Social Security Disability and SSI Benefits
Frequently Asked Questions
What is SSDI?
SSDI stands for Social Security Disability Insurance, also just called SSD. It is a Social Security program that will pay you a reduced Social Security benefit before you reach age 65 if you become disabled. The benefit is smaller because it is paid to you over more years than your retirement benefit. To qualify, you have to have worked and paid taxes into the Social Security system for a sufficient period of time.
I worked under the table and am now disabled, can I get SSD?
If you never paid taxes on your wages or did not pay taxes for enough years (typically, 20 out of the last 40 quarters, or 5 out of the last 10 years), you will generally not be insured for Social Security Disability benefits.
What is SSI and how is it different from SSD?
SSI is an indigent program. It uses the same medical criteria to determine if you are disabled, but you are only eligible to recieve benefits if you meet certain maximum levels for assets like cash, cars, and property. Social Security's website has a helpful pamphlet titled “What You Need to Know When You Get Supplemental Security Income (SSI)” at http://www.ssa.gov/pubs/11011.html.
How do I apply for SSD or SSI?
Please see the "How do I Apply" tab under Social Security Disability/SSI in the menu to the right of this screen.
When should I apply for Social Security Disability or SSI?
As a general rule, you should apply as soon as possible once your realize that your ability to work has been impacted by a sickness or injury.
What does it take to prove disability to Social Security, and what is the Social Security "Sequential Evaluation Process"?
Social Security's regulations (found at 20 C.F.R. §404.1520) explain that to be found disabled, a person has to prove the following things (and the government goes through these step by step):
- You cannot be engaging "substantial gainful activity.” The amount of earnings that qualifies as “gainful activity” is adjusted for growth in national wages each year. In 2008, you cannot earn more than $940 a month. If you are working at the level of “gainful activity,” you cannot be found disabled (and they will not even accept your application); and
- You must have a “severe” impairment. There must be medical signs and laboratory findings demonstrating the existence of a medically determinable physical or mental impairment that has lasted or is expected to last for a continuous period of 12 months or result in death which impacts your ability to do work related activities; and
- You meet or “equal” one of the impairments described in the Social Security regulations known as the “Listing of Impairments,” a sort of checklist for certain types of physical and mental problems. If a claimant can be found disabled at Step 3, the sequential process ends. If not, the case proceeds to Step 4. The Listing of Impairments for Adults can be found at http://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm; or
- Considering your “residual functional capacity," which is what you can still do even with your impairments, are you unable to do “past relevant work.” Past relevant work includes any work that the claimant has performed in the last 15 years; and
- Are you able to do other work within your RFC, considering your age, education and work experience, which exists in the national economy in significant numbers. Social Security's Medical-Vocational Guidelines, also known as the “Grids,” provide that the older a claimant is, the easier it is to be found disabled. The Grids can be found in Appendix 2 to Subpart P of 20 CFR 404 and are available at http://www.ssa.gov/OP_Home/cfr20/404/404-ap11.htm.
How long does it take to get approved for Social Security Disability or SSI?
Do not be surpised if the Initial Application process takes a very long time. Worse, it is extremely common for people to be denied at this level. The next step is the first appeal, and it is called Reconsideration. If you are denied at that step, you may file another appeal and seek a hearing before an Administrative Law Judge. Depending on where you live, the following processing times are not uncommon:
Initial Application: 90 to 150 days
Reconsideration: 90 days
Hearing: 18 to 26 months
If I got denied, how long do I have to appeal?
You have 60 days from the date on your denial letter (plus 5 days for mailing) to file the next level appeal if you were denied on Initial Application or on Reconsideration.
What does it mean to be insured for disability under the Social Security law?
Generally, to qualify as fully insured for Retirement and Survivor benefits under the Old Age, Survivors and Disability Insurance Program of the Social Security Act, a person must have earned at least a number of credits equal to the full number of the calendar years between the ages of 21 and 62, the age at the time of their disability, or the age at the time of their death, whichever occurs first.
