Do I Qualify for Social Security Disability Benefits?

If you or a loved one has become disabled and unable to work, what are your options for financial help? While private disability insurance or Workers’ Compensation (if disabled on the job) may offer some assistance, what else is available?

Two Types of Social Security Disability Benefits

The Social Security Administration (SSA) has two programs to assist those who have become disabled– Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). You may qualify for one or both of these programs.

Social Security Disability Insurance (SSDI) is a federal disability insurance that you are automatically enrolled in through the Social Security taxes that have been deducted from your paycheck. Those tax payments give you access to cash and medical benefits if you are disabled before the age of retirement. Qualified family members may also receive benefits through this program. The awarded benefits are based on your past income and typically continue until you can work again on a regular basis.

Supplemental Security Income (SSI) is a program to provide those who can’t work with financial assistance to meet their basic needs (food, clothing, shelter). SSI is funded from general tax revenues, so it does not require the recipient to have worked in the past or to have contributed to Social Security. Benefits are based on your current resources, financial and otherwise. Minors with physical or mental disabilities or blindness may also qualify for financial assistance under this program.

How Do I Know if I Qualify?

Both SSDI and SSI use the same qualifications to determine disability, but the difference in work history and financial requirements between the programs affects who qualifies for each.

SSDI Qualification Requirements

The Social Security webpage on qualifying for SSDI lists two basic requirements:

• Have worked in jobs covered by Social Security.
• Have a medical condition that meets Social Security’s strict definition of disability.

Though the two requirements seem simple, there is much behind them.

“Have worked in jobs covered by Social Security.”

Since SSDI is funded by Social Security taxes that have come from your past paychecks, you must have an earnings record to prove that you worked long enough and recently enough to qualify for disability benefits.

Social Security awards workers “work credits” based on their income to measure their rights to Social Security benefits. While the amount of income required to earn a work credit changes from year to year, a worker can currently earn the yearly maximum of 4 work credits with only $6,040 of earned income (2022). Generally, 40 work credits are required to qualify for benefits, with 20 of those work credits being earned in the last 10 years before your disability began. (Younger workers may qualify with fewer credits since they have not been of working age long enough to earn more.)

“Have a medical condition that meets Social Security’s strict definition of disability.”

Social Security’s definition of disability only covers those with total disability who are unable to work and does not provide benefits for those with partial or short-term disabilities.

A five-step evaluation uses five questions to determine if you have a qualifying disability.

1. Are you working?

If you are still working, Social Security uses your current earnings to determine if your work constitutes “substantial gainful activity (SGA).” As of 2022, monthly earnings of more the $1,350 ($2,260 if you’re blind) generally mean that you do not have a qualifying disability. If you are making less than that (or not working at all), then your claim will go on to Disability Determination Services (DDS) for evaluation of your medical condition based on the next four questions.

2. Is your condition “severe”?

A “severe” condition means that your condition will significantly limit your ability to do “basic work-related activities” and is expected to continue for at least 12 months or result in death.

3. Is your condition found in the list of disabling conditions?

The SSA maintains multiple lists of qualifying medical conditions. If your condition is not on the list, an individual determination must be made.

There are two fast-track options for cases with high probabilities of acceptance. Compassionate Allowances allows for approval upon confirmation of diagnosis for “certain cancers, adult brain disorders, and a number of rare disorders that affect children.” Quick Disability Determinations (QDD) uses technology to identify those applicants with the most severe disabilities who are very likely to qualify. These options can often speed up the qualification process from months to days for those with the most severe conditions.

4. Can you do the work you did previously?

If you can still perform your past job, you will not qualify for disability.

5. Can you do any other type of work?

If you cannot do the work you did previously, then your medical condition, age, education, work experience, and skills will all be considered in searching for other work that you can do. If no other job can be found, you likely qualify for SSDI benefits.

If you are accepted to receive disability benefits, your monthly benefit amount will be determined by your past average income and any other benefits that you are currently receiving (public disability, Workers’ Compensation, government pensions, etc.). The SSA provides an online benefits calculator to assist you in estimating your benefits. If you start receiving SSDI benefits before retirement, then your disability benefits will automatically convert over to retirement benefits when you reach full retirement age, though the monthly benefit amount will remain the same.

SSI Qualification Requirements

While Supplemental Security Income is also an option for disabled persons, it is different from SSDI in that it does not require a work history but instead requires proof of need.

To qualify for SSI, you must:

• Be blind, disabled, or age 65 and older
• Have limited income and resources

Let’s look more closely at these qualifications.

