A disability, illness, or medical condition that prevents you from working can induce serious anxiety that compounds an already stressful situation. Social Security Disability Insurance (SSDI) governed by the Social Security Act and Supplemental Security Income (SSI) governed by the same Act were implemented with the intent to help people just like you.
At the Law Firm of Madeline M. McIntosh we answer basic questions to help you get a fundamental understanding of SSDI and SSI benefits. Contact our office to schedule a free initial consultation and get questions specific to your situation answered.
What is Social Security Disability Insurance?
As an employee – even if self-employed – you or your employer pay Social Security Disability insurance as part of your payroll taxes. The more you work, the more you can potentially receive if you ever need to apply for disability insurance benefits.
The insurance is set up so that if you become disabled or ill later in life, you have a small cushion of income to help you through it. The monetary compensation you are able to receive through SSDI benefits is based on your work history, and is calculated based on earnings. SSDI benefits are meant to replace your earnings while you remain disabled, ill, or otherwise unable to work due to a medical condition.
What is Supplement Security Income?
SSI benefits are not based on your work history but on a limited income and limited resources. SSI benefits are meant to help you with basic needs, like:
SSI is not meant to replace income temporarily. In fact, you could receive SSI benefits long after you are no longer eligible for SSDI benefits and even when you start to work again.
Who qualifies for SSDI or SSI benefits?
Qualifications for SSDI and SSI benefits are not the same apart from one criterion: you must have been disabled for at least 12 months to qualify for either SSDI or SSI programs. In addition,
- to qualify for SSDI benefits, you must have earned an income and, as such, paid into the SSDI program with the exception of some dependents with certain disabilities who can qualify without having to have worked a day in their lives so long as they are dependents of a parent or another person who has worked and contributed to the Social Security trust fund via taxes on their earning; and
- to qualify for SSI benefits, your income or assets must not total more than a certain income ceiling established January 1st of each year (for 2020, the monthly maximum Federal amounts are $783 for individuals and $1,175 for individuals with an eligible spouse) – qualifying income and assets include $2,000, including cash, stocks, bonds, or life insurance.
This is an overview only. It is important to speak to a disability benefits attorney to confirm your specific circumstances qualify for either or both SSDI and SSI benefits. There may be a health condition that qualifies for one but not the other.
What does it mean to be disabled in order to obtain SSDI or SSI benefits?
The Social Security Administration defines disability for adults applying for disability benefits under the SSDI and SSI programs and disability for children under the SSI program.
Definition of Disability for Adults (SSDI & SSI)
When a person applies for disability benefits through SSDI or SSI programs, the definition of what qualifies as a disability is the same. Disability means a person's inability to take on any substantial gainful activity (SGA) due to a medically determinable physical or mental impairment that
1. has lasted or is expected to last for a minimum of 12 months continuously; and/or
2. is expected to result in one's death
A medically determinable impairment is an impairment flowing from
- physiological, or
- psychological abnormalities
These abnormalities must be shown by medically acceptable clinical and laboratory diagnostic techniques. The physical or mental impairment must be established by medical documents and tests and verified using standardized methods. Identification of the symptoms alone is not sufficient.
Definition of Disability in Children (SSI Only)
A child may be able to receive disability benefits under the SSI program if the child is under the age of 18 and is considered disabled due to a medically determinable physical or mental impairment or a combination of impairments that cause severe functional limitations. As with adults, this medically determinable physical or mental impairment must be expected to:
- last for a continuous period of not less than 12 months; or
- is expected to result in one's death
Likewise, the child's impairment must be diagnosed using standardized methods – symptoms are not enough.
Do You Need to Prove the Disability before Obtaining Disability Benefits?
The disability must be conclusively diagnosed by medical professionals using standard medical practices before disability benefits will be awarded.
Further, it is important to keep in mind that your doctor cannot say one way or another what your disability status is with regard to disability benefits. This means your doctor does not get to say that your established health condition satisfies the definition of what qualifies as a disability for the purpose of benefits. Your doctor can, however, attest to how your health condition impacts your ability to work.
How long can I get disability benefits?
Disability benefits are long-term, but when they end depends on whichever of the following occurs first:
- your health condition improves and you are able to return to work; or
- you turn 65 years old, at which point Social Security Retirement benefits begin
If your health condition is expected to improve, then within 18 months or every 3 years to every 7 years – depending on the circumstances and the health condition – your condition will be reviewed for improvement.
You can also lose your disability benefits if you are incarcerated for more than 30 days.
What happens if my disability application is denied?
If your disability claim is denied, not all is lost. You can appeal the decision. In most cases, initial applications are denied and chances actually improve upon an appeal, especially when you appeal the denial with the help of an attorney who knows how to move forward with your case timely and effectively.
Do you need a lawyer to help you get social security disability benefits?
You do not need a lawyer to help you file an application for Social Security disability benefits. Given, however, the high rate of denials and the medical complexity of these cases, having an experienced and knowledgeable disability attorney help you with your case can go along way to improving your chances and minimizing the stress the whole ordeal can have on a person.
At no risk to you, contact the Law Firm of Madeline M. McIntosh today at 469-678-7274.