be excluded. If you have less, the SSA will include a $0 in the calculation for every year you’re short.

The last step is to calculate your primary insurance amount (PIA) from your AIME. To calculate your PIA, the SSA will take a percentage of three different chunks of your AIME. The exact amount of these portions will differ slightly depending on the year you become disabled or turn 62. If you do either in 2019, the SSA will take 90% of your first $926, 32% of the amount between that and $5,583 and 15% of anything that remains. The total is your PIA.

When Does Disability Pay More than Social Security?

Your PIA is the amount you’d receive if you were to qualify for disability benefits. It’s not that simple with Social Security benefits, however. While you’re technically eligible to begin taking Social Security benefits at age 62, you won’t receive your PIA until your full retirement age (FRA), which will fall somewhere between 66 and 67. At 62, your benefit amount would be only 70% of your PIA, increasing gradually until you reach your FRA.

This means that between 62 and your FRA, your disability benefit would be higher. And there’s an additional benefit to taking disability: By electing for disability instead of Social Security, you allow your Social Security benefit to continue growing.

This disparity is even greater if you happen to become disabled after you turn, say, 63. The reason here is that your Social Security benefits will be determined by your PIA for the year you turn 62, while your disability benefits would be calculated with your PIA for the next year. Provided your AIME is the same or higher, then your PIA for the later year will be higher.

When Does Social Security Pay More than Disability?

The reverse of the above situation is if you are between your FRA and age 70. After you reach your FRA, your Social Security benefit amount increases by 0.8% for every month you hold off on electing. This continues until you reach 70, at which point your benefit reaches its maximum. In this situation, your monthly Social Security benefit would be larger than your monthly Disability benefit.

The Takeaway

It’s easy to get lost in all the different acronyms and calculations that come along with Social Security benefits. However, if you’re wondering if Disability would pay more, just ask yourself where you are relative to your full retirement age. If you’re under it, disability will be higher. If you’re above it, Social Security will be higher. Just like with any other Social Security issue, the way you can optimize your experience is by thoroughly understanding all of your options.

Tips for Navigating Social Security

  • A financial advisor can help you account for the various sources of retirement income, including Social Security benefits. Finding the right financial advisor that fits your needs doesn’t have to be hard. SmartAsset’s free tool matches you with financial advisors in your area in 5 minutes. If you’re ready to be matched with local advisors that will help you achieve your financial goals, get started now.
  • If you’re applying for Social Security disability benefits, you’ll need to fill out form SSA-827. This provides your consent for the SSA and Disability Determination Services (DDS) to view your medical records.
  • Dealing with a disability, either temporary or permanent, is hard enough without considering the financial impact. Having an emergency fund in place for unpredictable things like this can be a huge relief.

Photo Credit: ©iStock.com/Halfpoint, ©iStock.com/Dean Mitchell, ©iStock.com/

How Much in Social Security Disability Benefits Can You Get?

How much your Social Security disability benefit will be is based on your covered earnings—the wages that you paid Social Security taxes on—prior to becoming disabled. (Social Security Disability Insurance (SSDI) is the federal insurance program that provides benefits to qualified workers who can no longer work. To be eligible, you must be insured under the program and meet the Social Security Administration’s (SSA’s) definition of disabled. SSI payments, on the other hand, aren’t based on past earnings.)

Your SSDI benefit payment may be reduced if you get disability payments from other sources, such as workers’ comp, but regular income doesn’t affect your payment amount.

How Are My Benefits Calculated?

The SSA uses your Average Indexed Monthly Earnings (AIME) and Primary Insurance Amount (PIA) to calculate your benefits. The formula Social Security uses is quite complicated, and most people won’t be interested in trying to calculate their benefits on their own, especially because Social Security can give you an estimate.

To give you an idea of what you might receive, for 2020, the average SSDI benefit amount is $1,258 per month, but those whose income was fairly high in recent years can receive up to $3,011.

If you’re interested in how Social Security calculates your AIME and PIA, here’s how.

Average Indexed Monthly Earnings

First, the SSA will determine your AIME. To do this, the SSA will adjust, or index, your lifetime earnings to account for the increase in general wages that happened during the years you worked. This is done to make sure that the payments you get in the future mirror this rise.

The SSA will use up to 35 of your working years in the calculation. The SSA takes the years with the highest indexed earnings, adds them together, and divides them by the total number of months for those years. The average is then rounded down to reach your AIME.

You can see an example of how the SSA calculates an AIME on its website.

Primary Insurance Amount

Your Primary Insurance Amount (PIA) is the base amount of your benefits. The SSA uses the total of three fixed percentages of your AIME to determine your PIA. The dollar amounts that result from the calculation are called “bend points.” Bend points are changed each year to reflect the national average wage index.

The PIA for someone who becomes eligible for SSDI in 2019 is the sum (total) of the following:

  1. 90% of the first $960 of average indexed monthly earnings
  2. 32% of the average indexed monthly earnings over $960 through $5,785, and
  3. 15% of the average indexed monthly earnings over $5,785.

If the sum of the percentages isn’t a multiple of $0.10, it will be rounded to the next lower multiple of $0.10.

Check Your Statement

The easiest way to find out your benefit amount is to go to www.ssa.gov/mystatement, log in, and check your benefits statement. It will tell you exactly how much money you will receive if you become disabled this year.

Amount of Disability Backpay

By the time they get their approval letter from Social Security, most disability applicants are eligible for back payments of benefits. The number of months of back payments you’ll receive will depend on when you applied for SSDI and the date the SSA decided you became disabled (called your “established onset date,” or EOD.) The amount of your backpay depends on your monthly benefit amount.

In addition to getting payments going back to your application date, you can get up to 12 months of retroactive payments for the year prior to your application date (or your protective filing date, discussed below)—if you were disabled that long ago. You cannot get benefits for the months before your EOD (again, your disability onset date).

Five-month waiting period

Once you are approved for benefits, there is a five-month waiting period, starting at your disability onset date, before you can be paid benefits. This means that, to receive the maximum amount of backpay (going back for the 12 months before your application date), you must have an EOD of at least 17 months prior to your application date (or your protective filing date).

Protective Filing Date

You can establish a “protective filing date” (PFD) by making a written statement to the SSA that you intend on filing for disability benefits. A PFD is also established when you begin an online application, even if you don’t complete it. If you want to learn more, read our article about back payments.

Offsets for Other Disability Income

Some disability payments, such as workers’ compensation settlements, can reduce your benefit amount. These are called “offsets.” Most other disability benefits, however, such as veterans benefits or payments made by private insurance, do not affect your benefit amounts.

Cost of Living Adjustment (COLA)

Every year everyone’s Social Security benefits are recalculated to adjust to the increasing cost of living. COLA amounts are determined by increases in the Consumer Price Index (CPI).

Updated December 30, 2019

What Will Cause Your Social Security Disability Benefits to Stop?

If you’re receiving Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), it’s important to understand the circumstances in which your disability benefits might be terminated. Returning to work and experiencing medical improvement are two of the most common reasons, but several other major life changes could cause your benefits to stop as well.

When Returning to Work Can Terminate Your Disability Payments

Because Social Security’s definition of disability includes an inability to work due to medical impairments, working while receiving disability can raise red flags with Social Security.

Individuals receiving SSDI are allowed one nine-month trial work period (TWP) to experiment with working while still drawing their full monthly benefits. In 2019, monthly earnings over $880 will trigger a trial work period month. The nine months occur over a 60-month period, but the months need not be consecutive. Once you’ve exhausted the nine months of your TWP, you will no longer receive disability benefits for any month you earn over the Substantial Gainful Activity threshold ($1,220 in 2019). (Be sure you’re clear on the details regarding trial work periods before you begin working.)

Recipients of SSI will lose benefits if their income or assets exceed the SSI eligibility thresholds. In 2019, the limit is $771 per month for countable income, while the limit for assets is $2,000. Not all income from work counts toward the income limit, however (in fact, the SSA ignores more than half of your wages when counting your income). But some “in-kind” income, like free housing or food, does count against the limit, and keep in mind that some portion of spousal income and resources will be “deemed” to the SSI beneficiary. (Learn more about income limits and SSI.)

How Medical Improvement Can Lead to Cessation of Disability Benefits

If you experience medical improvement that would allow you to go back to work, Social Security may decide to terminate your disability benefits. The SSA makes this determination through a process known as a Continuing Disability Review (CDR).

