1. What is Social Security Disability?
If you are an American or documented worker who has worked in this country for at least 5 of the last 10 years, the deductions made for your Social Security taxes have been placed into a fund for you to be paid to you as a monthly income should you become disabled according to the social Security Administration Guidelines.
2. Who is eligible for Social Security Disability (SSD)?
If you are under the age of 65 and are disabled and have sufficient earning credits as determined by the Social Security Administration (SSA) you are entitled to Social Security Disability Income (SSDI) benefits. If you do not have enough credits to qualify for SSDI you may still qualify for Supplemental Security Income (SSI) benefits. The amount of your SSI payments will depend on the household income and assets.
3. How can I tell if I am disabled?
One can be found disabled medically or vocationally based on age, education and past work history. Medically, one is evaluated under the Social Security guidelines found in their guides to Disability Evaluation found at www.socialsecurity.gov. One can also be found disabled for approximately seventy five or more separate severe conditions found under compassionate allowances/conditions found on the Social Security Website.
Vocationally, as workers age, it becomes easier to be found disabled. If you are 45 and you cannot do any job you have done in the past 15 years and have a severe mental or physical impairment that keeps you from doing all but the easiest jobs, you should apply for Social Security Disability (SSDI) and supplemental Security Income (SSI). Younger persons and children are also eligible for benefits. The rules about social security disability are complex, however. The one sure thing that will keep you from getting disability benefits is not applying for benefits or not timely appealing a denial of benefits.
4. How Can I tell the Difference between Social Security Disability and Social Security Income?
|Issue||SS Disability (SSDI)||Supp. Security Income (SSI)|
|Disability Standard:||Same for both programs||Same for both programs|
|Source of Payment||Social Security Trust Fund||General Revenue|
|Amount of payment:||Based on worker’s earnings||Federal amount set by Congress plus state supplement, if any, set by state. State Supplement amount may vary according to living arrangement.|
|Payment to Children:||Yes, additional payment based on earnings records to children under age 18 or under age 19 and still in high school.||No increased federal payment for child; but some state SSI supplements add money for children. Otherwise, children may receive welfare, which is not counted as income; i.e., welfare does not reduce SSI benefit amount.|
|Payment to spouse:||Yes, if child in spouse’s care is under age 16 or is disabled. There is an income limit for Spouse’s payment.||No increased federal payment but some state SSI supplements add money for spouse.|
|Earnings requirement:||Fully insured (1 QC for each year after age 21): and disability insured status (20/40 rule)||None|
|Asset limitation:||None||$2,000 individual, $3,000 per Couple|
|Unearned income limit:||None||A small amount is disregarded; the rest is deducted from SSI benefit.|
|Earned income limit:||Same for both programs for claimants; SGA results in step one denial||After individual is receiving benefits, SSI has more liberal rules designed to encourage work.|
|Waiting period:||Five full months from date Of onset of disability||For applications on or after August 11, 1996, payment begins with first of month after all requirements are met. For earlier applications, payment begins with date of application if all requirements are met.|
|Retroactivity of application:||12 months if all requirements are met||No retroactivity.|
|Time limit for reopening:||4 years||2 years|
|Payment processing office:||Baltimore or regional payment center||Local Office|
|Payment applies to:||Previous month||Current month|
|Payment Date:||By birthday except concurrent cases paid on 3rd of month||1st day of month|
|Check says:||SOC SEC FOR INS.||SSI|
|Attorney’s fees:||25 percent of past due benefits withheld for direct payment (subject to statutory cap of $6,000)||No witholding.|
|Medical coverage:||Medicare begins after receipt of 24 months of benefits.||Medical coverage in most States begins with entitlement to SSI (sometimes 3 months before).|
|Eligibility of legal aliens:||Eligible||Aliens who were lawfully residing in the U.S. on August 22, 1996 are, for the most part, eligible for SSI disability benefits; but those who arrive later are ineligible with limited exceptions.|
5. Can’t I just wait or should I apply for Social Security Disability (SSDI) or SSI right away?
No matter what your circumstances, you should apply for Social Security disability benefits immediately. Social Security will pay benefits retroactively for 12 months prior to your filing date. By waiting, you may lose retroactive benefits and delay your entitlement to Medicare. Moreover, even though you have paid into the system, you are not insured forever and eligibility for SSD benefits will evaporate if you are not found to be disabled prior to your date of being last insured (usually 4 to 5 years after you were last gainfully employed). Finally, waiting may make it more difficult to gather the information that you need to support your claim.
6. How is the initial entitlement for Social Security Disabled Worker’s Benefits made?
You must have the required work credits, and your health problems must:
- Keep you from doing any kind of substantial work (described below), and
- Last, or be expected to last for at least 12 months in a row, or result in death.
7. What is “Substantial Work” and why is it important?
Generally “substantial work” is physical or mental work you are paid to do. Work can be substantial even if it is part-time. To decide if your work is substantial, SSA considers the nature of the job duties, the skills and experience you need and to do the job, and how much you actually earn.
Usually, the SSA will find that work is substantial if your gross earnings average $830.00 per month after SSA deducts allowable amounts. This amount is higher for Social Security disability benefits due to blindness
Your work may be different than before your health problem began. It may not be as hard to do and your pay may be less. However, SSA may still find that your work is substantial under their rules.
