Social Security disability benefits come from two different federal programs administered by the Social Security Administration (SSA). The first program, Social Security disability insurance (SSDI), only provides benefits to disabled workers who already paid taxes into the trust fund. The second program, Supplemental Security Income (SSI), provides financial assistance and health coverage benefits to disabled Americans who haven’t worked enough to qualify for SSDI.
What Is Social Security Disability Insurance (SSDI)?
Social Security disability insurance (SSDI) provides monthly benefits to eligible disabled Americans whose conditions prevent them from working for at least 12 months. This specific SSD program is designed for people who paid Social Security taxes throughout their working years. (You paid into Social Security disability fund if you worked full-time for 5 out of the last 10 years in a job that withheld FICA taxes from your paychecks.) Applicants who meet the SSA’s work history requirements must also meet the agency’s medical definition of a disability. Anyone asking, “What is Social Security disability?” can review the SSA’s eligibility guidelines for disability on their website.
What Disability Benefits Are Available Through the Supplemental Security Income (SSI) Program?
When you apply for SSDI, you’re also applying for SSI at the same time with just one set of paperwork. The SSA reviews each benefits application using identical criteria to determine whether or not you meet medical disability guidelines. The SSI program helps children and adults who are disabled, blind, or over the age of 65. If your condition meets the SSA’s medical requirements but you don’t have enough work history to qualify for SSDI, you may still get approved for SSI. In addition, SSI beneficiaries almost always qualify for Medicaid coverage as soon as their application’s approved. Finally, SSI recipients may qualify for additional state supplementary benefits. To learn more about how this particular program works, visit the Social Security Administration’s SSI website.
Who’s Eligible to Apply for Social Security Disability Benefits?
Anyone who is too disabled to work and currently in need of financial assistance to make ends meet may apply for SSDI. To qualify for Social Security disability benefits, you must prove that you’re unable to perform your current (or similar) job duties for at least one year. In addition, you must also meet the SSA’s definition of disabled for the agency to approve your benefits claim.
What Is Back Pay?
Qualified Social Security disability applicants may also be able to receive a lump sum cash payment. This is called “back pay.” For many claimants, it covers the mandatory minimum 3-5 month waiting period required to review and then approve your claim. However, eligible applicants may receive back pay going back to the initial date your doctor diagnosed your disability. This lump-sum back payment could cover several months or even years before you submit your application for SSD benefits.
What Is Retroactive Pay?
You may also qualify for “retroactive pay,” which covers the 12 months prior to submitting your application. The SSA limits retroactive pay to 12 months, but your back pay may cover a much longer timeframe. Unfortunately, the SSI program does not provide retroactive pay for that same 12-month period.
What Is Social Security Disability Health Coverage Like?
Once your SSDI claim’s approved and you receive Social Security disability benefits for at least 24 months, you may qualify for Medicare. In most cases, the SSA deducts Medicare medical insurance premiums from your monthly benefits at a deeply discounted rate. To learn more about enrollment, benefits and monthly costs for Social Security disability beneficiaries, see the SSA’s Medicare information page.
What Is a Social Security Disability Denial?
If the SSA denies your claim, that means you failed to meet all required eligibility guidelines. Here are some examples where your claim might result in denial:
- Your medical condition qualifies as a disability but should improve enough for you to start working again in less than 12 months. The SSA doesn’t provide temporary or short-term disability benefits. If your condition isn’t expected to result in your death or last for at least 12 months, you’re automatically ineligible for SSDI. However, you may qualify for workers’ compensation through your employer if you have a work-related illness or injury.
- Your condition meets the SSA’s definition of a disability, but your work history or income level make you ineligible for benefits. To qualify for SSDI, you must work 5 in the last 10 years full-time and paid FICA taxes. If you’re not currently working and cannot meet the income or resource requirements for SSI, you may still qualify for state-level assistance programs. The Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) programs administer benefits to qualified applicants in each state.
- You’re still working when you file your benefits claim. In order to qualify or either SSI or SSDI, your disabling condition must prevent you from working for at least one year. The only exception is if your doctor confirms your diagnosis is terminal or likely to become terminal in less than 12 months. If this happens and you believe you’re otherwise qualified for benefits, consult an attorney immediately.
You May Qualify for Legal Assistance
When it comes to applying for Social Security disability, you don’t have to go through the claims process alone. Experienced disability attorneys can answer your questions, review your claim paperwork and even file on your behalf with the SSA. Having a lawyer file your claim makes you nearly 3x more likely to win benefits on your first try. Those who qualify for legal assistance through this website typically win $12,000 in lump-sum backpay as well as monthly disability. But those who have attorney representation during the appeals process are far more likely to win monthly benefits.
Worried you cannot afford a lawyer to help with your claim? Don’t be! All disability attorneys work on a contingency basis. This means you’ll pay nothing unless they help you win benefits. Even then, the government caps how much they can charge you in legal fees after your approval. If qualifying for monthly disability benefits is important to you, talk to a lawyer for free today.
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