If you’re selected to undergo a CDR, you’ll receive a notice in the mail from Social Security stating that your claim is being reviewed. You will be asked to provide information about your recent medical treatment and your daily activities. A disability claims examiner will review your medical records to decide whether medical improvement has occurred since your “comparison point of decision,” or the date you were last found to be disabled. If the claims examiner does not find medical improvement, the CDR is closed and your benefits continue. If the claims examiner finds that your condition has improved and that you’re able to work, you will no longer be considered disabled.

Appealing a Cessation of Benefits

You have 60 days to request an appeal, which consists of a relatively informal hearing before a Hearing Officer. At this hearing you can present additional evidence, call witnesses, and testify about your condition. If the Hearing Officer finds that your disability has ended, you have 60 days to ask for a hearing in front of an Administrative Law Judge (ALJ). Note that you have only ten days from the Hearing Officer’s decision to ask that your benefits continue while your ALJ hearing is pending.

How Often Do CDRS Occur?

While it’s impossible to predict with any certainty whether or when a CDR will occur, CDRs are usually scheduled every three years or seven years, depending on the severity of your condition and your prospects for experiencing medical improvement. Generally, the younger the disabled individual, the more likely he or she will experience a CDR. Significant earnings can also trigger a CDR, although earnings that occur during a TWP will rarely cause a review.

Sometimes when an Administrative Law Judge awards benefits, the judge will recommend a review of a case after a certain length of time (often 12 months) because medical improvement is expected. While this doesn’t always guarantee a CDR will take place, you should certainly be prepared for it by continuing to seek medical care, taking prescribed medications, and following your doctor’s treatment recommendations.

Other Reasons Your Disability Payments Might Be Terminated

Disabled Child Turning 18

Social Security will automatically review the cases of children receiving SSI when they turn 18. Benefits will be discontinued when the beneficiary fails to meet the adult standards of disability, although this decision may be appealed.

Reaching Full Retirement Age

Once you reach full Social Security retirement age, your disability benefits are automatically converted into Social Security retirement payments. Any earnings during or after the month you reach full retirement age will not reduce your Social Security retirement benefit.

Death of the Beneficiary

The death of a disability recipient (“beneficiary”) will terminate both SSI and SSDI benefits. However, if an individual was receiving SSDI and left a surviving spouse, children, or even dependent parents, survivors benefits may be available. (For more information, read Social Security Survivors Benefits After Death of a Disabled Worker.)

Significant Changes in Living Situation

Entering a nursing home, assisted living facility, or hospital may affect your eligibility for SSI, but it depends on the kind of facility and how long you’re staying. If you can demonstrate to Social Security that you will be institutionalized for 90 days or less, your SSI benefits may continue. Notify Social Security of your changed living situation as soon as possible.

Disability benefits will also be stopped for as long as a person is incarcerated, and occasionally for a felony conviction, even one that does not result in jail time. SSI recipients who are incarcerated for at least 12 months in a row will need to re-apply for benefits once they’re released.

What to Do If Your Case Is Being Reviewed

If you receive notice from Social Security that your case is being reviewed, contact an experienced disability attorney immediately. While a CDR can be a frightening prospect for a disability recipient, having a knowledgeable representative on your side will increase your chances of retaining your much-needed benefits.

Social Security Disability Insurance & Supplemental Security Income (SSDI & SSI)

How Do I Get Money from SSDI or SSI?

Gordon, Wolf & Carney fights to get the benefits their clients deserve from Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

If you are totally disabled and the disability has or is expected to continue for 12 months, you can qualify for SSDI benefits if you worked 5 out of the last 10 years (or 20 out of the last 40 quarters). However, if you haven’t worked 5 of the last 10 years (or 20 of the last 40 quarters) you may still be eligible for SSI. Call us to inquire if you may qualify for SSDI or SSI benefits.

SSDI Basics FAQs

  • How does the Social Security Administration define disability?
  • What is the difference between SSI and SSDI?
  • What are the work requirements established by the SSA and what exactly are work credits?
  • Is it possible to receive both SSI and SSDI at the same time?
  • Can I receive Social Security disability benefits and still work at the same time?
  • Is there a list of illnesses that the SSA considers disabling?
  • What is the probability of being approved for Social Security disability benefits?
  • Can I get both worker’s compensation and Social Security disability benefits?
  • Can I still qualify for disability benefits if my disability isn’t permanent?
  • Does the SSA consider a mental illness disabling?
  • If I have never worked a job before and I am disabled, can I still receive benefits?
  • I have a child who is disabled. Can my child receive disability benefits?
  • I have been taking care of my children at home and have not worked a job in several years. Do I still potentially qualify for disability benefits?
  • If I am receiving Social Security Retirement benefits, can I still receive Social Security Disability benefits as well?
  • If my application is accepted, how much money can I receive from disability benefits?

SSDI Process FAQs

  • How to apply for Social Security disability benefits?
  • What documentation is needed before applying for disability benefits?
  • Who determines If I am approved for disability benefits?
  • What is a Social Security Disability technical denial?
  • What is a Residual Functional Capacity (RFC)?
  • How long does the disability application process take?
  • What are my options if the SSA denies me disability benefits?
  • What are my chances of getting approved at reconsideration?
  • What is the appeals council?
  • What are the fees associated with representation?
  • Is it necessary to hire an advocate or lawyer to represent me in my Social Security disability claim?

Basics

How does the Social Security Administration define disability?

The Social Security Administration defines a “disability” as the “inability to engage in any substantial gainful activity by reason of any determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of no less than 12 months.”

The SSA will consider you disabled if:

  • You cannot do work that you did before
  • We decide that you cannot adjust to other work because of your medical condition(s)
  • Your disability has lasted or is expected to last for at least one year or to result in death.

What is the difference between SSI and SSDI?

The SSA runs two different disability programs, Supplemental Security Insurance (SSI) and Social Security Disability Insurance (SSDI). SSI is a financial need-based program for disabled individuals who haven’t earned enough work credits or haven’t worked at all in the past 10 years. SSDI is a disability program for workers who have earned enough work credits based on taxable employment in the past 10 years. Overall, the main difference resides in how long an individual has worked in the past 10 years.

What are the work requirements established by the SSA and what exactly are work credits?

The rule of thumb is that an individual must have worked at least 5 out of the past 10 years to qualify for Social Security Disability Insurance (SSDI). The SSA calculates this by awarding “work credits when an individual is employed and was paying Social Security taxes. Work credits are based on your income when you were working. Currently in 2019, one work credit is equal to $1,360, which will increase to $1,410 in 2020. An individual can earn no more than 4 work credits per year. To qualify for SSDI, you need to have earned at least 20 work credits in the past 10 years. If you fall below the requirement, you may still qualify for Supplemental Security Income (SSI).

Is it possible to receive both SSI and SSDI at the same time?

An individual may apply for both Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) simultaneously but can only receive one of the benefits at a time. There are some unusual circumstances in which an individual may receive SSI until becoming eligible for SSDI. However, you cannot receive both at the same time.

Can I receive Social Security disability benefits and still work at the same time?

The SSA gives out benefits based on an individual’s inability to work due to an illness or condition. The benefits are provided to compensate for the lack of “significant gainful activity (SGA).” An individual may earn a modest amount per month which will not be considered SGA. That amount currently is in 2019 is $1,220 per month.

Is there a list of illnesses that the SSA considers disabling?

The SSA provides two lists: (1) Compassionate Allowance List; and (2) Listing of Impairments. The Compassionate Allowance List is a discreet list of serious illnesses and conditions that automatically qualify as disabling without further evidence. The Listing of Impairments gives an overview of the major types of impairments that can be potentially approved for benefits. The list covers a wide selection of serious conditions but is not exclusive to these impairments. Any illness or condition, if severe enough, can potentially qualify for disability benefits.

What is the probability of being approved for Social Security disability benefits?

Due to the immense magnitude of new applications, severe budget cuts from the federal government and the unpredictable nature of the economy, the Social Security administration denies over 70% of the applications in the initial stage. The SSA might deny a valid case for several reasons including missing or not enough medical documentation, application was not completed correctly, applicant is working too many hours, etc. Approximately 12% of claimants who put in a request for reconsideration are approved and roughly 35% who put in a request for a hearing before an Administrative Law Judge (ALJ) are approved.

An effective alternative to raise your chances of approval is to seek help through a disability advocate or attorney. Disability advocates know how the social security system works and will efficiently handle your application by collecting all necessary evidence and documentation. A disability advocate will also continue to help you through the appeals process should you get denied. For more information, contact us on our contact page.

Can I get both worker’s compensation and Social Security disability benefits?

Yes, it is possible to receive both at the same time however there is a counterbalance. In the majority of states, when an individual receives workers compensation it reduces their social security disability benefits. In the minority of states workers compensations is reduced due there is approval of disability benefits.

