If you’ve made the tough decision to stop working because of your medical conditions, it’s time to apply for Social Security Disability. Another decision you’ll have to make is whether you should apply for Social Security Disability Insurance or Supplemental Security Income—or both! Each Disability Program is administered by the Social Security Administration and has its own eligibility requirements. Which disability program is right for you?
SSDI vs SSI: What are the Differences Between the Two Disability Programs?
- Social Security Disability Insurance (SSDI)
- Supplemental Security Income (SSI)
- Are SSDI and SSI the Same? What are the Differences?
- Are SSDI and SSI Payments Taxable?
- SSDI and SSI Health Insurance Benefits
- Can I Get Both SSDI and SSI Benefits?
- SSDI and SSI Work Incentives
- Does SSDI or SSI pay more?
- Social Security Payment Schedule – When Do Disability Payments Arrive?
Social Security Disability Insurance (SSDI)
Social Security Disability Insurance (SSDI) is a long-term disability program. Your “premiums” are paid by your Social Security payroll deductions while you’re working and are shown on your paystub as “OASDI” (Old-Age, Survivors, Disability Insurance).
To be eligible for SSDI, you must have enough work credits to be considered “fully insured.” Retirement benefits for Social Security payments require 40 quarters of coverage over your entire work history, but many disabled individuals must stop working long before they have time to earn 40 covered quarters, which is about 10 years of steady work. There are special earnings requirements for workers under 31 years of age to be fully insured.
Like a private long-term disability insurance plan, your insured status for disability will eventually expire after your premiums aren’t paid for a certain amount of time. If you cannot continue to work, do not delay in filing your application for SSDI benefits.
How to Apply for SSDI
You can file your SSDI application online at www.SSA.gov/benefits/disability if you’re over age 18, haven’t had a previous SSDI application denied in the last 60 days, and aren’t currently receiving Social Security benefits. You must also be disabled, which is defined as being unable to perform work based on a medical condition that’s expected to last 12 continuous months or result in death.
What is Supplemental Security Income (SSI)?
SSI is a needs-based program that provides benefits for disabled, aged, and blind individuals with limited resources and assets. Unlike SSDI, Supplemental Security Income (SSI) does not have an earnings requirement. However, SSI does have the same requirements for disability: You must be unable to work due to a medical condition that will last 12 continuous months or is expected to result in death.
How to Apply for SSI
You can complete an application for SSI online if you’re applying for SSDI at the same time and you meet the following conditions: This must be your first time applying for SSI, you have never been married, and are between ages 18 and 65. You also must be a U.S. citizen living in the U.S., Washington D.C., or the Northern Mariana Islands.
Are SSDI and SSI the Same? What are the Differences?
SSDI and SSI are similar in some ways, but there is a difference. While both programs share the same set of disability rules, the “eligibility” rules are different.
As we discussed above, there is an earnings test for SSDI. You must have had enough wages throughout your work life that were covered by Social Security deductions. These work credits act as premiums and provide you with coverage for SSDI, and you must be fully insured.
There is no earnings requirement for eligibility for SSI, however, you must have less than $2,000 in assets. The Social Security Administration requires that all assets, earned and unearned income, and financial and material assistance received by you and everyone in your household be revealed before your application for SSI can be approved.
SSDI and SSI have the same rules regarding disability. To be entitled to each of these disability programs, you must have a medical condition that prevents you from working for 12 months or is expected to result in death.
Social Security uses a process to determine whether an individual is disabled. First, are you working and performing “substantial gainful activity”? Work is considered to be substantial gainful activity (SGA) if it requires physical or mental activities, and it’s performed for profit (even if you’re not getting a profit). This means that volunteer work or a part-time job could be considered SGA. If a person is performing SGA, they’re not considered disabled by the Social Security Administration.
Once a determination is made that SGA is not being performed, SSA considers any work-related limitations imposed by your medical condition. If a medical condition does not cause significant work-related limitations, it is not considered “severe,” and your condition is not disabling.
If your medical condition is severe, then SSA looks at your medical records, including statements from your treating physicians, counseling records, notes from schools for children, and compares the information to the Listing of Impairments found in the Social Security regulations. This is a list of serious medical conditions with specific symptoms supported by objective medical testing (x-rays, blood work, etc.) that are considered disabling. If your medical impairment matches one of these listed conditions, you will be found disabled.
