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Social Security Disability Insurance

The United States federal government provides a safety net for the disabled who can no longer work to support themselves. That net is called Social Security Disability benefits. The Social Security Administration (SSA) administers two programs that provide benefits based on disability: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).

What are the available types of Social Security Disability benefits?

There are two basic types of Social Security Disability benefits: SSDI and SSI. Both SSDI and SSI are administered by the Social Security Administration (SSA).

SSDI (Social Security Disability Insurance)

SSDI is available to individuals who have worked enough in the past that they are eligible for social security benefits. To qualify for SSDI, an individual must have a certain number of work credits. The amount of work credits needed varies depending on the age of the applicant.

To qualify for SSDI, a person must have worked long enough and recently enough under Social Security to earn the required number of work credits. In general, people need 40 credits, 20 of which were earned in the last 10 years ending with the year they become disabled. However, younger workers may qualify with fewer credits.

SSI (Supplemental Security Income)

SSI is a separate income from SSDI. SSI is available to disabled individuals who have not worked enough in the past to be eligible for SSDI benefits. It is a needs-based program that is available to people who meet certain criteria. Applicants may receive both SSI and SSDI.

It’s a federal program designed to help blind, disabled, or elderly individuals financially. Unlike Social Security benefits, disabled individuals eligible for SSI need not have worked and paid into the Social Security system to receive the benefits. Whether a person is eligible for SSI, and how much aid he/she will receive, is also determined by a person’s income.

Individuals who are 65 or older are eligible to apply for and receive SSI. Adult non-students between 18 and 65 must have a qualifying disability to be eligible for SSI benefits. Minors, up to age 18, can receive SSI if their parents or guardians meet the income requirements for aid. Students under age 22 may still receive SSI benefits as a minor.

What is the difference between SSI and SSDI?

  • SSDI is a disability insurance program that provides monthly benefits to workers who have become disabled and cannot work. The amount of the benefit depends on how much money the worker has earned in the past.
  • SSI is a needs-based program that provides monthly benefits to disabled people who do not have enough money to live on. To be eligible for SSI, a person must have very limited income and assets.
  • Costs of the SSI program are paid from Treasury general revenue funds, not by SSA payroll taxes.

Can I receive both SSI and SSDI benefits?

Although SSI and Social Security Disability Insurance are two different programs, you can receive both. However, if you are receiving Social Security benefits, it reduces the SSI amount because those benefits are based on income.

What is the maximum amount of SSI?

The maximum SSI amount a person can receive in a year is $7,000. However, some states have higher maximums. For example, California has a maximum of $9,000. Couples can receive up to $14,000 per year. The amount of SSI is the same nationwide. Individual states can add money to the basic benefit. SSI payments are reduced if the person has income from other sources. And even if income is low, resources of over $2000 for an individual or $3000 for a couple can make people ineligible.

Do you have to be a U.S. citizen to qualify for SSI?

To qualify for SSI, applicants must either be United States citizens or resident aliens. Other non-citizens may be eligible to receive benefits as well, under certain circumstances. Special privileges to qualify for SSI may be granted to refugees, individuals granted asylum, current or discharged alien U.S. Military personnel, and disabled alien individuals lawfully living in the U.S. before August 1996.

Are there other social security benefits?

Yes. Under the Social Security law, the types of benefits you may be eligible for include not only Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), but also Widow/Widower’s Disability Benefits, and Adult Disabled Child and Blind.

How do you apply for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits?

You can apply online for benefits through the Social Security Administration’s online portal available here. Most applications for SSDI are denied and you can increase your odds of getting approved for benefits by highering a disability attorney.

What is the process of applying for SSDI?

There are four steps in the process of applying for SSDI.

First, you must gather the information needed to support your application. The information includes your employment history, medical conditions, and educational history.

Second, you fill out the application and submit it to the Social Security Administration.

Third, the SSA determines if you worked enough years to qualify and evaluates your current work activities.

Fourth, your application is sent to the Disability Determination Services office in your particular state, which decides your claim.

When should you apply for Social Security Disability Insurance?

You should apply for Social Security Disability Insurance benefits as soon as you become disabled. Even if you are entitled to worker’s compensation, you should apply for SSDI benefits as soon you become disabled.

How does the SSA decide to approve or deny Social Security Disability claims?

The SSA has created a five-step process to determine whether an application for SSD is approved.

  1. Are you making less than a specified amount each month? A disability claim is premised on your inability to work or to work less than you were before the disability. Your claim will be denied if you make more than a specified amount each month.
  2. Is your medical condition severe?You must be unable to perform the basic functions of work for at least one year.
  3. Are you suffering from a condition that automatically qualifies as disabling by the SSA? If your medical condition is on the list of illnesses that automatically qualify for disability, the SSA will check to see if the condition is as severe as those on the list.
  4. Can you work as you did before developing the medical condition? If no, then SSA will proceed to step
  5. Is your disability expected to last at least 12 months? Step Five: Is the applicant’s disability expected to last for at least 12 months?

If the answer is yes to all five of these questions, you how a good chance at getting approved for SSD benefits.

What are some examples of medical conditions that automatically qualify as disabling by the SSA?

The Social Security Administration (SSA) provides benefits to Americans who are unable to work due to a qualifying medical condition. The SSA’s definition of disability is quite broad and includes many medical conditions that most people would not consider disabling.

Here is a small sample of medical conditions that automatically qualify as disabling by the SSA:

Leukemia, lymphoma, and most kinds of cancer.

Mental disorders, such as bipolar disorder, autism, depression, panic attacks, anxiety, schizophrenia and post-traumatic stress disorder (PTSD).

Musculoskeletal system problems, such as back and spine conditions, arthritis, amputations, fractures, carpal tunnel syndrome, scoliosis, and fibromyalgia.