Can I still qualify for disability benefits if my disability isn’t permanent?

The SSA considers an individual disabled under Social Security rules if their “disability has lasted or is expected to last for at least one year or to result in death.” If your disability isn’t permanent but will last more than a year, you still can qualify for disability benefits.

Does the SSA consider a mental illness disabling?

Yes but it depends if the mental illness is severe enough to qualify. Hundreds of thousands of American beneficiaries receive disability benefits for their mental illnesses. If you would like to know if your mental illness qualifies for disability benefits, feel free to contact us on our contact page or test us using the link on this page for a pre-screening evaluation at no cost.

If I have never worked a job before and I am disabled, can I still receive benefits?

Yes. Even if you have never worked in your entire life or worked very little, you may qualify for Supplemental Security Insurance (SSI) benefits as long as you don’t exceed the SSA’s limits in unearned income and assets.

I have a child who is disabled. Can my child receive disability benefits?

Potentially. If your child is under 18 years old, your child may qualify for Supplemental Security Insurance (SSI) benefits as long as you (the parents) don’t exceed the SSA’s limits in income and assets. If your child is over the age of 18, your child may qualify for SSI while completely disregarding the parent’s income and assets. If you have questions about disability benefits for your children, contact us on our contact page or text us using the link on this page.

I have been taking care of my children at home and have not worked a job in several years. Do I still potentially qualify for disability benefits?

Possibly. If you haven’t worked much or not at all during your lifetime, you may qualify for Supplemental Security Insurance (SSI) benefits as long as you don’t exceed the SSA’s limits in income and assets. If you have worked 5 out of the past 10 years or earned enough work credits in the past 10 years by the SSA’s standards, you may qualify for Social Security Disability Insurance (SSDI).

If I am receiving Social Security Retirement benefits, can I still receive Social Security Disability benefits as well?

In most instances, you cannot receive Social Security Disability benefits and retirement benefits at the same time. If an individual has been receiving disability benefits and has reached full retirement age, the SSA simply takes your disability benefits and transfers it to retirement benefits. The check will continue to be the same amount as your disability check, which is larger than a normal retirement check.

If my application is accepted, how much money can I receive from disability benefits?

The SSA determines the amount of benefits one receives by reviewing that individual’s past work history, the amount of income received, and the current household situation. In April of 2015, the national average SSDI payment given out to beneficiaries was $1,165 while the national average SSI payment was $541. The maximum payment allowed for SSDI in 2019 is $2,861. The maximum payment for SSI in 2019 is $771 and will increase in 2020 to $783.

Process

How to apply for Social Security disability benefits?

To apply for disability benefits, an individual may go to the nearest Social Security office and wait in line (can be up to a couple hours at times) to file a claim in person, call the closest Social Security office and schedule a telephone interview, or file online. Filing through the SSA can be a frustrating and difficult task; an attorney can be of significant assistance in filing your application. To learn more about using a lawyer to assist with applying for disability benefits, contact us on our contact page or text us using the link on this page.

What documentation is needed before applying for disability benefits?

SSA will request your medical records from the doctors you identify in your application. Missing important documents, however, can result in an incomplete application that will be delayed or rejected. It is important to inform your doctors and medical experts of your intentions to apply. Your doctors should have all information and medical records that directly relate to your disability(s). These documents are necessary to support your claim and will help for a quick and timely response. For more information about documentation, contact us using our contact page or text us using the link on this page.

Who determines If I am approved for disability benefits?

Social Security Disability claims are sent to your state’s local Disability Determination Services Office (if your state has one) to be evaluated by a disability examiner working with a doctor. If the claim is denied and the claimant asks for reconsideration, the claim is sent through the same exact process but with a different examiner and doctor. If denied again and the claimant wants to appeal, the case is sent to an Administrative Law Judge for a final decision.

What is a Social Security Disability technical denial?

Over 27% of initial applications are denied before even being reviewed due to what is called a “technical denial.” A technical denial occurs when an applicant does not meet the general, non-medical requirements for disability benefits. Below are some common reasons for technical denials:

  • Not enough work history was shown for proper eligibility.
  • The claimant is currently working over the allowed limit.
  • The claimant is receiving too much in earned and/or unearned income.
  • The claimant has too much in assets.

The other 45% of Americans that are initially denied up to 52% have qualifying cases but the SSA denies them in hope that the claimant will not pursue an appeal saving the federal government money. The entire approval process may be extensive; but statistically a majority of claimants who face initial denials are awarded benefits later in the appeal process. An attorney can be of valuable assistance in successfully navigating this process.

What is a Residual Functional Capacity (RFC)?

Residual Functional Capacity (RFC) is the maximum work amount an individual is capable of despite their impairment(s). When your case is sent to the Disability Determination Services (DDS), a disability examiner and medical consultant will complete an RFC assessment on your claim. Based on medical record and work history, the consultant will determine your functional limitations, physical capabilities, and job restrictions. You may choose to have your own physician(s) fill out the RFC form if they are willing to do so. This provides an advantage because your physician(s) will be more knowledgeable about your impairments then the DDS consultant who never meets you in person.

How long does the disability application process take?

Disability claims can take a long time. The initial application process takes approximately 4 to 6 months for the initial decision. If denied, an individual has 65 days to file a request for reconsideration and will take approximately another 2 to 4 months to receive a decision from the SSA. The application processing time varies depending on your medical condition(s), documentation provided, and whether or not you were denied and would like to file an appeal. If your claim is denied on reconsideration, the appeal to an Administrative Law Judge can take 18 months or longer to schedule a hearing and obtain a written decision.

What are my options if the SSA denies me disability benefits?

When an applicant is denied at the initial stage, they have exactly 65 days from the letter of denials date to file a request for reconsideration. If an applicant waits more than 65 days to file an reconsideration, they will have to start the whole process over with a new application. If you are denied at the request for reconsideration level, you have another 65 days to file an appeal. If you need help filing an appeal or starting a new application, contact us on our contact page or text us using the link on this page.

What are my chances of getting approved at reconsideration?

Approximately 84% of applicants who file a request for reconsideration are denied. This means around 16% of the applicants who file a request are approved at the reconsideration stage.

What is the appeals council?

The Appeals Council is the last administrative decisional level for SSDI and SSI claims. The council consists of “approximately 71 Administrative Appeals Judges, 46 Appeals Officers, and several hundred support personnel.” The council reviews the Administrative Law Judge (ALJ) decisions and ensures national consistency in decision-making.

What are the fees associated with representation?

Attorney’s fees are regulated by the SSA itself and applies to all attorneys or disability advocates. The attorney receives one-fourth of the back due benefits or $6,000 whichever is less, and may require payment of actual out-of-pocket costs, but only if the claimant wins. Should the claimant lose the case, there are no fees involved and the attorney or advocate incurs all costs.

Is it necessary to hire an advocate or lawyer to represent me in my Social Security disability claim?

Assistance from an advocate or lawyer is not necessary. Individuals can go through the whole process themselves if they desire. However, statistically over 75% of applicants who apply on their own are denied even if their disability claim is valid. This happens due to several reasons including missing or not enough medical documentation; applicant didn’t complete the application correctly, etc. Legal assistance can significantly increase a claimant’s chances of approval. If you would like to learn more about having one of our lawyers assist with your claim, contact us on our contact page or text us using the link on this page.

Where Can I find more information?

Contact the Social Security Disability Team at Gordon, Wolf & Carney at 410-825-2300

The Social Security and Supplemental Security Income disability programs are the largest of several Federal programs that provide assistance to people with disabilities. While these two programs are different in many ways, both are administered by the Social Security Administration and only individuals who have a disability and meet medical criteria may qualify for benefits under either program.

Social Security Disability Insurance pays benefits to you and certain members of your family if you are “insured,” meaning that you worked long enough and paid Social Security taxes.

Supplemental Security Income pays benefits based on financial need.

When you apply for either program, we will collect medical and other information from you and make a decision about whether or not you meet Social Security’s definition of disability.

Use the Benefits Eligibility Screening Tool to find out which programs may be able to pay you benefits.

If your application has recently been denied, the Internet Appeal is a starting point to request a review of our decision about your eligibility for disability benefits.

If your application is denied for:

  • Medical reasons, you can complete and submit the required Appeal Request and Appeal Disability Report online.
    The disability report asks you for updated information about your medical condition and any treatment, tests or doctor visits since we made our decision.
  • Non-medical reasons, you should contact your local Social Security Office to request the review. You also may call our toll-free number, 1-800-772-1213, to request an appeal. People who are deaf or hard of hearing can call our toll-free TTY number, 1-800-325-0778.