Be blind, disabled, or age 65 and older

Individuals who are blind or totally disabled (as defined above) may qualify for SSI assistance. This means that they cannot perform any “substantial gainful activity (SGA)” for at least 12 months because of their condition. Adults who are 65 and older without disabilities may also qualify if they meet the financial qualifications.

Have limited income and resources

Because SSI is awarded on the basis of need, only those with low income and few resources may qualify. “Income” and “resources” have specific definitions to help determine eligibility.

Income: Income is considered any money that you receive (such as wages, pensions, or Social Security benefits) and any food and shelter that you are given. Acceptable income levels differ from state to state. Portions of spousal income or parental income (if a minor) are also included, but there are also many exceptions that are NOT included, such as Supplemental Nutrition Assistance Program (SNAP) benefits, most home energy assistance, housing from private non-profits, some scholarships, and a portion of any earned wages.

Resources: Resources are things that you own. To qualify for SSI, your resources must be worth no more than $2,000 (no more than $3,000 for a couple). Resources that are counted include cash, bank accounts, stocks and bonds, and real estate. Resources that are NOT counted are the home/land where you live, your car (typically), burial plots (yours and immediate family), burial funds for you and your spouse (up to $1,500 each), and life insurance policies with a face value of $1,500 or less.

If you qualify, the monetary amount of the SSI payments will depend on your available income and resources as well as which state you live in. Some states add money to the federal amount to increase the payment. Also, it is possible to qualify for and receive both SSI and SSDI at the same time, something that the Social Security Administration calls receiving “concurrent benefits.”

What About My Family?

As a side note, benefits are also available for spouses and children through these two programs.

Social Security Disability Insurance (SSDI): In the event that the insured worker no longer collects SSDI because of retirement or death, there are MANY options for family members to continue to collect benefits off of the worker’s record. A Social Security representative or Social Security Disability lawyer can help you determine if you are eligible.

• Spouses can collect a one-time death payment and other benefits.
• A disabled spouse with little to no work history could collect disability off of the deceased spouse’s record.
• A divorced spouse may qualify to collect benefits off of the deceased’s record if they were married for at least 10 years.
• Minor children and those caring for the children of the deceased may qualify for benefits.
• Disabled Adult Children (DAC) of the worker who are unmarried and were disabled before the age of 22 may qualify to collect off of their parent’s record.
• Parents of the deceased worker, if age 62 or older, may be eligible for benefits if they were dependent on the deceased for at least half of their support.

There is a limit as to how much a survivor can earn while collecting benefits, and there is also a limit as to how much a worker and their family members can collect off of the worker’s work history, typically 150 to 180 percent of the insured’s disability benefit. A divorced spouse’s benefits are not included in the family total.

Supplemental Security Income (SSI): Under SSI, disabled or blind children can qualify for financial assistance if their household is very limited in income and resources. The child must have a condition (physical or mental) that severely limits his or her activities and has lasted (or is expected to last) at least 1 year or will result in death. The online Child Disability Starter Kit and Fact Sheet can get you started by answering some common questions and supplying a worksheet to help you gather information for the Child Disability Report.

How Do I Apply?

The SSA website has a button to fill out an application for disability online. The online application can be used to apply for both SSDI and SSI concurrently, but can only be used if you are not currently receiving Social Security benefits. Before filling out the application though, consider the following steps.

• Gather information about yourself. You will need detailed information about you, your medical condition, and your work history. The online checklist found here can help.
• Collect necessary documents. Documents such as birth certificates, last year’s W-2 forms, or medical evidence about your condition will also be required. A list of documents can be found on the SSA application information page here.
• Consider speaking to a Social Security Disability lawyer. Social Security Disability lawyers offer free consultations and most work on a contingency basis, which means that they don’t get paid unless they win you benefits, and even then they are paid from back-owed benefits that are being awarded. An experienced lawyer can help with the many details and exceptions in the Social Security application process, as well as with any uncertainties in reporting work experience, medical information, or financial need requirements. Application denials are also common, and a Social Security Disability lawyer can assist you through the appeals process.

If you choose to have the assistance of a Social Security Disability lawyer, he or she can help you fill out and submit your application. Otherwise you can apply through the SSA website, through your local Social Security office, over the phone through the SSA’s toll-free number, or by mailing your application. Once your application is received, if no new information is needed, you will receive a letter with the SSA’s decision.

Take the First Step

While Social Security Disability programs are a complex subject, help is available to make the complex attainable. Talk to a lawyer or Social Security employee to get more information to see if Social Security Disability benefits are an option for you.