The Basics About Disability Benefits
The SSDI program pays benefits to you and certain if you are insured. This means that you worked long enough and recently enough – and paid Social Security taxes on your earnings. The SSI program pays benefits to adults and children who meet our requirements for a qualifying disability and have limited income and resources.
While these two programs are different, the medical requirements are the same. If you meet the nonmedical requirements, monthly benefits are paid if you have a medical condition expected to last at least one year or result in death.
Iii: Who Receives Ssdi
Eligibility criteria are strict, and most SSDI applicants are rejected. Applicants for SSDI benefits must be
- Insured for disability benefits .
- Suffering from a severe, medically determinable physical or mental impairment that is expected to last 12 months or result in death, based on clinical findings from acceptable medical sources.
- Unable to perform substantial gainful activity anywhere in the national economy regardless of whether such work exists in the area where the applicant lives, whether a specific job vacancy exists, or whether he or she would be hired.
Lack of education and low skills are considered for older, severely impaired applicants who cant realistically change careers but not for younger applicants.
There is a five-month waiting period for SSDI, but Supplemental Security Income may be available during that period for poor beneficiaries with little or no income and assets.
SSA denies applicants who are technically disqualified and sends the rest to state disability determination services for medical evaluation. Applicants denied at that stage may ask for a reconsideration by the same state agency, and then appeal to an administrative law judge at SSA. Roughly half of people who get an initial denial pursue an appeal.
SSA monitors disability decisions at all stages of the process. SSA conducts ongoing quality reviews at all stages of the application and appeal process. Many reviews occur before any benefits are paid, thus reducing errors.
Question : Workers’ Compensation
This question asks: are your illnesses, injuries, or conditions related to your work in any way? In this context, SSA is exploring the applicants eligibility for Workers’ Compensation .
Note: Members of the military are not eligible for Workers’ Compensation from injuries received during military service. Alternatively, they may be eligible for VA disability benefits.
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Visiting Or Calling Your Local Social Security Office To Apply
While applying online is convenient, another method to complete the entire application process is by visiting your local social security office.
The closest social security office can be contacted by phone in order for an initial interview to be scheduled.
In-person and phone interviews are available at many offices.
You can find out your local SSA office and its contact information by using the SSAs Find An Office Tool.
In-person interviews allow SSA employees to ask questions that help them determine whether an applicant is eligible for benefits.
While an employee can identify basic qualification criteria , the ultimate is based upon a review of all evidence of your disability.
You should note, however, that the employee taking your application will also make observations about your appearance, as well as your ability to answer questions and complete the interview. These observations will be made a part of the claim file.
Phone interviews also give SSA employees a chance to determine which forms an applicant will need to fill out in order for their application to be considered complete.
These forms are then mailed to the applicant for completion.
While this makes it easy for applicants to understand what forms are necessary, the forms themselves often seek important information in less than clear terms.
Dealing With Medical Insurance Has Been Another Unexpected Roadblock
Filling out an application and having it approved in a timely manner would be the optimal way to go about this grueling and soul-stripping process. This process is like a huge fishing expedition into your unpleasant past. You have to gather all your medical records that detail your health journey from pre-diagnosis to after, any medical report summaries from every doctor youve ever seen, and anything else to build your case as if having a disabling medical condition means that you are guilty of something.
Newsflash: No one is at fault for getting sick, being in pain, and being unable to work like a normal person. Ive learned to accept that sometimes this just happens and its out of our control. Weve been through enough dealing with our medical conditions proving over and over again that were really disabled just adds to the burden and trauma of living with a disabling disease, especially at such a young age.
After you go through the entire process of sending in your life story, you are then told you must wait approximately two years to receive medical insurance. According to the SSA, everyone eligible for Social Security Disability Insurance benefits is also eligible for Medicare after a 24-month qualifying period. You might think of Medicare as government-issued insurance for people over age 65, but this kind of insurance can also be issued to people under 65 with disabilities. It includes two parts: hospital coverage and medical insurance.
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People Question How You Spend Your Money
Receiving disability benefits is far from winning the lottery. I get about $1,250 in my bank account every month, which is well below the poverty line. Its not enough money to buy a home, a car, or anything other big splurges that people my age buy so freely. Yet, when people see you dressed well or going on vacation, they think you have all the money in the world.