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An Overview of Social Security Disability Insurance (SSDI)

Social Security disability insurance (SSDI, sometimes also abbreviated as SSD) is a Social Security program that pays monthly benefits to you if you become disabled before you reach retirement age and aren’t able to work. Some people know it as “workers’ disability.”

Eligibility for Social Security Disability

To qualify for the SSDI program, you must have worked a certain number of years in a job where you paid Social Security taxes (FICA) taxes. (If you haven’t worked long enough when you become disabled, and have low income and assets, you can apply for Supplemental Security Income (SSI) instead. Specifically, you need to have earned a certain number of work credits; you can earn up to four work credits per year.

Work Credits

How many work credits you need to qualify for SSDI benefits depends on how old you were when you became disabled. For example, if you are 50 years old when you become disabled, you need 28 work credits, or to have worked for seven years (and at least five of those years must have been within the last 10 years). For more information on eligibility for SSDI, see Legal and Financial Requirements for SSDI.

Medical Eligibility

You also must have a medical condition that meets the SSA’s definition of disability. SSDI benefits are eligible only to those with a severe, long-term, total disability.

Severe means that your condition must interfere with basic work-related activities. Long-term means that your condition has lasted is expected to last at least one year. Total disability, to the SSA, means that you aren’t able to perform “substantial gainful activity” (SGA) for at least one year. If you are currently working and make over a certain amount ($1,220 per month in 2019 for disabled applicants, $2,040 for blind applicants), the SSA will find that you’re performing SGA and that you are not disabled enough to qualify for SSDI benefits. For more information on whether you qualify medically for SSDI, see Medical Eligibility for Disability Benefits.

Approval for Disability Benefits

After you are approved for disability benefits, you won’t receive SSDI benefits until you have been disabled for five complete months, because SSDi has a five-month waiting period. If you are approved right away (for instance, because you just had a liver transplant), you would still have to wait five months for your checks to start.

However, it’s more likely you wouldn’t be approved for about six months to a year (and after at least one level of appeal). In that case, when you finally get approved, you would be paid disability backpay starting with the sixth month after your disability began (your disability onset date).

After you are paid any backpay owing, you would get a disability benefit check each month. If your household income is over a certain amount, you will have to pay taxes on your disability benefits.

Your family members may also be eligible for a partial monthly benefit. For more information, see How to Get Disability Benefits for Your Dependents.

You can keep receiving SSDI as long as your medical condition prevents you from working. The SSA will perform a continuing disability review (CDR) on your file every one to three years to determine if your condition has improved.

Denial of Disability Benefits

If your application for SSDI is denied (most initial applications are), you can appeal the decision. You have to request a review of the denial within 60 days of when you receive the denial letter. The first step of the appeal process is the Request for Reconsideration, a review of your file by a different disability claims examiner. If you are denied again, you can appeal to the next stage, by requesting a hearing with an administrative law judge who works for the SSA.

Updated February 11, 2019

Most applications for Disability Insurance are denied under this strict standard, and many workers with significant disabilities do not qualify. Between 2006 and 2008 only about 40 percent of applications were ultimately approved. The level of severity required by the disability standard is apparent when one considers how poorly workers who have been denied Disability Insurance subsequently fare in the labor market. A recent study found that among people whose Disability Insurance applications were denied by the Social Security Administration, the vast majority—70 percent to 80 percent—did not go on to work in jobs with annual earnings above the substantial gainful activity level.

Further underscoring the strictness of the disability standard are the considerably elevated mortality rates for disabled workers found eligible for benefits. One in five men and nearly one in six women die within five years of being approved for benefits. Disability Insurance beneficiaries have death rates at least three times higher than other people their age.

What other requirements are beneficiaries required to meet?

In order to receive Disability Insurance, a worker must have worked during at least one-fourth of his or her adult lifetime and during at least 5 of the 10 years before disability onset. There is also a five-month waiting period before a worker can qualify for benefits.

Supplemental Security provides assistance to people with severe disabilities who have very low incomes and assets and who either lack sufficient work history to be covered for Disability Insurance or receive only a very small Disability Insurance benefit. It is important to note that many Supplemental Security beneficiaries, although lacking the sustained work history necessary to be insured under Disability Insurance, have worked and paid into the Disability Insurance system. And others, particularly women, are not eligible for Disability Insurance because they took time out of the paid labor force to care for children or other family members.

Workers must apply for and exhaust all other available benefits before qualifying for Disability Insurance or Supplemental Security. Accordingly, Social Security’s disability programs serve as a true last resort for people with severe disabilities and little to no ability to work.

How common is it for beneficiaries to return to work?

Both Disability Insurance and Supplemental Security provide incentives for beneficiaries to work. Disability Insurance beneficiaries are encouraged to work up to their full capacity and can earn an unlimited amount for up to 12 months without losing any benefits. Beneficiaries who work for more than 12 months and have earnings above the substantial gainful activity level cease to receive a monthly benefit. If at any point in the next five years their condition worsens and they are not able to continue working above the substantial gainful activity level, however, they are eligible for “expedited reinstatement” of their benefits. This means they do not need to repeat the entire, and typically lengthy, disability-determination process that they initially went through to qualify for benefits.

Supplemental Security beneficiaries who are able to work are encouraged to do so as well. Their benefits are reduced based on their earnings—after the first $85 of earnings each month, which is not counted against the benefit—but by only $1 for every $2 of earnings. Beneficiaries who are able to do some work will therefore always be better off with both earnings and a reduced benefit than just the benefit alone.

Supplemental Security beneficiaries who are able to sustain work above the program’s income limit can generally do so without risk of losing the health insurance that they receive through Medicaid. Moreover, if their condition worsens and they no longer have earnings above Supplemental Security’s income limit, they can start receiving benefits again without having to go through the initial disability-determination process.

These incentives are helpful for beneficiaries who are able to do some work or whose conditions improve. Due to the program’s strict disability standard, however, most beneficiaries have such severe impairments and health conditions that they are not able to work at all—and most beneficiaries do not have earnings.

The best available data on annual employment rates among working-age beneficiaries of Disability Insurance and Supplemental Security come from a recent report that linked Social Security data and earnings records in 2007, before the onset of the Great Recession. This report found that 16.9 percent of all disability beneficiaries worked at some point during the year. Disability Insurance beneficiaries were somewhat more likely to have worked than Supplemental Security beneficiaries: 19.5 percent of the former worked during the year, compared to 12.6 percent of the latter. The vast majority of beneficiaries who did work had extremely low earnings—just 2.9 percent earned more than $10,000 during the year.

How have the number and share of people receiving disability benefits changed over time, and what accounts for these changes?

There has been little change over the past two decades in the share of nonelderly adults receiving Supplemental Security due to a disability. In 2011, 2.4 percent of nonelderly adults received Supplemental Security for a disability, compared to 2.1 percent in 1996. This comparison does not, however, take into account demographic and economic changes, particularly the aging of the population and the increase in poverty, which both have increased the number of people who are potentially eligible for Supplemental Security.

Controlling just for income, participation in Supplemental Security by working-age adults who are potentially eligible because of low income has actually declined over the past decade and a half. In 2011 there were 17.6 nonelderly adults receiving Supplemental Security for every 100 nonelderly adults with incomes below 100 percent of the poverty line, compared to 18.5 nonelderly adults in 1996. In other words, the number of nonelderly adults receiving Supplemental Security grew at a slower rate than the number of nonelderly adults with very low incomes.

The share of nonelderly adults receiving Disability Insurance has increased over time. This is largely due to demographic factors, including:

  • The aging of the Baby Boom generation: Disability risk increases considerably with age—an individual is twice as likely to be disabled at age 50 as he or she is at age 40, and twice as likely at age 60 as at age 50. As a result, a workforce with a greater share of workers in their 50s and early 60s will include many more workers with severe disabilities.
  • The long-term increase in women’s employment, which means more women are meeting the work-history standard required to qualify for Disability Insurance: Since 1980 the share of working-age women who meet the work-history standard for Disability Insurance has increased considerably, from 50 percent to 68 percent.

Because these demographic factors are so important, the preferred way to assess trends in Disability Insurance is by looking at the “age-sex adjusted disability prevalence rate” used by actuaries at the Social Security Administration, since it controls for changes in the age and sex distribution of the insured population. The disability-prevalence rate, adjusted for age and sex, was 4.5 percent in 2011, compared to 3.5 percent in 1995.