What are the differences between the amount of Social Security Disability and SSI benefits?
SSD |
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SSI |
- SSD pays a monthly benefit based on the amount of F.I.C.A. payroll taxes the person has paid into Social Security over his/her working career.
- The benefit may be anywhere from one dollar per month to a maximum of $2,185 per month.
- The calculation attempts to estimate what the retirement benefit would be if the person continued working to retirement and pay that amount as the SSDI monthly benefit. 20 CFR §404.317.
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Amount of Monthly Benefit |
- Amount is set each month
- In Florida - $637 for an individual, $956 for a couple. 20 CFR §416.410; 20 CFR §416.412.
- The amount can vary depending on whether the beneficiary lives independently, lives in a board and care facility, has cooking facilities, lives rent-free, is blind, and several other factors. 20 CFR §416.414.
- Some states supplement the federal SSI payment with an additional payment raising the monthly payment.
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How do I determine how much Social Security will pay me for my Social Security Disability benefit?
Each year, Social Security sends an earnings statement called "Your Social Security Statement," which explains how much you have paid into the system, and what your different benefit levels will be for Disability, Old Age, and other benefits. You will find your benefit amounts on page 2 of that form. You can find a sample "Social Security Statement" under our FORMS link at the top of this page.
You can also go on Social Security's website, and run one of their Benefit Calculators at: http://ssa.gov/planners/calculators.htm.
How much can I earn each month and still receive Social Security Disability benefits?
In 2008, you cannot earn more than $940 a month. If you are working at the level of “gainful activity,” you cannot be found disabled. If you are earning more than that, Social Security will not even let you apply for SSD benefits.
Can I have assets or property and still get SSD or SSI?
Your assets do not impact whether you can get Social Security Disability because it is based on your earnings history and taxes you paid. SSI is a welfare program, and there are strict assets maximums that apply to be eligible. The following chart explains the differences between the 2 programs:
- SSDI financial eligibility is based solely on the Social Security (F.I.C.A.) payroll taxes.
- Resources are not taken into account
- To be eligible for SSDI, you must have paid F.I.C.A. taxes in 20 out of the last 40 calendar quarters (five out of the last ten years). If the claimant is under age 31, that number is reduced. If the claimant is over age 42, the minimum number of quarters increases approximately one quarter for each year over age 42. 20 CFR §404.130.
- As long as the claimant can meet the payroll tax payment requirement, a claimant may receive SSD benefits if they become totally disabled, regardless of what other income or wealth you may have.
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Financial Eligibility
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- Resources/assets must be less than $2,000 ($3,000 for a married couple). 20 CFR §416.1205. This includes all money in checking, savings, as well as retirement savings accounts. It also includes real estate (except your home), stocks, bonds, mutual funds, and other investments. 20 CFR §416.1201. It does NOT include one car, the residence you live in, most personal property including furniture and clothing, and certain other exempt items. 20 CFR §416.1210; 20 CFR §416.1212; 20 CFR §416.1216. 20 CFR §416.1218.
- Income is more complicated since it is related to the amount of SSI benefit a claimant is eligible to receive and that varies. Generally, the claimant’s income must be less than the amount of benefit they would be eligible to receive, and SSI will only pay the difference between the claimant’s other income and the amount they would be entitled to receive based on your residence and living situation. 20 CFR §416.1100.
- If a claimant gives money away or transfers assets at less than market value to establish eligibility for SSI or Medicaid, the claimant will be charged with the difference between the fair market value of the resource and the amount of compensation received. This can result in ineligibility for 24 months. If the transferred asset is returned, it will not be considered income, but will be considered a resource. 20 CFR §416.1246.
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If I get Social Security Disability benefits or SSI benefits, when will the payments start?
