Social Security Disability Insurance is meant to help individuals when they’re unable to work because of a medical condition. The Social Security Administration can help with disability benefit payments, health insurance, and even job retraining. In this article, we’ll talk about Social Security Disability Insurance and eligibility criteria.
- SSDI Eligibility Requirements
- Apply for Social Security Disability Insurance
- SSA Disability Definition and Requirements
- Can Mental Illness Be Disabling?
- Frequently Asked Questions about SSDI Eligibility
SSDI Eligibility Requirements
Social Security Disability Insurance (SSDI) works like a long-term disability plan available from many employers. Your insurance “premiums” are paid when you work and have Social Security taxes withheld from your paycheck. On your pay stub, you’ll see a deduction for “OASDI,” which stands for Old-Age, Survivor, and Disability Insurance. Social Security benefits are paid for retirement and families of deceased workers, as well as for disability.
The Social Security Administration has set out strict eligibility criteria to qualify for disability benefits, and the first is filing an application. The Social Security Regulations state that, in order to receive payments from SSA, an individual must file an application, even if you’re otherwise entitled to those benefits. So, how do you apply for SSDI?
Apply for Social Security Disability Insurance
SSDI applications are available at the Social Security website. This is a good time to set up your “My Social Security” account, so you can check that all of your previous employment is listed and your wages are correct. There are also disability benefit calculators on the website that will help you estimate your monthly disability payment amounts.
As you’re preparing to complete your disability application, you’ll need to gather some information. The Social Security website has a checklist for online applications. SSA requires information about your birth and citizenship, including any naturalization paperwork if you were born in another country, documentation of any marriages or divorces, along with dates, places, and your spouse’s name and Social Security Number. If you have children under age 19 who are still attending secondary school full time, or who are under 22 and are disabled, you’ll need their names and birth dates. If you were in the military, including the National Guard or Reserves, you’ll need the branch and dates you served.
The disability application will also require your former employers’ names, the starting and ending dates of your work, and your total earnings. If you were self-employed, SSA will also need the type of business and your total net earnings. When did your medical condition start affecting your ability to work? When did you finally have to stop working? What were the job duties you performed at each of your past jobs? Did you have a workers’ compensation claim?
What’s the highest level of education you completed and the date you completed it? If you’ve had addition job training, went to a trade school or vocational school, you’ll need that information as well. Also, if you had special education while you were in school, give the school name, city, and the dates you attended.
The Federal Government requires direct deposit of federal payments, so you’ll have to supply your banking information, including your bank’s routing number and your account number. If there’s another person who can talk to Social Security and discuss your claim, be sure to have their name, address, and phone number readily available.
SSA Disability Definition and Requirements
Social Security’s definition of disability means an individual cannot perform any type of work activity due to a medical impairment that is expected to last 12 continuous months or is expected to result in death.
First things first. If you’re working and performing “substantial gainful activity,” you will not be found disabled. While your wages matter to the agency when they look into your current work activity, they’re equally interested in the type of work you’re doing. For work to be “substantial,” it must be “real” work. If you’re “working” in your family business or for a friend, and you’re getting paid at the same rate as other employees for doing less work, that work may not be considered substantial. If you get extra breaks or additional time off because of your medical problems that others don’t get, your work may not be considered substantial.
On the other hand, if you’re doing volunteer work that could be paid if you performed the same duties for another organization, that work may be considered “SGA.” Also, part-time work can be SGA as well, even though your earnings are less than a full-time job would pay. It all depends on the services you’re performing for your employer. If you have special accommodations that allow you to work, be sure to explain your situation in your application documents.
Before Social Security even looks at any of your medical records, they will check out your past wages and make sure you have enough work credits to be “fully insured” for disability benefits. Remember those OASDI taxes you paid while you were working? Those taxes paid the premiums for disability insurance. When you register for a “My Social Security” account on the Social Security website, you can check your insured status and your monthly disability payment amounts. You can also call Social Security’s toll-free phone number at 1-800-772-1213 and ask that one be sent to you. Don’t put off filing your application for disability benefits, because your insured status will expire after a time once you stop working.