The truth is people who receive disability benefits know what its like to struggle and survive through that struggle. We know what its like to not be able to do what we want. The majority of the money goes to basic necessities such as food and bills. There isnt enough wiggle room for extras. This has forced the word no into my vocabulary a big adjustment, as I have always considered myself to be a yes person. Now I have to say no, out of necessity, to certain invitations or opportunities that I simply cant afford at that moment. Pain and hardship teach you how to budget, save, and treat yourself to something once in a while.
Wait Time For Decisions And Hearings
The amount of time it takes for an application to be approved or denied varies, depending on whether it is an initial decision or a decision based on an appeal. In fiscal year 2019, it took an average of 120 days for SSA to make an initial determination on a disability claim. The figure increased following the COVID-19 pandemic and, for months in fiscal year 2021, the average wait time for an initial decision is 165 days.
The high number of cases and long wait times for a hearing before an Administrative Law Judge has drawn significant attention from Congress in recent years. Congress provided additional funding for this workload and the number of cases and wait times have declined. In fiscal year 2020, the average wait time for a hearing was 386 days .
For some cases, SSA will expedite disability determinations. These include Quick Disability Determination and Compassionate Allowance cases. These are cases where statistical models or medical diagnoses indicate the person has an extremely severe medical condition. These cases can often be processed in under 30 days. Additionally, many cases involving military veterans are expedited.
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What Do I Need To Know About Advance Designation
You should be aware of another type of representation called .
Advance Designation allows capable adult and emancipated minors who are applying for or receiving Social Security benefits, Supplemental Security Income, or Special Veterans Benefits the option to choose up to three people in advance who could serve as their representative payee, if the need arises.
In the event that you can no longer manage your benefits, you and your family will have peace of mind knowing that someone you trust may be appointed to manage your benefits for you. If you need a representative payee to assist with the management of your benefits, we will first consider your advance designees. We must still fully evaluate them and determine their suitability at that time.
You can submit and update your advance designation request when you apply for benefits or after you are already receiving benefits. You may do so through your personal account, contacting us by telephone at 1-800-772-1213 , or at .
Social Security Disability Insurance
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Social Security Disability Insurance is a payroll tax-funded federal insurance program of the United States government. It is managed by the Social Security Administration and designed to provide monthly benefits to people who have a medically determinable disability that restricts their ability to be employed. SSDI does not provide partial or temporary benefits but rather pays only full benefits and only pays benefits in cases in which the disability is “expected to last at least one year or result in death.” Relative to disability programs in other countries in the Organisation for Economic Co-operation and Development , the SSDI program in the United States has strict requirements regarding eligibility.
People frequently confuse Social Security Disability Insurance and Supplemental Security Income . Unlike SSDI where payment is based on contribution credits earned through previous work and therefore treated as an insurance benefit without reference to other income or assets, SSI is a means-tested program in the United States for disabled children, disabled adults, and the elderly who have income and resources below administratively mandated thresholds. A legitimately disabled person of any income level can receive SSDI.
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The Online Application Process
A convenient option if you have access to the Internet is to begin the application process online.
The SSA website allows you to start the disability application process by providing basic personal information.
However, it is important to remember that medical records and other proof of eligibility status will need to be provided to and/or obtained by the SSA before an application is considered complete.
Applying online is simply a convenient starting point for the entire process. The only place to file your application online is www.SSA.gov.
Let me offer a warning there are many sites that appear official but are not associated with the Social Security Administration.
These sites will have you believe you are submitting an application for disability benefits to SSA, but you are really giving your personal information to a third party who will then attempt to have you sign a contract with them to represent you.
Please be sure that you know the difference and are making an informed choice. The only sites directly administered by the Social Security Administration are www.ssa.gov and www.socialsecurity.gov.
Please note that SSI or Title XVI applications are not accepted over the internet at this time, and you must make this application directly with your local office.
Forms Related To Social Security Disability
Here are some specific forms that must be filled out by every disability benefit applicant. These forms are used to evaluate the eligibility of each individual applicant.
Form SSA-3368-BK: Adult Disability Report you provide all of the relevant information concerning your medical conditions, medical doctors and treatment, medications, how your daily activities are affected by your disability, your educational background, and other information.
Form SSA-3369-BK: Work History Report you provide specific information on your jobs and what type of function was required of you in each job. This is used in determining what your past relevant work experience is, whether you can perform your past relevant work with your disability, and to determine what transferable skills, if any, you may have.