Neurological disorders, such as cerebral palsy, stroke, traumatic brain injury (TBI), Parkinson’s disease, and epilepsy.

Heart conditions, such as congestive heart failure and coronary artery disease.

Respiratory system problems, such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis.

What happens if my Social Security Disability Insurance claim is denied?

Most SSDI claims are denied. Denied Social Security Disability Insurance claims can devastate an individual and their family. While most disability claims are denied at first that is not the last step. You have options.

How long do you have to appeal a denied social security claim?

You have 60 days to appeal a denied social security disability claim.

If your application for Social Security Disability was denied, you may appeal the decision by filing a written request within 60 days of receiving the decision letter. However, it may make sense not to appeal the denial and reapply for benefits. Every case is different and you need an experienced Social Security Disability lawyer to help decided what is best for you and your family.

If you decide to appeal a decision denying SSI – SSDI benefits there are four levels of appeal:

  1. Reconsideration
  2. Hearing
  3. Appeals Council
  4. Federal Court

Reconsideration: Your Social Security lawyer will ask for a reconsideration if your claim was denied. A claims examiner who didn’t look at your application the first time around will review it. They will consider any new evidence you or your attorney found to support your claim for disability benefits. Your attorney can answer any questions the claims examiner has during this stage and it is helpful to have someone help you through this process.

Hearing: If your disability claim was denied after reconsideration or you feel the amount awarded was not enough, the next step would be to request a hearing. This hearing takes place in front of an administrative law judge who only handles Social Security Disability claims. An experienced Social Security lawyer could present new evidence; request the judge to subpoena witnesses needed to prove your claim; argue your case before the judge; question witnesses and experts; and, if you have already been awarded benefits, ask the judge to review and reassess the calculations.

Appeals Council: If your claim fails after a hearing before the administrative law judge, you could ask to be reviewed by the Social Security Appeals Council. At this point, it is usually more effective to file a new Social Security claim in most cases.

Federal Court: Finally, if the claim fails the Appeals Council step, you can file a lawsuit in federal district court.

You can reapply for disability in a new claim or you can appeal the process. Often people who are denied Social Security Disability benefits do not appeal the decision. The appeals process is lengthy, and it can be unclear as to what individuals should do next. An experienced Social Security Disability lawyer like Sadaka Law has the experience and the knowledge to help disabled people get the benefits they deserve.

What does a Social Security Disability attorney do?

Since you should apply for all the benefits you may be entitled to, an experienced disability attorney will have no problem identifying what benefits you could qualify for.

It’s a Social Security attorney’s job to help you win your disability claim. A disability attorney knows the law and will help carry out tasks that might be difficult for you to do on your own. He/she will follow the case as it progresses and prepares your appeal for a hearing in front of an administrative law judge if that is necessary.

Experienced Social Security Disability lawyers should secure copies of all medical records supporting your claim and make sure the records are sent to the Social Security Administration. If more information is requested by the Social Security Administration, or if they need you to schedule a medical exam, your lawyer will assist by communicating with the disability examiner and making sure you’re aware and ready for any appointments.

How much does it cost to hire a lawyer for your Social Security Claim?

In most cases, a Social Security disability attorney’s fee is limited to 25% of the retroactive, or “past-due” benefits you are awarded. This fee is “capped” at a maximum of $6,000.00, so the fee is whichever is less: either 25% or $6,000.00. There is no minimum fee.

You usually don’t have to pay anything upfront to a disability lawyer. Instead, any fee is paid out of the back benefits you receive. Usually, Social Security handles the payment of fees directly, withholding the money from your back pay award, and sending the remainder to you.

What about the costs associated with my social security disability claim?

Some of the costs associated with your social security disability claim include postage and medical records. There could be other costs incurred during the process. There is no way for an attorney to recover the costs of a Social Security Disability claim.

Typically, a Social Security lawyer will request reimbursement of the costs whether you win or lose.

Costs should be a concern for you when selecting a Social Security attorney and you need to talk to them about their practices and get it in writing. Our firm has a clause like this built into every one of our fee agreements that act as a promise that we will not spend more than a pre-agreed amount on costs unless we get your express approval.

What are the other types of benefits available?

Disabled Adult Child Benefits (DAC): 

Dealing with a child with special needs is challenging. Parents are often left asking, what happens when my special needs child becomes an adult? There is help. Disability benefits are available from Social Security (Disabled Adult Child benefits).

Who qualifies as a Disabled Adult Child?

A Disabled Adult Child (DAC) is defined by the Social Security Administration as an unmarried person, age 18 or older, has a disability that started before age 22, and meets the definition of disability for adults. The Disabled Adult Child does not need to meet any work requirements, and the benefit amount is based on the parent’s earnings record.

Children Can Receive Disability:

Benefits can also be paid to your unmarried children if they’re younger than 18; between 18 and 19 but in an elementary or secondary school as full-time students; or age 18 and older and severely disabled (DAC as outlined above).

Disabled Widow or Widower (DWB): 

Another program that is often overlooked is the Disabled Widow or Widower (DWB) benefits. DWB benefits are available to disabled widows and widowers who have a deceased spouse who received Social Security disability benefits. The child does not need to meet any work requirements, and the benefit amount is based on the child’s age.

MARK T. SADAKA, ESQ., MSPH

MARK T. SADAKA, ESQ., MSPH

Principal & Founder
This article was written by Mark Sadaka, a seasoned trial lawyer in nationally significant cases. He fearlessly champions clients impacted by fatal or severe injuries caused by others or corporations. Renowned for his expertise in complex litigation, he's featured in books, sought after by media for interviews, and a highly sought speaker. Notably, he exclusively represents individuals facing life-changing injuries or substantial financial losses.

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