Not everyone’s medical condition is exactly as described in the Listings, so the Agency will consider the limitations caused by your impairments and determine what work activities you are capable of despite those limitations. This is called a “residual functional capacity” or RFC. SSA will look at your RFC and decide if there are any jobs you can do. If you can return to your past work or if there are available jobs that you’re capable of performing, you will be found not disabled. If you cannot return to work, your application for disability will likely be approved.
Are SSDI and SSI Payments Taxable?
SSI payments are not taxable, but SSDI payments may be, depending on your total income and the income of your spouse. In most circumstances, taxes are paid only when an individual has substantial additional income, like interest, dividends, self-employment, or wages that must be reported to the IRS. Taxes are paid on 85% of your SSDI benefits if you have more than $34,000 income for a single filer or more than $44,000 for a couple. If your income is between $25,000 and $34,000 for an individual or between $32,000 and $44,000 for a married couple, taxes must be paid on 50% of your SSDI benefits.
Each January, Social Security beneficiaries receive a Form SSA-1099 showing benefit amounts for the previous year. When you complete your income tax return, you’ll report the appropriate amounts to calculate the taxable amounts.
SSDI and SSI Health Insurance Benefits
SSDI beneficiaries are eligible for Medicare coverage after receiving disability benefits for 24 months. Medicare Part A (Hospital Insurance) is free, and Part B (Medical Insurance) has a premium that must be paid, either by you or a third party. Some people have a disabling medical condition but are able to return to work. In those cases, Medicare coverage can continue for another 8.5 years even after Social Security Disability Payments end. If your job includes medical insurance coverage, Medicare will be a “secondary payer.” You may be able to purchase Medicare Insurance once the 8.5 years has elapsed, as long as your disability continues.
SSI recipients may be immediately eligible for Medicaid, although some states require disabled individuals to file a separate application for Medicaid coverage. Eligibility for Medicaid coverage can continue even when an individual returns to work as long as the disability continues, and the resource limitations are still met. Any earned wages must not exceed the SSI payment, Medicaid, and other public assistance amounts.
Can I Get Both SSDI and SSI Payments?
Yes, you may qualify for both SSDI and SSI payments if you meet the requirements for “disability” described in the Social Security Regulations.
The amount of your monthly SSDI benefit payment is based on the wages you earned (and paid OASDI taxes on) over your entire work history. If you worked in a low-paying job or had sporadic employment, your monthly SSDI benefit may be low enough to qualify you for SSI payments as well. The amount of monthly SSI payments depends on which state you live in, and there is a maximum SSI payment set by the Federal Government.
SSDI vs SSI Back Pay
When you file an application for Social Security Disability Insurance or Supplemental Security Income (or both), you have to give the date you stopped working. This is called your “alleged onset date” or AOD. Once your application is approved, Social Security will establish the date your disability actually began. In most cases, your AOD becomes the “established onset date” (EOD) and SSA will use the EOD to begin your payments.
Even if you stopped working long before filing your disability application, SSA limits the EOD to one year before the date you filed for SSDI. Payments are made for the first full month you’re eligible, and there is a five-month waiting period for SSDI payments. So, if your EOD is January 15, you would be eligible for benefits in July. SSDI payments are made the month after they’re due, so your July payment would be sent in August.
Supplemental Security Income payments begin no earlier than the date an application for SSI is filed. If you wait until your application for SSDI is approved and then realize you qualify for SSI as well, your benefits will be significantly delayed. It’s vital that you file for SSI at the same time you apply for SSDI benefits. Ask about filing for SSI when you file your application for disability benefits.
SSDI and SSI Work Incentives
Let’s face it, Social Security Disability Insurance and Supplemental Security Income payments are not a complete replacement for your lost wages. Your disability payments are a small percentage of what you would earn if you could return to work. The average SSDI payment in 2017 was $1,179.85 per month for a single person and only $2,108.14 per month for a married couple with two children.
The Social Security Administration has developed Work Incentive Programs that can help you return to work when and if your condition improves. SSA calls the work incentives a “Ticket to Work.” Anyone who collects SSDI or SSI is eligible for Ticket to Work program and the benefits it provides.