A number of factors account for this one-percentage-point increase in the disability-prevalence rate after accounting for the changes in the age and gender distribution of the workforce, including the following:

  • The increase in the Social Security retirement age means that more people who would have received Social Security as retirees under previous rules are now receiving Disability Insurance. About 5 percent of Disability Insurance beneficiaries are now ages 65 or 66.
  • Among workers who are insured for Disability Insurance, the gender gap in rates of receipt of Disability Insurance has closed. Until the mid-1990s women who met Disability Insurance’s work-history test were substantially less likely than men to receive benefits on their own work records. Since then the gender gap has narrowed steadily and now no longer exists. A factor here may be the overall increase in female “breadwinners”—women who earn as much as or more than their husbands.

Finally, declining job opportunities for older workers, particularly older workers with severe physical limitations, have likely contributed to the increase. Currently, the number of U.S. jobs is roughly 10 million below the number we need to reach prerecession employment levels while also absorbing the people who enter the labor force each month. It is important, however, to not overstate the impact of the Great Recession or of economic recessions generally. While the economic downturn is believed to have led more unemployed workers to apply for Disability Insurance, the program’s stringent disability standard bars the door to benefits for most of them.

Why is there a shortfall in the Disability Insurance trust fund, and what can be done about it?

As described above, Disability Insurance is funded by a dedicated share of payroll tax contributions—0.9 percent of taxable wages paid by workers and the same amount by employers. Since the mid-1990s the Social Security Administration has consistently projected that the Disability Insurance trust fund would have sufficient reserves to cover all scheduled benefits until 2016, but that after that date, additional funds would be needed to avoid a shortfall in the necessary funds to continue paying full benefits. If no action is taken to address the shortfall, the Disability Insurance trust fund will only be able to pay 80 percent of scheduled benefit levels after 2016.

Congress has addressed similar shortfalls—in both the Disability Insurance trust fund and the Old Age and Survivors Insurance trust fund, which pays retirement benefits—nearly a dozen times in the past by temporarily reallocating the share of overall payroll tax revenues that is dedicated to each trust fund. In some cases, they have reallocated funds from the Disability Insurance trust fund to the Old Age and Survivors Insurance trust fund; in others, they have reallocated funds from the Old Age and Survivors Insurance trust fund to the Disability Insurance trust fund.

According to the Social Security Administration, the current shortfall could be closed through 2033 by temporarily reallocating a modest share of funds from the Old Age and Survivors Insurance trust fund to the Disability Insurance trust fund. Alternatively, the shortfall could be closed over the long term by a small—0.2 percent—increase in the payroll tax rate paid by both employers and employees.

Absent increased revenues or decreased costs, both the Disability Insurance and Old Age and Survivors Insurance trust funds face shortfalls in the mid- to late 2030s. Long-term—75-year—solvency for both programs could be achieved through an increase in the payroll tax rate from 6.2 percent for workers and employers (12.4 percent in total) to 7.6 percent each (15.2 percent in total). Another frequently discussed option is raising or eliminating the cap on earnings that are taxed for Social Security. This would mean that the 5 percent of workers who currently earn more than the cap—$133,700—would pay into Social Security through the entire year, as other workers do.

How does the United States compare with other countries?

According to a recent analysis by the Organisation for Economic Co-operation and Development, or OECD, the United States has the least generous disability-benefit system of all OECD member countries except Korea. The OECD describes the U.S. disability-benefit system, along with those of Korea, Japan, and Canada, as having “the most stringent eligibility criteria for a full disability benefit, including the most rigid reference to all jobs available in the labor market and the shortest sickness benefit payment duration.” In addition, the United States spends less as a share of its economy on incapacity-related benefits than other nations. In 2009 public expenditures on incapacity-related benefits comprised just 1.5 percent of U.S. gross domestic product, or GDP, compared to an average of 2.4 percent for all OECD nations.

Proponents of cutting disability benefits in the United States sometimes point to particular elements of disability program reforms in Europe—particularly in Germany, the Netherlands, and the United Kingdom—as potential models for changes to the Social Security disability programs. In general, however, such proposals fail to take into account that these nations have much more generous disability systems, less rigorous disability standards, higher levels of social expenditures—not just on incapacity benefits but on social assistance generally—and more regulated labor markets than the United States.

How can the Social Security disability programs be improved to increase economic security and work opportunities for beneficiaries?

Disability Insurance and Supplemental Security increase economic security for millions of disabled workers. For beneficiaries whose conditions improve, the programs also provide important incentives and supports for returning to work. Still, the programs could be further strengthened to increase disabled workers’ economic security and provide a more seamless transition for those who are able to return to work.

Modernize Supplemental Security

The value of Supplemental Security benefits has eroded considerably since the program’s inception in 1972, as the program’s income exclusions and asset limits have not kept pace with inflation and living standards. The current maximum benefit is equivalent to just three-quarters of the also-outdated federal poverty line for a single person. The general income exclusion ($20 per month) and earned income exclusion ($65 per month) have never been increased. To address this erosion, H.R. 1601, the Supplemental Security Restoration Act, sponsored by Rep. Raul Grijalva (D-AZ) and introduced in Congress in April 2013, would increase the monthly maximum benefit to $937, which is 100 percent of the current federal poverty line, and would increase the general income disregard to $110 per month and the earned income disregard to $357 a month. Increasing the income exclusions and indexing them to inflation going forward would restore the monthly benefit amount to its intended value and significantly increase beneficiaries’ economic security.

Additionally, Supplemental Security’s asset limits—$2,000 for a single person and $3,000 for a couple—have only been increased once, in 1989, and are not adjusted for inflation. These out-of-date restrictions make it impossible to maintain even a modest amount of savings, forcing beneficiaries to remain asset poor and unprotected in the event of an unexpected dental bill, leaky roof, or other unforeseen emergency expense. H.R. 1601 would address these out-of-date restrictions as well, increasing the asset limit to $10,000 for a single person and $15,000 for a couple.

Support a more seamless transition for beneficiaries able to return to work

Many disabled workers who receive disability benefits have made repeated attempts to work in spite of their impairments before finally turning to Disability Insurance or Supplemental Security as a last resort. Due to the strictness of the disability standard, many beneficiaries are terminally ill, and most are in poor and declining health. As discussed above, however, for beneficiaries whose conditions improve, the Social Security disability programs encourage beneficiaries to work up to their capacity and return to work if and when they are able, with protections in the event of failed work attempts.

But more should be done to ensure that beneficiaries are aware of the work incentives, supports, and protections that Disability Insurance and Supplemental Security provide. Additionally, consideration should be given to further enhancing these incentives, supports, and protections. Options include:

  • Make work pay more for Supplemental Security beneficiaries: Permitting Supplemental Security beneficiaries who work to keep more of their earnings by reducing benefits by $1 for every $3 of earnings, rather than the current reduction of $1 for every $2 of earnings, would provide enhanced support and encouragement for beneficiaries who are able to do some work.
  • Simplify work incentives: The disability programs’ work incentives are complicated, and it can be difficult for beneficiaries to understand how working will impact their benefits. This is especially the case for “concurrent” beneficiaries, who receive both a small amount of Disability Insurance and Supplemental Security. Demonstration projects such as the Work Incentive Simplification Pilot, or WISP, hold promise for testing major simplifications to the Disability Insurance work incentives, which would make them easier for beneficiaries to understand and less costly for the Social Security Administration to administer. The Social Security Administration’s authority to test the WISP, however, as well as other proposed demonstration projects related to Disability Insurance, expired in 2005 and has not yet been renewed by Congress. This authority, which already exists in Supplemental Security, should be renewed for Disability Insurance.
  • Support benefits counseling for disability beneficiaries: The Work Incentives Planning and Assistance, or WIPA, and Protection and Advocacy for Beneficiaries of Social Security, or PABSS, programs provide crucial support for disability beneficiaries who are considering employment and should be reauthorized on a multiyear basis. These programs inform beneficiaries about how employment will affect their disability income and medical coverage and address many of the real fears that individuals have about going to work at the risk of losing health coverage. They offer a wide range of services to beneficiaries, including information and advice about obtaining vocational rehabilitation and employment services, information and referral services on work incentives, and advocacy or other legal services that a beneficiary needs in order to secure, maintain, or regain gainful employment.
  • Provide the Social Security Administration with sufficient administrative funding to process disability beneficiaries’ earnings reports in a timely fashion: Currently, when beneficiaries report earnings, it can take the Social Security Administration several months—and sometimes even years—to adjust benefits based on the report. This late adjustment often results in beneficiaries being told that they have been overpaid benefits in past months, which they may then be required to repay. Many individuals are wary of attempting work for fear of incurring this kind of overpayment.

