Social Security Disability: Eligibility and Application Processes
It is important to understand that there are actually two different programs that fall under Social Security Disability (SSD): Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). These are two distinct programs that have some separate eligibility criteria, as well as some similarities between them. The biggest similarity with SSDI and SSI is that the applicant must be medically disabled, according to the Social Security Administration’s (SSA’s) definition of disability to receive benefits through either program.
Social Security Disability Insurance (SSDI)
Social Security Disability Insurance is designed to provide benefits to workers who become disabled. The majority of American workers pay into the SSD fund over the course of their employment. Contributions are made to the SSDI fund through standard payroll contributions, which are actually included in the Social Security taxes (FICA), withheld from your paychecks. Self employed individual are also required to make contributions to the SSD fund, through their self employment taxes.
Supplemental Security Income (SSI)
Supplemental Security Income is a need-based program. It is designed to provide SSD benefits for workers (and their qualifying dependents) that do not meet the eligibility criteria for receiving SSDI, but are nonetheless disabled. SSI is also the program under which disabled children may receive SSD benefits.
Qualifying for the SSDI Program
To qualify for SSDI, you must be disabled, according to the SSA’s definition, and must additionally:
• Earn less than the SSA’s definition of Substantial Gainful Activity (SGA) per month, which is adjusted annually, with 2013 limits set at:
• $1,040 for disabled workers
• $1,740 for blind applicants
• Have the required work credits based on your age
Work credits are accumulated over the course of your employment. These credits are achieved through making tax contributions to the SSD fund. Learn more about work credit requirements here (http://www.disability-benefits-help.org/glossary/work-credits)
If you meet the medical requirements for disability, but do not have sufficient work credits to qualify under SSDI rules, you may still be able to receive disability benefits through SSI.
Qualifying for the SSI Program
To qualify for SSI, you must:
• Be 65 or older, or be blind or disabled
• Have limited income and other financial resources
Income limits for SSI reference any money earned through employment, as well as:
• Money from other sources, including, among others, unemployment benefits, SSDI benefits, workers compensation, and support you receive from friends and family
• Food or shelter you receive, free of charge, from any source
Financial resource limits for SSI refer to many, but not all, of the assets and financial resources you have at your disposal. These may include, but are not limited to:
• Cash and bank account balances
• Land, vehicles, and personal property
• Life insurance and retirement plans
For the purposes of determining eligibility for the need-based portion of SSI qualification, the SSA counts earned and unearned income, but does not count all your other financial resources. The limits placed on your available financial resources are:
• $2,000 for a single adult or child
• $3,000 for a married couple
Applying for SSD Benefits
For both SSDI and SSI, you must submit an application to initiate your claim. You may complete your application online or in person with the SSA. To make an appointment to complete your application at your local office with the assistance of an SSA staff member, call the main SSA phone line at 1-800-772-1213 (TTY 1-800-325-0778), or contact your local office directly.
You can begin your application online to avoid delays associated with scheduling and waiting for an appointment. There are three steps required for completing your application on the SSA’s website: https://secure.ssa.gov/iCLM/dib
Steps in the SSD Application Process
For many SSD applicants, whether applying for SSDI or SSI, the initial application and review is only the first step in pursuing disability benefits. Most people will have to proceed to the appeals process in order to be approved.
The Initial Application
The SSA will review your initial application to determine if it meets the eligibility criteria for receiving SSDI and/or SSI benefits. It can take just a few weeks for you to receive a determination on your claim, or it may be several months before you have a decision. Don’t be discouraged if your claim is denied, since almost 60% of claims are denied at this stage.
The Request for Reconsideration
If your claim is denied at the initial level, you should request a reconsideration of your claim for benefits. The reason for denial determines if you can have your claim re-evaluated. The denial letter you receive in the mail following the initial review outlines the process for requesting a reconsideration. A reconsideration requires the SSA to take a second look at your claim. This process can also take anywhere from a few weeks to several months.
The Disability Hearing
If your claim is denied a second time, you must proceed to the appeal hearing stage to continue pursing SSD benefits. Again, the denial letter you receive will contain instructions on how to file an appeal. An appeal hearing is conducted with an administrative law judge (ALJ) presiding. The ALJ makes a final decision regarding your eligibility for SSD benefits. It can take almost a year to have a hearing scheduled, due to the high volume of cases that are pending. The good news is almost 60% of claims are approved at this stage.
Article by Ram Meyyappan