Once SSA determines that you’re fully insured for disability, they will review your medical records and the description of your medical impairments you made on your application and other forms. Social Security regulations contain a “Listing of Impairments” that describe serious illnesses and medical conditions that are considered disabling. You can find the “Listings” in Appendix 1 to Subpart P, Part 404 of Social Security laws.
If your medical disorders aren’t among those listed in Appendix 1, the next step in the evaluation process is determining what limitations are imposed by your medical conditions and whether you can return to your past work and, if not, whether there are other jobs you’re capable of performing despite those limitations. If you can work, you’re not disabled. If you can’t and need long-term care, Social Security will determine your medical impairments are disabling.
Can Mental Illness Be Disabling?
Section 12.00 of the Listings of Impairments describes mental illnesses that are considered disabling conditions by Social Security. The “A” Criteria of the Listings contains diagnoses and symptom descriptions of 11 different mental impairments. If you’re alleging a mental impairment (such as Alzheimer’s Disease) as part of your disability, your medical records and written statements will be reviewed to determine how your ability to function in everyday activities is affected. These functional areas include the following: understanding, remembering, and applying information; interacting with others; concentrating, persisting, or maintaining pace; and adapting and managing oneself. Some of the mental illnesses outlined in the Listings require additional disability determination of the seriousness and persistence of a mental disorder.
If your disability includes a mental illness, having written statements are helpful–those who know your abilities and problems you’ve had, including teachers, co-workers and supervisors, and family members.
Frequently Asked Questions about SSDI Eligibility
Is There an Age Limit for SSDI Eligibility?
You cannot qualify for SSDI payments if you are over the maximum retirement age. If you elected to receive early retirement benefits at age 62 and became disabled, you can apply for SSDI benefits. If approved, your disability payment amount would rise to the full retirement level and you would receive Medicare benefits after 24 months of disability.
Can I Apply for SSDI if I’m Receiving Workers’ Compensation?
You can be found disabled while you’re receiving workers’ compensation payments, although it’s vital that you keep SSA informed about the amount of your payments and any settlement you receive. Your SSDI payment amounts will be reduced while you receive workers’ compensation, but you will be eligible for Medicare after 24 months of disability payments.
Can I Return to Work and Still Receive Disability Benefits?
SSDI payments are not meant to replace your working income and, in fact, the average Social Security beneficiary received $1,179.00 in 2017. The Social Security Administration has several programs to help disabled workers return to work after they’ve been approved for disability. The “Ticket to Work” programs include the following:
- Trial Work Period: This is a 9-month period where you can test your ability to work. SSA doesn’t look at your wages during this period, nor do they re-evaluate your medical condition, called a Continuing Disability Review, as long as you register for a Ticket to Work.
- Extended Period of Eligibility is a 36-month period during which disability benefits continue even though you’re performing a work You receive disability payments for any month during which you earn less than the allowable amount ($1,180 for 2018). You’re still eligible for Medicare (not to be confused with Medicaid eligibility) if your disability has lasted more than 24 months.
- Vocational Rehabilitation and Job Training: Social Security will pay vocational rehabilitation or another employment training facility to help you qualify for work in a different industry. While undergoing necessary training, your disability payments will continue as long as you’re making progress in your training program.
Even if you have a Ticket to Work, you must keep Social Security informed of your wages in order to avoid being overpaid. Timely reporting of wages will help keep your Social Security payments on track. Many state Vocational Rehabilitation agencies require you report your wages to them and they send the information to Social Security. However, it’s your responsibility to know the wage reporting requirements for your particular program so you won’t get an overpayment.
If you have a disabling condition that prevents you from working, you may be eligible for Social Security Disability Insurance benefits. This program operates like other insurance programs, and the “premiums” are paid while you are working. To determine eligibility, you must fill out the application properly, and be able to prove your disability. If you’re unsure or have any questions about your eligibility status, contact Acadia Law Group today for assistance with the SSDI program.