Shawn Fremstad is a consultant on social policy and a senior research associate at the Center for Economic and Policy Research in Washington, D.C. Rebecca Vallas is an attorney and policy advocate specializing in disability law and policy at Community Legal Services in Philadelphia.

Anyone can become temporarily or permanently disabled. In fact, many experts believe that Americans in their 20s today have about a 30% chance of experiencing a disabling condition severe enough to cause at least three months of missed work before they retire. Yet despite the significant risk of disability, most Americans have neither short-term nor long-term disability insurance.

If you sustain an illness or injury that leaves you unable to work, what can you do? One option is to apply for monthly disability benefits through the Social Security Administration, which also provides retirement benefits to seniors. However, qualifying for Social Security disability benefits can be complicated, and the bar for qualifying is set fairly high.

If you think you may come to rely on Social Security disability benefits — or if you simply want to find out how they work — this complete guide will provide the answers you need.

Image source: Getty Images.

What are Social Security disability benefits?

Social Security disability benefits are monthly payments that help support people who become too disabled to work. There are two different programs through which the SSA pays disability benefits. Those programs are:

  • Social Security Disability Insurance (SSDI)
  • Supplemental Security Income (SSI)

Although both programs use the same basic definition of “disabled,” and there’s some overlap between the programs, there are also major fundamental differences. SSI and SSDI are intended for two different groups of disabled workers; the benefits and qualifying requirements differ; and the funding sources are different.

What is Social Security Disability Insurance?

Social Security Disability Insurance is a safety net program that essentially insures workers in the case they get sick or injured and can’t work as a result. However, with SSDI, you don’t pay premiums to an insurance company. Instead, you pay Social Security taxes out of each paycheck, and a portion of this tax money goes to fund the SSDI program.

If you have a qualifying disability, you can apply for SSDI benefits. These benefits can be paid to you the entire time you’re disabled until you reach retirement age and transition to retirement benefits.

How much income does SSDI provide?

If you qualify for SSDI, the amount of income you receive is determined by your work history and the wages you earned over your career. A similar approach is used to calculate Social Security retirement benefits. As with retirement benefits, the SSA calculates your average wages over your working life and plugs that number into a formula, and the result is the amount of your monthly check.

However, with retirement benefits, the SSA looks at your average wages over the 35 years when you earned the most — but you may not have a 35-year work history if you’ve become disabled. To determine how many years of wages to consider in calculating SSDI benefits, the SSA:

  • Subtracts 22 from your current age. So, if you were 50, you’d subtract 50-22 = 28
  • Takes one-fifth of that number and rounds down to the nearest whole number. So, you’d take 1/5 of 28 in our example, which equals 5.6 and which rounds down to 5.
  • Subtracts the second number from the first. If the second number is less than two, then SSA subtracts two instead. If it’s more than five, the SSA subtracts five. In our example, the SSA would take 28-5, so it would consider 23 years of work history.

The SSA looks at your earnings over this designated number of work years (23 in our example), adjusts your wages for inflation, and calculates your average indexed monthly earnings (AIME). Once the SSA determines your AIME over the appropriate number of years, you’ll receive benefits equal to:

  1. 90% of the first $895 in AIME
  2. 32% of AIME between $895 and $5,397
  3. 15% of AIME above $5,397

This is the formula as of 2018. You can also sign into your Social Security account (or create a new one) to find out how much you’d receive in SSDI benefits if you became disabled.

As of 2018, the maximum SSDI benefit is $2,788 monthly, while the average benefit is $1,197 per month.

How do you qualify for SSDI?

To qualify for SSDI, you need to meet some basic requirements.

  • You must have earned a sufficient number of work credits.

Work credits are basically points you accumulate by earning, and paying Social Security taxes on, a certain amount of money. In 2018, you earn one work credit for every $1,320 in wages or self-employment income. You can earn four credits per year, so once you’ve earned $5,280 in taxable income in a year, you can’t earn any more credits until the next year.

The specific number of work credits you need to qualify for SSDI will vary depending how old you are when you become disabled. As a general rule, you can potentially qualify if you’ve earned at least 20 credits in the 10 years prior to becoming disabled and if you’ve earned a total of 40 credits or more.

However, if you’re younger when you become disabled, the work credit requirement is reduced based on age. For example, if you’re under 24 when you become disabled, you can become eligible for SSDI if you’ve earned at least six work credits in the three year period before your disability occurs.

If you’re between the ages of 24 and 31, you can qualify if you’ve earned work credits at least half the time between age 21 and the time you develop your disability. If you’re between the ages of 31 and 62, there’s a chart showing the number of credits you need.

  • You cannot be engaged in substantial gainful activity

“Substantial gainful activity” (SGA) is basically defined as earning at least a certain amount of income from work (earnings from other sources don’t count in determining SGA). The SGA level changes periodically. In 2018, if you earn at least $1,180 per month from working — or $1,970 per month if you’re blind — you won’t be allowed to receive SSDI, benefits because the SSA will deem you to have engaged in substantial gainful activity.

This restriction exists because the SSA wants to make sure your disability is in fact preventing you from working. If you earn a regular paycheck, then by definition you are not too disabled to work.

  • You have to meet the definition of disabled

We’ll talk about this in greater detail later, but generally, this means you need to have a serious long-term medical condition that prevents you from working. The cause of your impairment doesn’t matter — it can be the result of an accident, an illness, or any other cause. The important thing is that you meet the SSA’s specific and narrow definition of what it means to be disabled.

  • You must be unable to do any job you’re qualified for

You must be unable to do not only the job you were doing when you became disabled, but also any other job for which you’re qualified. The SSA will look at your transferrable skills to find out whether you can do any work despite your disabling condition.

In general, the younger you are, the more likely it is that the SSA will decide you have transferrable skills and can find some type of work despite your disability.

What if you don’t have enough work credits?

If you don’t have enough work credits to qualify for SSDI, it’s possible you may be able to qualify based on a spouse’s or parent’s work record. For example:

  • Widows or widowers between the ages of 50 and 60 who become disabled may qualify for widow’s disability benefits based on a spouse’s work history.
  • If you become disabled before age 22, you can be classified as an adult child and potentially become eligible for SSDI benefits based on a parent’s work history.

The Social Security Administration has more information on qualifying for benefits on a family member’s work history. If you can’t qualify based on your own work record or a family member’s work record, then you will not be able to get SSDI benefits. However, you may still be eligible for disability benefits through the Supplemental Security Income program.

What is Supplemental Security Income?

Supplemental Security Income benefits are awarded to with a disabling condition, a low income, and limited resources. Seniors over 65 can also qualify for SSI benefits.

SSI benefits are funded through general tax revenue, rather than through special taxes collected solely for the program. You can qualify for these benefits regardless of your work history, but you must have low income and few valuable assets.

How much can you receive in Supplemental Security Income?

The monthly income you’ll receive from SSI is typically lower than the monthly benefit you’d get from SSDI. It’s not based on past wages but is instead a fixed amount based on the federal benefit rate.

As of 2018, the monthly maximum SSI benefit is $750 for eligible individuals and $1,125 for couples.

How do you qualify for SSI?

You can qualify for SSI if:

  • You’re aged, blind, or disabled

This would mean you’re over 65, you’re legally blind, or you meet the SSA’s definition of disabled. The definition of disabled is the same for SSI and SSDI, and we’ll cover that in more detail later.

  • You have limited income

You can’t get SSI benefits if you’re engaged in substantial gainful activity. The definition of SGA for SSI is the same as it for SSDI, so you won’t be eligible for benefits if you earn $1,180 per month or more, or $1,970 per month or more if you’re blind.

Because SSI benefits are needs-based, there are other rules when it comes to income as well. If you have $750 per month or more in countable income, you can’t qualify for SSI. If you have some countable income, your maximum $750 monthly benefit will be reduced on a dollar-for-dollar basis.

The SSI counts only certain types income in determining whether you will receive reduced benefits or become ineligible. This includes income earned from working, workers’ compensation or unemployment benefits, the Department of Veterans’ Affairs, other Social Security benefits, or family or friends. If you’re provided with free food or shelter, this also counts as income.

However, SNAP benefits, income tax refunds, certain other government benefits, loans, grants or scholarships for tuition, and the first $20 in income received in a month are not countable for the purpose of determining whether you can get SSI benefits.

  • You have few assets

There’s also a limit on how much you can own before you become ineligible for SSI. Individuals with more than $2,000 in countable assets won’t qualify for SSI, while couples are allowed up to $3,000 in assets.