The following chart explains the differences between how each program calculates the start date for benefits:
- A claimant can receive benefits payable from the date of their application, as well as up to twelve months before the date of application. 20 CFR §404.621.
- A claimant is not eligible to receive any SSD benefits during the first five calendar months of their disability, regardless of when they apply for benefits. 20 CFR §404.315.
- The regular monthly checks for SSD come in the month following the month that you “earn” the benefit. For example, an SSD check for April will come during May. 20 CFR §404.1807
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When Monthly payments start |
- SSI benefits are payable on the first of the month that a claimant first submits their application, even if it takes several months to get approval. 20 CFR §416.501.
- For example, if a person submits their SSI application on April 14 and their claim is approved on July 25. Social Security will pay benefits from April 1 forward. Past due benefits will be sent as a lump sum payment.
- Once a claimant is approved, SSI checks arrive on the first of each month. 20 CFR §416.502.
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If I get SSD or SSI, do I get health insurance - Medicare or Medicaid?
Generally, if you receive Social Security Disability benefits, you will get an entitlement to receive Medicare Part A for free and you can purchase Part B or D. You can also opt to buy a Medicare Supplement or alternative plan. If you get SSI benefits, you typically would be eligible to receive Medicaid through your state. Here is a simple summary of the differences between the programs as it relates to health insurance:
- SSD is accompanied by Medicare, the federal healthcare plan, regardless of what state you live in. However, a person receiving SSD benefits does not become eligible for Medicare until they have received benefits for twenty-four months (29 months after date of disability counting the five month waiting period for SSD benefits). 42 CFR §406.5.
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Medical Coverage |
- SSI will vary some by state, but in almost all states, a claimant is eligible for Medicaid if they receive even one dollar from SSI. In most states, Medicaid comes automatically with approval for SSI benefits. In some states a person must make separate application with their state’s Department of Human Services. 42 CFR §435.120.
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What law does Social Security use to decide my claim?
Social Security's rules and regulations for Social Security Disability and SSI claims can be found in 4 places:
The Social Security Act (http://www.ssa.gov/OP_Home/ssact/comp-ssa.htm)
Code of Federal Regulations (http://www.ssa.gov/OP_Home/cfr20/cfrdoc.htm)
Social Security Rulings
Rulings are published under the authority of the Commissioner of Social Security and make available to the public a series of precedential decisions relating to Federal old-age, survivors, disability, supplemental security income, and black lung benefits programs. Social Security Rulings may be based on case decisions made at all administrative levels of adjudication, Federal court decisions, Commissioner's decisions, opinions of the Office of the General Counsel, and other policy interpretations of the law and regulations.
Social Security Rulings are first published in the Federal Register and are effective upon publication. Although Social Security Rulings do not have the force and effect of the law or regulations, they are binding on all components of the Social Security Administration (SSA) in accordance with 20 CFR §402.35 and are to be relied upon as precedents in adjudicating other cases. The Rulings can be found at http://www.ssa.gov/OP_Home/rulings/rulings.html.
Program Operations Manual Systems
The POMS is a primary source of information used by Social Security employees to process claims for Social Security benefits. The POMS states only internal SSA guidance. If the content of the POMS conflicts with the Social Security Act, another relevant statute, SSA regulations, or Social Security Rulings, those authorities have priority over the POMS.
Additional links to Social Security program rules can be found at http://www.ssa.gov/regulations/index.htm
What do all of Social Security's acronyms stand for?
Figuring out what all of Social Security's acronym abbreviations mean can be mind boggling. Here is a link to the Social Security website that might help: Social Security Online - Red Book.
Does Tucker & Ludin, P.A. offer free consultations for Social Security Disability benefit claims or SSI benefits claims?
Yes, Tucker & Ludin offers free consultations. Social Security Attorney John Tucker manages our Disability Benefits Team, and he or another member of our team would be happy to speak with you on the telephone at (727) 572-5000 or toll-free at (866) 282-5260.