If you contact the Social Security Administration and request a Ticket to Work, one major benefit is that SSA cannot perform a Continuing Disability Review of your medical condition as long as you’re making progress in your program. Another benefit is that Social Security will pay an employment services provider or your state’s vocational rehabilitation to retrain you, provide vocational counseling, and even help you find a job. Your SSDI and SSI payments continue, along with your eligibility for Medicare and Medicaid. In fact, if you’re eligible for Medicaid, that coverage may continue for a time after you begin working, even if your SSI payments stop.
Many people on SSDI have a “Trial Work Period.” This is a 9-month duration in which a disabled individual can test his or her ability to return to work but continue to receive disability benefits. The services performed are not considered “substantial gainful activity” (SGA) while you attempt to return to the workforce. In 2018, any month that you earn more than $850 counts toward the 9-month limit. The 9-month Trial Work Period (TWP) doesn’t have to be continuous months, though. SSA keeps a rolling 60-month calendar to track TWP months, so if you’ve earned over the allowable amount in a 5-year period, those months will be counted.
There is also an Extended Period of Eligibility (EPE), a 36-month period during which you may be eligible to continue receiving SSDI or SSI disability benefit payments. Once your Trial Work Period is completed, any month in which you earn over the allowable rate is considered SGA (in 2018, the allowed amount is $1,180.00). In this situation, you won’t be eligible for disability payments, although your eligibility for health insurance continues.
“Impairment-Related Work Expenses” refers to the money you spend on your disability in order to work. These expenses may be deducted from your wages and not counted toward to allowable amount. For instance, if you require an attendant or special equipment to keep your job that wasn’t required while you weren’t working, those expenses may be deductible. The expenses must be paid by you and not paid for or reimbursed by an insurance company.
Despite your efforts to return to work, if your medical condition prevents you from maintaining your work activity, your disability benefits will continue.
Does SSDI or SSI Pay More?
SSDI payments are based on your work history, including the wages you earned and the income taxes you paid. SSI payments are based on limitations set by the Federal Government. For 2018, the maximum Federal payment is $750 for an individual. For an eligible couple, the monthly SSI payment is $1,125. If you receive Workers’ Compensation or you had wages that weren’t taxed by Social Security, your SSDI payments will be reduced.
There is also a “Windfall Elimination Provision,” which can reduce the amount of your monthly benefits. The WEP prevents a worker from getting payments from work that was covered by Social Security taxes and work that was exempt from SSA withholding. For instance, if you worked for a county agency that had its own retirement plan and didn’t pay into Social Security, and then you changed jobs and began working for an employer who did pay OASDI taxes, you might have a financial advantage over other workers. Your SSDI payment amount would be reduced if you received payments from the county.
For SSI payments, countable income can reduce the amount of your monthly payment. Countable income includes money, food, shelter or any other assistance that helps you in a month. Certain items are excluded from being considered countable income, such as any income you set aside or use to help get a job, food stamps, or impairment-related work expenses. If you receive free medical care or assistance paying medical bills, those items are not considered income.
Social Security Payment Schedule – When Do Disability Payments Arrive?
The payment date for SSDI depends on your birthday. If your birth date falls between the 1st and 10th, your SSDI payment will be made on the 2nd Wednesday of each month. If your birth date is between the 11th and 20th, your payment will arrive on the 3rd Wednesday. SSDI payments are made on the 4th Wednesday for birth dates between the 21st and the 31st.
In 2018, SSI Payments are made on the first day of the month or, if the first day of the month falls on a weekend, the payment will be made on the Friday prior.
When it comes to applying for Social Security Disability Insurance and Supplemental Security Income, there are many complex issues to manage. Here at Acadia Disability, we have a team of experts who can help you figure out which disability program is right for you and answer any questions you might have about SSDI and SSI. We can help you apply for disability benefits, order and evaluate medical records and, if your application for SSDI or SSI has been denied, we can file an appeal.
Our attorneys have experience with SSA Administrative Law Judges, ordering medical records, filing pre-hearing briefs explaining how your medical impairment is disabling, and appearing at hearings to argue your case. Call us today toll-free: 1-800-653-4600, or email us at firstname.lastname@example.org.