Assets or resources that are counted for the purpose of determining whether you hit this $2,000 or $3,000 threshold include cash, bank accounts, stocks, savings bonds, vehicles, land, personal property, life insurance, and other things you own that you could convert into shelter or food. However, some of your assets — such as the home you live in, one vehicle, and some personal property — won’t count when determining your resources.

If you give away your resources to fall below the asset limits, you could be disqualified from getting SSI benefits for up to 36 months.

What is the Social Security Administration’s definition of “disabled”?

To obtain disability payments from either SSI or SSDI, you must meet the Social Security Administration’s definition of disabled. This is not as easy as it sounds. For the SSA to consider you disabled, your condition must:

  • Last a year, be expected to last a year, or be expected to result in your death.
  • Significantly limit your ability to do basic activities necessary to work, such as walking, sitting, standing, or retaining and remembering information.
  • Be included in the SSA’s “Listing of Impairments” (more on that shortly) or be medically equivalent to listed conditions. This Listing of Impairments is also called the “Blue Book.”
  • Prevent you from doing any work for which you’re qualified.

More than half of all applicants for disability benefits are denied, often because their ailment does not meet this very limited definition of what it means to be disabled.

What is the Listing of Impairments?

The Listing of Impairments is a list of conditions or health problems the SSA has prepared that are usually considered severe enough to allow you to qualify for benefits. It’s divided into Part A, which lists adult conditions, and Part B, which lists children’s conditions.

Within each part, there are specific categories of medical ailments that deal with different parts of the body, including:

  • The Musculoskeletal System
  • Special Senses and Speech
  • Respiratory Disorders
  • The Cardiovascular System
  • The Digestive System
  • Genitourinary Disorders
  • Hematological Disorders
  • Skin Disorders
  • Endocrine Disorders
  • Congenital Disorders that Affect Multiple Body Systems
  • Neurological Disorders
  • Mental Disorders
  • Cancer (Malignant Neoplastic Diseases)
  • Immune System Disorders

In each of these individual subsections are diseases, disorders, and medical problems that the SSA believes may allow you to qualify for benefits. However, having a listed condition still isn’t enough. The SSA also lists specific symptoms you must exhibit or criteria you must meet to qualify for benefits based on that condition.

For example, to qualify for disability benefits based on chronic heart failure, you must be undergoing treatment and still have medically documented proof of systolic or diastolic failure. The SSA even defines exactly what it considers to be systolic or diastolic failure.

The chronic heart failure also must result in: persistent symptoms of heart failure that interfere with daily living; three or more separate episodes of acute congestive heart failure over a consecutive 12-month period; or an inability to perform an exercise tolerance test for specified reasons, such as chest discomfort.

For many listed conditions, there are extensive details about what symptoms you have to experience — and with what frequency. If your condition isn’t listed, you’ll need documented proof it causes symptoms as severe as those exhibited by patients with ailments on the Listing of Impairments.

How do you apply for disability benefits?

If you believe you meet the qualifying criteria to apply for disability benefits, you can:

  • Apply online: You can apply for SSDI benefits online if you’re over 18, do not currently receive benefits, and have not been denied benefits in the past 60 days. That said, only certain people applying for SSI benefits can apply online. You must be between age 18 and 65, and you cannot apply online if you’ve been married, if you’re blind, or if you’ve applied for or received SSI benefits before. You also must be applying for SSDI benefits at the same time.
  • Apply at your local Social Security office. You can call 800-772-1213 or contact your local Social Security office to schedule an appointment to submit an application for benefits.

What you need to apply for benefits

When you apply for benefits, you’ll need to provide some basic demographic information, including details about:

  • Your work history
  • Your current earnings
  • Your household income and household assets
  • Your bank or financial institution
  • Your current and past employers
  • Up to five jobs you’ve held over the past 15 years
  • Other benefits you may be receiving
  • Your citizenship status
  • Discharge from the military (if applicable)

You will need to provide certain documents, including pay stubs, proof of citizenship, and W-2s. Most importantly, you will also need to provide information about your disabling condition, including detailed medical records.

Providing information about your medical condition

Providing proof of your disabling condition is the most important part of applying for Social Security Disability. You will need to provide any medical records you have in your possession and give the Social Security Administration authority to access other medical records.

The SSA wants to receive information about your condition from your treating physician. This is the doctor who sees you on a regular basis. The SSA only accepts medical information from licensed physicians and prefers to have records provided by experts in the field of medicine related to your disability. If you’re applying because you have cancer, the SSA would expect to see medical records from your oncologist.

It’s imperative that your doctor fully document your symptoms and any treatments you undergo; this will give you the best chance of obtaining SSDI or SSI benefits. The Social Security Administration may also ask you to undergo an examination or evaluation with one of its doctors at some point during the application or appeals process.

How does the application process work?

When you provide details about your medical condition to the SSA, your local Social Security office reviews your basic information to see if you could potentially qualify based on income and work history.

Your file is then sent off to a disability claims examiner who will review all of your medical documentation. The claims examiner will make a decision on your case, and you’ll be notified via mail whether your claim has been approved or denied. It usually takes around a month to 90 days to receive the decision on your application.

What if your application is denied?

The denial rate for Social Security Disability benefits is very high, so there’s a significant chance your application won’t be approved. If your claim is denied, there are multiple stages of appeal, including:

  • Request for reconsideration, which means a new disability claims examiner reviews your claim again
  • A hearing before an administrative law judge (ALJ)
  • A review by the Social Security Administration’s internal appeals board
  • Appeal to a federal court

The decision not to award you benefits could be reversed at any stage of the appeals process. For example, your request for reconsideration could result in your benefits being approved and you wouldn’t need to move on to additional appeals. However, you must go through each phase if your claim continues to be denied and you want to keep fighting.

If you must appeal a benefits denial, the process of getting benefits can take a very long time. In fact, depending where you live, it may take around a year for a hearing to be scheduled. You may be able to attend your hearing via video if you’re unable to attend in person.

All of these stages of appeal take place within the Social Security’s administrative process until you get to the federal court appeal. The ALJ works for the Social Security Administration but is still supposed to impartially weigh the evidence to determine whether your claim was handled properly.

If you don’t already have an attorney and your benefits claim is denied, it’s often best to get legal representation so a knowledgeable advocate can guide you through the appeals process.

Compassionate allowance conditions

Although it generally takes a lot of time and effort to receive Social Security Disability benefits, some people who are very sick with a serious medical condition may be able to get their claims approved through a streamlined process.

This is possible if you have a Compassionate Allowance Condition, or a condition on the SSA’s Compassionate Allowance List. Listed conditions include metastatic cancers, Amyotrophic Lateral Sclerosis (ALS), Lewy Body Dementia, some genetic conditions, and a number of other serious ailments.

When you specify that you have a medical condition included on the Compassionate Allowance List, your application will be fast-tracked, and you may get a decision in as little as 10 days from the time you apply for benefits. You may also need to provide only a small amount of objective medical data, rather than having to meet extensive requirements for documenting your ailment, as most other applicants must provide.

Applying for disability benefits could provide the income you need

When you’re physically or mentally disabled due to an illness or injury, the last thing you need is to worry about your finances. Social Security disability benefits provide a secure source of income so you can provide for yourself and your loved ones. You should apply for benefits as soon as possible if you’re eligible so you will have the money you need to be financially secure and maintain the highest quality of life you can.

Staying Physically Fit When You’re Physically Disabled

Wheelchair users should focus on regular aerobic exercise that raises their heart rate and combine it with muscle-strengthening exercises to help them with the challenges they face in trying to maneuver or push a wheelchair. The combination of these two types of exercise will prevent muscle strains in the upper body that can come from the stress put on certain muscles, and help ward off weight gain, which is a chronic issue for people with confined mobility.

Many wheelchair users may not be used to a regular cardiovascular physical regimen, so it’s best to start out in small increments of 10 to 20 minutes and build from there. You’ll want to raise your heart rate and break a sweat, and you should aim to be slightly out of breath at the end of your workout. For wheelchair users, those types of activities might include swimming, wheelchair sprinting, using a rowing machine, and wheelchair sports such as basketball or badminton. The important thing is to choose an activity you enjoy, meaning you’ll be more likely to stick with it.

Strengthening activities are just as important. They will help you keep your muscles and bones strong, improve your posture and you overall physical well-being. If possible, seek out a trainer to design a program that best meets your needs and limitations. Certain trainers have been certified to work with disabled people and take their unique issues into consideration. You may end up doing a combination of free weight exercises and resistance machine training, as well as other types of related exercises to improve your core and upper body strength.