If you are self-employed, we consider the kind and value of your work, including your part in the management of the business, as well as your income, to decide if your work. If you are employed and earning over $1,000.00 per month from “work activity” you are not considered disabled.
8. If I qualify for SSDI to how much am I entitled?
Amounts generally vary but you may be eligible to receive on the average between $650.00 per month to $2,500.00 per month from the Social Security Administration and perhaps more depending on what you have paid into the system and the number of legal dependents living in your home. In December 2002, the Social Security Administration stated that the average monthly benefit for disabled workers in Florida was $838.00 and $246.00 for dependents of disabled workers. This amount has been subject to yearly COLA amounts and has increased ever since. As of November 2012, at the upper end of the spectrum (earnings of 95.000 per year or more) the maximum benefit for an individual under SSDI would be $2,515.00 per month. The maximum family benefit would be $4, 42 4.00 per month.
9. If I am found to be disabled for SSI or SSDI, will I be eligible for Medicare or Medicaid?
If you are accepted as disabled by the Social Security Administration (SSA) you will be eligible for Medicare. If you are disabled and under the age of 65, your medical bills are covered by the state Medicaid program for the first two years after you become disabled. During this time you may select coverage under an approved Medicaid HMO to reduce co-pays or out-of-pocket expenses. Your minor children and dependents may also be entitled to Medicaid coverage after you are determined to be disabled. Medicaid, to some degree, is income dependent. So, there are limitations to eligibility. This is not generally true with Medicare however.
10. If I am disabled, how will Social Security and Medicare help me?
Social Security pays retirement, disability, family and survivors benefits. Medicare, a separate program run by the Centers for Medicare & Medicaid Services, helps pay for inpatient hospital care, nursing care, doctor’s fees, drugs, and other medical services and supplies for people age 65 and older, as well as to people who have been receiving Social Security disability benefits for two years or more. Medicaid a State run federally funded program will supplement and pay for your medical case if you are disabled for your first two years of disability. Medicare does not pay for long-term care, so you may want to consider options for private insurance. Your Social Security covered earnings qualify you for both programs. For more information about Medicare, visit www.medicare.gov or call 1-800-633-4227 (TTY 1-877-486-2048) if you are deaf or hard of hearing.
11. If I decide to file for SSDI, will Social Security disability insurance help my dependents?
Yes. If you are approved for SSDI benefits, other family members may also qualify for benefits.
Generally, benefits will be available for:
• Children under 19 who have not finished high school
• A spouse who is caring for a child under the age of 16
• A spouse over age 62
To avoid unnecessary delays, apply for SSDI dependent benefits at the same time you are applying for your own benefits.
12. Can a non-citizen receive Supplemental Security Income benefits?
Yes. A non-citizen may receive Supplementary Security Income (SSI) if he or she meets the requirements of the laws for non-citizens that went into effect on August 22, 1996 and all the other requirements for SSI eligibility, such as the limits on income and resources. In general, beginning August 22, 1996, most non-citizens must meet 2 requirements to be potentially eligible for SSI:
- Be in a “qualified alien” category
- Meet a condition that allows qualified aliens to get SSI.
There are 8 categories of “qualified aliens”. The categories are:
- Lawfully admitted for permanent resident in the U.S. (“LAPR”), including certain “Amerasian immigrants”.
- “Conditional Entrants” under the law in effect before April 1, 1980;
- Paroled into the U.S. for certain reasons for a period of one year or more;
- Granted asylum;
- Deportation or removal is being withheld for certain reasons;
- Cuban and Haitian entrant under the Refugee Education and Assistance Act of 1980; or
- One of certain aliens who have been subjected to battery or extreme cruelty or whose child or parent has been subject to battery or extreme cruelty.
A “qualified alien” is potentially eligible for SSI if he or she meets one of the following conditions:
- Was receiving SSA on August 22, 1996 and is lawfully residing in the US;
- Is lawfully admitted for permanent residence and has 40 qualifying quarters of work. Work done by a spouse or parent may be counted toward the 40 quarters of work. Some restrictions may apply if the non-citizen or the working spouse or parent received certain Federally funded benefits after December 31, 1996; Important: If you entered the U.S. on or after 8/22/96, then you may not be eligible for SSI for the first five years as an LAPR even if you have 40 qualifying quarters of earnings.
- Is an active duty member of the U.S. armed forces, one of certain honorably discharged veterans, or one of certain dependents of U.S. military personnel;
- Was lawfully residing in the United States on August 22, 1996 and is blind or disabled;
- Filed for SSI within 7 years of being granted status as a refugee, asylee, Cuban and Haitian entrant, Amerasian Immigrant, or deportation or removal is being withheld.
A qualified alien in one of these categories may be eligible for a maximum of 7 years from the date status was granted. If a qualified alien in one of these categories also meets one of the conditions listed above, then SSI can continue beyond the 7 – year period. In addition to qualified aliens who must meet a condition for eligibility, there are certain categories of non-citizens who are exempt for SSI. These categories include certain Canadian-born American Indians and non-citizens members of a Federally recognized American Indian tribe.
A non-citizen may also be eligible under certain circumstances if the Department of Health and Human Services determines that he or she meets the requirements of the Trafficking Victims Protection Act of 2000.