If you are disabled, you may be eligible for benefits through the Social Security Administration.
If you have a work history that qualifies you for SSDI benefits, Social Security Disability Insurance, you may petition for benefits based upon your work history. If you do not have a sufficient work history to qualify for SSDI, you may petition for SSI benefits, Supplemental Security Insurance. SSI benefits are available only to people of limited means.
Under the rules of the Social Security Administration, a "disability" means:
the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.
To qualify as disabled under that definition, you must establish that:
- You cannot do work that you did before;
- You cannot adjust to other work because of your medical condition(s); and
- Your disability has lasted or is expected to last for at least one year or to result in death.
Your disability claim must be supported by a doctor's opinion that you are presently disabled, with some manner of evidence (preferably a medical treatment history) to document the duration of the disability.
For certain medical conditions that are accepted to be disabling in nature, qualification may follow from proof of a valid diagnosis of that condition. Certain other serious medical conditions may qualify an applicant for the Compassionate Allowance initiative, meaning that the applicant's Social Security disability application is reviewed on an expedited basis.
There are two disability programs offered by the Social Security Administration:
Social Security Disability Insurance Benefits (SSDI / DIB)
These benefits are extended to disabled workers whose work history has allowed them to obtain sufficient "credits" to be eligible for benefits. In most cases, that will mean having worked at least five of the past ten years, with earnings above a base threshold and payment of FICA taxes. In addition to SSDI benefits, certain of their dependents may also qualify for Disability Insurance Benefits (DIB) benefits based upon the applicant's disability.
Supplemental Security Income (SSI)
The SSI program is intended for the elderly, blind, or disabled people who have limited financial resources. To qualify for benefits, you must prove that you are disabled as defined by the SSA, and must also demonstrate financial need.
The SSI program imposes strict limits on the income and resources to be eligible for benefits. If you earn too much money, or have too many assets, you will not qualify. Information on the current limits can be found on the Social Security Administration website.
It is possible for a disabled worker who is of limited means to qualify for both SSI and SSDI / DIB benefits. This is known as "concurrent eligibility".
There are three ways to apply for Social Security disability benefits:
You may obtain an application for benefits from your local Social Security Administration (SSA) office;
You may apply online through the Social Security Administration website; or
You may call the SSA (1-800-772-1213), and schedule an appointment to make an application by telephone.
Should You Use An Attorney
You do not need to use an attorney to file for Social Security Benefits. The Social Security Administration attempts to make it easy to apply for benefits without a lawyer. However, statistics from disability applicants and denials suggest that your chances of receiving benefits are significantly improved if you apply with the help of a lawyer.
You may consider filing the initial application yourself, and using an attorney to file for reconsideration or to appeal if you are denied benefits.
Lawyer fees are regulated by the Social Security Administration for both the application for benefits and administrative appeals process.
You should file as soon as possible after you believe you have a qualifying disability.
- Most applicants are denied the first time they apply, and they have to go through an appeals process before they receive any benefits.
- The longer you wait, the longer it will take for you to receive the benefits - and many people who have disabilities will suffer from financial hardship during a delay.
If you qualify for a retroactive award of benefits, those benefits are available only for a limited number of months and your delay in applying may thus cause you to lose benefits.
Should You Apply for Social Security Benefits if You Have Significant Savings
If you are applying for SSDI and DIB benefits, your savings will not be counted against you.
Your savings may be a factor if you are eligible only for SSI benefits, as the limits on cash holdings for SSI recipients are low. You will be required to spend down your excess assets before you qualify for SSI benefits.
Should You Apply for Social Security Disability Benefits While Collecting Workers Compensation
Your receipt of workers compensation benefits does not affect your eligibility for Social Security benefits. Thus, you should not wait to apply merely because you are already receiving workers compensation benefits.
However, before applying for Social Security disability benefits you consult an attorney in your state about how your Social Security benefits will be coordinated with your workers compensation benefits. In many states, there is a direct set-off such that any amount you receive from Social Security Disability is deducted from your workers compensation benefit, and the workers compensation agency may have a claim against any award of back pay.
Should You Apply for Social Security Disability Benefits While Collecting Unemployment Benefits
When you apply for unemployment benefits, you certify to the state that you are able to work. When you apply for Social Security disability benefits, you certify to the federal government that you are unable to engage in gainful employment. As those two positions are in conflict:
- Your application for Social Security benefits may be viewed by the state as a basis for disqualification, or even as a basis to investigate whether your unemployment application was fraudulent or if you should be ordered to repay benefits.
- Your claim to your state of being able to work may reflect negatively on the Social Security Administration's review of your contention that you are disabled.
If you are collecting unemployment, you should consult a Social Security lawyer about whether and when you should apply for Social security benefits.
If you qualify for SSDI benefits, you will qualify for Medicare after two years. If you qualify for SSI benefits, you should be eligible to receive Medicaid, and should investigate your eligibility for Medicaid with your state at the time you apply for SSI.
If your application for Social Security disability benefits is denied, you should apply for reconsideration of the denial. A reconsideration involves an informal hearing within the Social Security Office that processes your application.
- Approximately 75% of first time disability applications are denied.
- You may benefit from consulting a lawyer before filing your application for reconsideration, as approximately 90% of such applications are denied.
A lawyer may be able to help you, legal fees are regulated, and in most cases the cost of legal help is not unreasonable. A lawyer will likely be most helpful if contacted immediately upon your receipt of the initial benefits denial. If your application for reconsideration is denied, you should proceed with an appeal.
If your application for Social Security disability benefits is accepted, you will receive a monthly payment for the duration of your qualifying disability. You may also receive a retroactive payment for benefits based upon the date of your application and the date of onset of your qualifying condition.
If you qualify for SSDI benefits, any retroactive payment of SSI or DIB will start from the fifth month after you became disabled, with a maximum retroactive benefit of twelve months before the date of your application for benefits.
If you qualify only for SSI benefits, your retroactive payment will be for the period between the date of your application for benefits through the time your application was approved.
Your monthly SSDI benefit, and any DIB benefit received by a dependent, will be in the amount you would have received had you retired at full retirement age.