In addition to cardiovascular and strength training exercises, you may also want to build in some type of flexibility exercises as well. Sitting in a wheelchair for a long period of time can create a general sense of uneasiness, and improving your range of motion through stretching will help minimize these types of issues.

How much exercise is appropriate? Guidelines suggest that disabled or not, all adults between 19 and 64 years old should target 150 minutes a week of physical activity. This can be broken down into small time increments during the week, or longer workout sessions on the weekend. Studies have shown that the benefits are the same, regardless of how the activities are performed.

Exercise is an important component of healthy living, especially for individuals with disabling conditions.

According to the Centers for Disease Control and Prevention, adults with disabilities are three times more likely to have heart disease, stroke, diabetes or cancer than adults without disabilities.

Exercise can help minimize these risks. In fact, exercise is arguably more important for people living with a disability, as they are often less active than those without.

Not only can exercise minimize your risk for health complications, but it can help strengthen muscles, improve stamina and reduce depression/anxiety.

However, before starting any type of exercise regimen, it’s important to talk to your doctor about your options and limitations. They will be able to tell you which exercises are safe and which ones you should avoid, as well as what intensity you should stick to.

You don’t have to do strenuous workouts to reap the benefits of physical activity either. Two and a half hours of moderate exercise per week, such as a short walk, light weight lifting or adapted yoga, can be just as beneficial as one hour and 15 minutes of vigorous exercise.

It’s important to take it easy at first and work your way up. Even if you can only exercise in 10-minute increments, that’s better than nothing. Start with what you can, and then set goals to progress.

You might also look to see if your local community center has a fitness program you are interested in. Don’t be afraid to ask to meet with the instructor beforehand to discuss any concerns or limitations you may have. Oftentimes they’ll be more than happy to work with you and adapt the program to your needs.

So, next time you’re visiting your doctor, ask what exercises might be beneficial for you, and resolve to give them a try. You’ll see a difference in your health (and mood) in no time!

There are pros as well as cons to receiving social security benefits.

Should You Apply For Social Security Disability Insurance?

Suffering from an injury or an illness that leaves you disabled can have a drastic impact on your life. One of the major issues people with disabilities must face is that they are no longer able to work.

Without a source of income, this leaves many disabled people in a dire state. If you have recently suffered a disabling injury or illness, then you may want to consider applying for social security disability insurance; however, you should consider the following benefits and drawbacks of doing so first:

The Pros of Receiving Social Security Disability Insurance

Here are some reasons you should apply for SSDI if you cannot work because of a disability:

  • You will receive monthly payments – You will be provided with a portion of your last income that you can use to pay your monthly bills as well as for your day-to-day needs. These payments help safeguard against foreclosure and bankruptcy.
  • You will receive Medicare – You will receive Medicare 24 months after the date of your disability. Medicare provides you with medical insurance that helps pay for medical costs associated with your disability. Examples include medication and continual treatment. This is particularly beneficial since the medical costs of treating an injury or illness that caused your disability can be extremely expensive.
  • Private disability insurance payments do not change – If you are receiving disability insurance payments from private sources, they do not change if you qualify for social security disability insurance.

The Cons of Receiving Social Security Disability Insurance

Although receiving social security disability insurance may seem like a no-brainer for anyone that has suffered from debilitating injuries or illnesses, there are a few potential drawbacks that you should keep in mind. These include:

  • It takes a long time to process the application – It can take months to process an application. This means if you decide to apply for social security disability insurance, you shouldn’t wait until the last moment.
  • You must prove you meet disability standards – You won’t qualify if your injury or illness is resulting in a disability that is temporary. For example, if you are a waiter and you break your foot, you are ineligible for social security disability insurance. You need to have a long-term disability to qualify.
  • You cannot work anymore – You won’t be able to seek employment, even part-time employment, while you are on social security disability insurance. An exception to this is the nine-month trial work period where you can still receive benefits and also work.

For many people, there’s no choice but to apply for social security disability insurance, and the pros far outweigh the cons. However, you should definitely keep the drawbacks in the front of your mind.

Confused? Get answers to your questions. Call SSDA USA anytime at 602-952-3200 or contact us online. Feel free to use our LiveChat feature, as well. Consultations are free, so you’ve no reason to wait; contact an attorney today!

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.

SSDI Recipients Need Better Understanding of Pros and
Cons
of Debit Card

Social Security recipients participating in the Direct Express program are allowed one free ATM cash withdrawal per month from a designated ATM. They are assessed a 90-cent fee for each additional ATM withdrawal. Cardholders may be charged an additional “surcharge fee” by ATM owners outside of the Comerica Bank network, which issues the debit cards. Additionally, program participants have access to online bill payment for a fee of 50 cents per online bill payment and can receive a paper statement for a 75-cent monthly fee.
Gada advises potential cardholders to consider how they would use the debit card. For example, rather than having to pay for a cashier check or carry large amounts of cash and pay bills in person, incurring a small transaction fee for electronic bill payment may be worth it, particularly for individuals who have a difficult time getting around. However, Gada noted, individuals should check to see if the organization they are paying will assess an additional charge for accepting electronic bill payment.
On the other hand, people who are going to head for an ATM every time they need cash will find transaction fees quickly adding up to little added value.
“In these cases, it’s time to seriously consider what is preventing you from getting an account at your local bank, because that probably would be your best option,” said Gada. “Many banks offer no minimum balance checking accounts where you can have your Social Security benefits direct deposited and electronically pay bills or use their ATMs at no additional charge.”
Overcoming Banking Barriers

One of the reasons that some Social Security recipients continue to insist on paper checks is the fear that their bank accounts could be attached by creditors. However, under federal law, Social Security benefit payments are protected from attachment, meaning creditors do not have the right to take these funds from a recipient’s bank account. The same rules will apply to funds placed on Direct Express debit cards. There are a few explicit exceptions to the rules guarding against attachment of Social Security benefits. For example, Social Security funds can be taken to pay child support or alimony payments the individual owes.
“At any given time, there are likely millions of dollars in Social Security payments that are at risk because people on fixed incomes got into debt or are having a dispute with a creditor,” said Gada. “Unfortunately, they are acting on inaccurate information that has them afraid to put their money into bank accounts where it can be protected and they can be afforded other benefits of being banked.”
About Allsup
Allsup, Belleville, Ill., is a leading nationwide provider of financial and healthcare related services to people with disabilities. Founded in 1984, Allsup has helped more than 100,000 people receive their entitled Social Security Disability Insurance and Medicare benefits. Allsup employs more than 500 professionals who deliver services directly to consumers and their families, or through their employers and long-term disability insurance carriers.

Social Security Disability Benefits: Pros & Cons

Disability is a very real problem that impacts a worker’s ability to perform a job and earn a living. According to the Social Security Administration, 30 percent of all new workers will suffer from some form of disability prior to reaching retirement age. Social Security, which also provides benefits to senior citizens, regardless of their disability status, offers disability insurance to workers who would otherwise struggle with the loss of their livelihoods.

Filling Need

The Social Security disability insurance program provides money to disabled workers who need it most. Only workers who are expected to be disabled for at least a full year, or whose injuries are expected to result in death, qualify to receive benefits. These workers face at least a year out of their jobs, which puts them at much greater risk of financial hardship, including losing their homes or going bankrupt. While other disability insurance programs pay workers for short-term disability, Social Security focuses on the most severe cases.

Limited Eligibility

Social Security only pays disability benefits to workers who meet certain criteria. To determine eligibility the Social Security Administration looks at a worker’s age and employment history. Disabled workers must have worked a certain percentage of time in the past to qualify. These requirements vary based on age. For example, a 30-year-old who becomes disabled needs to have worked at least 4-1/2 years between age 21 and age 30. However, a 50-year old needs to have worked for five out of the 10 years immediately prior to the disability and a total of at least seven years since age 21.

Video of the Day

The process for activating a Social Security disability benefits claim can be slow and complex. Workers need to file a claim soon after becoming disabled and the full process can take up to five months before the first check arrives. The Social Security Administration will review the worker’s paperwork and also consult with doctors who are familiar with the worker’s condition. If the agency denies a claim, the worker may appeal it, but this adds more time to the process and may or may not result in a reversal of the decision.

Funding

Social Security disability benefits have the advantage of drawing their funding from existing sources of federal revenue. This money comes from paycheck withholdings known as FICA, or the Federal Insurance Contributions Act, and taxes on self-employed workers. The money from workers’ paychecks goes into the Federal Disability Insurance Trust Fund, where managers invest the money and increase the value of the fund to pay out benefits to workers as they become disabled. As the fund grows over time it can support more workers and pay benefits without the risk of being depleted.

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