The Social Security Administration provides Social Security benefits through several programs. The two most common are Social Security Disability Insurance and Supplemental Security Income.
Both programs are for people who can’t work because of a disability. The main difference between the two programs is that SSDI eligibility is based on work history and SSI eligibility is based on financial need.
Both programs have the same medical eligibility requirements. Whether applying for SSDI or SSI, beneficiaries must provide evidence that their medical condition meets the SSA’s definition of a disability and is expected to last for at least 12 months or result in death. For adults, this is closely tied to the ability to perform work. For children, disability is defined as a physical or mental impairment that causes severe functional limitations. However, people age 65 and older don’t need to have a disability to qualify for SSI.
Social Security Disability Insurance
To qualify for SSDI benefits, you must meet the earning and disability requirements.
Funds for the SSDI program come from payroll taxes. You can receive SSDI only if you have worked jobs where you paid Social Security payroll taxes (FICA). This is known as an earning requirement.
The amount of your monthly disability benefit will vary depending on your average lifetime earnings. The Social Security Administration sends a yearly statement to all people who have paid into the system. The statement shows your lifetime earnings and provides an estimate of your disability benefit based on a weighted formula of the amount of taxes you have paid over the years. It also includes estimates of retirement and survivors’ benefits that you or your family might be eligible to receive in the future.
Children under 18 typically don’t qualify for SSDI, but they might be eligible for SSI depending on family income. Adults who are unmarried and were disabled before age 22 might be eligible for a portion of their parent’s SSDI benefits. The benefits would be based on a parent’s Social Security earnings record if that parent starts receiving disability or retirement benefits, or dies and had worked long enough to collect retirement or disability benefits.
To qualify for SSDI, you must have a medical condition that meets the Social Security Administration’s definition of disability. SSA considers you disabled if:
- You can’t do the work that you did before.
- You can’t shift to other work because of your medical condition(s).
- Your disability is expected to last for at least one year or to result in death.
Qualifying for Supplemental Security Income
To receive SSI benefits, you must meet the low income and disability requirements.
The income level to qualify for SSI benefits depends on age, marital status and whether you have children. The SSA takes into account income from a job, as well as disability benefits, unemployment and pensions and other sources. The agency also considers assets such as vehicles, property and money in bank accounts.
Receiving benefits
If your application is approved, you will receive your first Social Security benefit payment six full months after the Social Security Administration determines when your disability began or the first month after your approval, if your approval takes longer than five months. Beneficiaries can expect to see their Social Security benefits for a particular month paid the following month.
Benefits usually continue until you can work again regularly. Special rules called work incentives provide continued benefits and health care coverage to help you transition back to work if you can.
If you are receiving SSDI benefits when you reach full retirement age, your disability benefits automatically convert to retirement benefits. The amount remains the same.
After you start collecting SSDI benefits, you will become eligible for Medicare insurance coverage. Your Medicare benefits (Part A and B) will begin 29 months after your disability onset date, or 24 months after you receive your first benefit check.
Your disability rights
It is important to know your rights if you receive Social Security Disability Insurance or Supplemental Security Income.
You have the right to:
Receive help. The Social Security Administration can help you get the documents they require to show that you meet SSDI or SSI requirements. If Social Security wants you to have a medical exam before it makes a decision, it will pay for the doctor’s visit and travel expenses to and from the appointment to complete this exam.
Be represented. You can appoint someone to help you with your SSDI or SSI claim. The representative doesn’t have to be a lawyer. People often appoint family members to assist them.
Examine your file. You or your representative may request a copy of the information in your case file.
Receive notice. The SSA will notify you in writing of any determination about your eligibility or any change in your benefit amount. Each notice will explain your appeal rights.