Form SSA-3373-BK: Adult Function Report you provide specific information about how your medical condition affects your ability to perform tasks and function.
Form SSA-827-BK: Authorization to Disclose Information to the Social Security Administration you must sign and return this form so that SSA can obtain your medical records which are used to determine the extent of your disability.
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The Proving Your Disability Part Never Stops
Even after you receive disability benefits, the proving part never stops. I have found myself constantly needing to provide explanations and justifications to everyone from my local SSA office to friends and others in my life to complete strangers.
In the beginning, everyone wanted to know why, as in, why did you go on disability? I heard this especially from older adults who seemingly wanted me to have a chance at life rather than succumb to receiving disability. Its not an easy decision to make, and sometimes you can feel like you gave up or are a failure in societys eyes.
Some friends would ask questions out of general concern, curiosity, and wanting to learn about the disability benefit process. Others would listen, but ultimately impart judgment and negativity focusing on how I could possibly afford certain things or question whether I was really in too much pain to work, since I could work from home part-time. If I had good days, they didnt understand that didnt mean I was okay to go back to work full-time.
Then there is a medical review that SSA requires, where you need to send in proof of your disability and be examined by a doctor they send you to . My review is every three years. The process used to make me nervous, but not as much anymore.
Part of whats made me less nervous about these reviews is that I have built up knowledge about what to expect. Plus, I have a lot more patience about navigating these roadblocks.
What’s The Difference Between Social Security Disability Insurance And Supplemental Security Income
While SSDI is an earned benefit based on Social Security taxes you’ve paid in during your career, you can receive SSI payments without ever having worked.
Both SSDI and SSI pay benefits to people that the Social Security Administration determines have physical or mental disabilities severe enough to prevent them from engaging in “substantial gainful activity” for at least a year or that are expected to end in their death.
The Social Security Administration generally uses the same medical criteria to determine if a disability entitles an adult to SSDI or SSI and collecting both benefits is allowed.
SSDI is an earned benefit. As with retirement benefits, it comes from paying Social Security taxes during the course of your employment. In 2022, the estimated average monthly SSDI benefit was $1,358.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
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Likelihood Of Receiving Benefits
Considering all levels of adjudication, about 4 in 10 SSDI applicants are awarded benefits. Slightly more than 50 percent of applicants who meet technical requirements of eligibility are determined to be medically eligible.
The number of cases and percentage allowed at each stage of adjudication for all types of disability cases in fiscal year 2020 are as follows:
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The Ssa Oversees Two Crucial Programs Providing Financial Support For Disabled Americans Each Designed To Benefit Different Groups
The Social Security Administration has introduced a new procedure to speed up the decision-making process for applicants with severe disabilities.
The Compassionate Allowances program identifies claims where the applicant clearly meets Social Securitys statutory standard for disability and grants them the support on the basis of a medical confirmation of the diagnosis alone.
Acting Commissioner Kilolo Kijakazi explained: Our Compassionate Allowances program allows us to strengthen our commitment by accelerating the disability application process for people with the most severe disabilities.
The SSA oversees two key programs that provide financial support to Americans with disabilities. Social Security Disability Insurance and Supplemental Security Income are both available to individuals who meet certain medical criteria but have differing requirements to qualify.
While payments for the former are based on ones work history the latter is a needs-based program. Contrary to popular belief, the severity of the recipients disability does not affect the size of the payment for either. Recipients may be eligible for both programs at the same time but receiving both, along with other income may affect the amount paid.
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What You Need For Apply For Ssdi Or Ssi Benefits
You will get a faster decision when you apply for Social Security Disability Insurance or Supplemental Security Income with the Social Security Administration if you provide:
- Your Social Security number
- Medical records from your doctors, therapists, hospitals, clinics and caseworkers
- Laboratory and test results
- Names, addresses, phone and fax numbers of your doctors, clinics and hospitals
- Names of all medications you are taking
- Names of your employers and job duties for the last 15 years
If you are applying for a child, you also need school records regarding your child’s disability.
IMPORTANT NOTE: Don’t wait to file your claim for disability payments even if you don’t have all this information.
If you think you may be eligible for payments, call 772-1213 to file a claim or contact your local Social Security Office . You must contact the Social Security Administration to apply for benefits. If you are looking for an online application for either SSDI or SSI visit ssa.gov. For an update on case status call the Vocational Disability Examiner as identified in your introductory claimant letter