SSDI (Social Security Disability Insurance) and SSI (Supplemental Security Income) are both programs managed by the Social Security Administration to help people with disabilities. Many people don’t differentiate between the two. While the medical eligibility is determined in the same way for both, they are two completely different programs.
SSDI (Social Security Disability Insurance) is funded through payroll taxes and is available to workers who are younger than 65 years old and have accumulated a minimum number of work credits. Recipients are considered insured because they have made payroll contributions in the form of FICA Social Security taxes. The monthly benefit amount is based on your work earnings record.
SSI (Supplemental Security Income is a need-based program based on a person’s income and assets and is funded by general taxes. This program does not evaluate work history and is strictly based on financial need. To be eligible for SSI, you must have less than $2,000 in assets (or $3,000 for a married couple) and have a very limited income.
If you’re under the age of 65, and have paid into the FICA fund for 5 of the last 10 years, you may qualify. Applicants must also have a medically diagnosed disability that is expected to prevent them from working for a minimum of 12 months. While some medical conditions are so severe that they are automatically qualified as disabled, usually the process requires careful screening.
- Are you currently working? If you’re working and earning more than $1,180 in 2018, you are considered to fall above the Substantial Gainful Activity limits and would not be qualified for benefits.
- Is your condition considered a “disabling medical condition” by the SSA? If your condition is on the SSA’s list of automatically qualified conditions, you are considered disabled. If not, the SSA will determine if your condition is severe enough to prevent you from work-related activities.
- Can you do the work you did previously? If your condition doesn’t prohibit you from doing the work you used to do, you would not be considered disabled.
- Can you do other types of work? If you’re unable to do your previous work, but could work in other types of jobs that take into account your age, education, work experience etc, you would not be considered disabled.
Applying for Social Security Disability benefits is frustrating for most people. There are numerous forms to complete, long lines to wait in, numerous people to talk to about your disability, medical forms to compile, and more. You can increase your chance of approval by filing with an advocate on your side that is experienced in the processes, tricks, and techniques of dealing with the Social Security Administration. An experienced representative will increase your chance of approval with maximum benefits by:
- Keeping on top of your claim - An advocate will document the application process and regularly check the status of your claim to make sure it doesn’t slip through the cracks.
- Making your claim stand out - An experienced representative will make sure you claim stands out by providing accurate and thorough medical records that clearly demonstrate your diagnosis and how they limit your ability to work.
- Providing medical evidence - Advocates know how to properly submit a claim that clearly shows medical evidence to support the doctor’s diagnosis.
- Proactively submitting your claim as soon as possible - A representative can assist with filing promptly so that your benefits are approved as soon as possible. If you wait to apply, you may lose significant benefits.
- Working on a contingency basis - Most SSDI advocates or attorneys work on a contingency basis and are only paid if they are successful in getting you benefits. This fee must be approved by the Social Security Administration and has limits.
Over 70% of initial applications are denied by the SSA. What can you do to appeal the decision? Firstly, you should not give up hope, as it is still possible to receive disability benefits through the appeals process. The first step to the appeal is filing a request for reconsideration. It is beneficial at this stage to involve an attorney to add new or different information which might be beneficial to the case. Having a representative can make a significant impact by reorganizing facts, filling in any missing information, and pushing your claim forward. The next step is a disability hearing in front of an administrative law judge. This stage may include medical and vocational experts to advise the judge. The final step would be a decision by the Appeals Council who will make sure the administrative law judge followed the correct procedures in making the denial decision. If you’ve been denied Social Security Disability benefits during the initial application stage, you should seek out help from an attorney prior to filing an appeal. Remember, you only have 60 days from the date of receiving your denial from the SSA to appeal the decision so contacting a qualified Social Security Disability attorney as soon as possible is critical.