Applying for disability benefits through the SSDI or SSI programs can be daunting. Here is a brief overview of how the application process works and what you can expect after you’ve applied.
What Is Supplemental Security Income?
Supplemental Security Income (SSI) has been a federal program since the 1970s. It provides modest monthly payments to assist seniors, people with disabilities, and others who have limited income.
To qualify, you must be unable to work, and your income and assets must meet very specific restrictions. In 2023, the standard monthly SSI benefit is $914 per individual.
What Is SSDI?
Social Security Disability Insurance (SSDI) is another federal program offering cash assistance. People with disabilities can benefit from SSDI regardless of how much they have in terms of income or assets.
In 2023, SSDI payments average $1,483 a month per individual.
How to Apply for Federal Disability Benefits Through SSDI or SSI
You can apply for federal benefits through SSDI and SSI as a result of a disability. Your personal circumstances will dictate which program is right for you. In some circumstances, you can apply for both.
The SSDI program pays disability benefits to those who cannot work due to a medical condition that is expected to last at least one year or result in death. SSDI does not give money to people with a partial disability or short-term disability.
To apply for SSDI successfully, a person must meet two different earnings tests:
- The “recent work” test, which requires a person has worked for a certain amount of time ending with the quarter they developed a disability and is based on the age at which a person became disabled; and
- The “duration of work” test, which requires a person has worked a minimum amount of years or quarters before the age they developed the disability and is also based on the age a person became disabled.
You can apply for SSDI by:
- using the Social Security Administration’s (SSA’s) online application,
- telephone (1-800-772-1213), or
- by making an appointment to visit your local Social Security office. (Find your local office online.)
As part of this process, you have the right to be represented by an attorney or other qualified person.
The SSA recommends that applicants apply for disability benefits as soon as they develop a disability. Gather the following documentation to apply for SSDI:
- Your Social Security Number
- Your date and place of birth
- Medical records, including:
- Information on all medications you take
- Lab and test results
- Information about all doctors and medical professionals you have seen for your medical condition
- Your work history for the past 15 years
- A copy of your most recent W-2 Form and most recent tax return
You must provide specific details regarding your disability and medical condition in your application. The SSA can assist the applicant with getting the information if they cannot.
Applying for SSI
Another way to apply for benefits is through the SSI program. SSI provides financial assistance to people with limited means and who are either over 65, blind, or have a medical condition that keeps them from working. Similar to SSDI, the applicant’s a medical condition must be expected to last at least one year or result in death.
If you are applying for SSI, be prepared to provide financial information about yourself and potentially your spouse’s or family’s income and assets.
You can apply for SSI online on the SSA website.
How to File for SSDI and SSI
If you’re over age 18 with a disability and intend to file for both SSI and SSDI, you can apply online for both benefits simultaneously as long as you:
- Are between 18 and 65
- Have never been married
- Are a U.S. citizen residing in one of the 50 states, the District of Columbia, or the Northern Mariana Islands
You should expect to provide your personally identifying information, contact information, birth certificate, as well as information on the following:
- Your Social Security
- Your living situation (whether you rent, live at home, etc.)
- Your income, if applicable
- What assets you own
- All the doctors and medical professionals you have seen for your condition, if you are applying for SSI because you are disabled or blind
If you apply via phone or online, you will need to send the SSA additional supporting documentation to prove U.S. citizenship or residence. Once the application is complete, the SSA begins reviewing your application to decide whether you are eligible for benefits.
In order to receive concurrent benefits, you typically must be under certain income and asset levels. An example of when this may occur is where your resulting SSDI award is under the current SSI monthly payment amount. If you are below the SSI thresholds, you may also be entitled to an SSI payment.
Rejections and Appeals
The SSA initially rejects approximately 70 percent of disability applications. Its most common reasons for denying applications for benefits are when:
- The applicant has an impairment that is expected not to exceed 12 months,
- The impairment is not considered severe,
- The SSA believes the applicant can perform their usual type of work or another type of work,
- An impairment resulting from drug addiction or alcoholism is not sufficiently medically documented or evidenced, or
- The applicant did not cooperate with the SSA, did not follow treatments, or returned to substantial work before the disability could be established.
If SSA rejects your application, it’s important to retain a competent attorney immediately to advise you about the next steps in the appeals process. Whatever you do, do not delay; failing to file a timely appeal could jeopardize your chances of obtaining retroactive disability benefits that you might otherwise be entitled to receive based on the date of your initial application.
The appeals process can be demanding, but is worth it if it opens up your access to these federal benefits and the medical coverage that comes with them. In the first stage of an appeal, called a “request for reconsideration,” the disability agency that made the initial determination gets a second look at your application. Very few appeals are won at this level.
If rejected for reconsideration, you go to a hearing before an administrative law judge to plead your case. Applicants who make it this far have a roughly even chance of winning the appeal – a chance that grows larger if competent counsel represents you. If the judge rejects your appeal, you can file for review by the Appeals Council, which approves only between 2 and 3 percent of all appeals.
Your final recourse is to file suit in federal court, which can be costly.
Retroactive and Back Payments
Because the disability application process can take months, the SSA awards successful applicants back payments that they would have received in the months between the date an application for benefits was filed and a final determination is made.
In addition to back payments, SSDI (but not SSI) recipients can receive retroactive payments going back one year from their application date if they were disabled during that time. However, the SSA takes five months off of a successful applicant’s established disability onset date when calculating retroactive payments. So, an applicant would have to have been disabled for 17 months before applying to receive the full 12 months of benefits.
If all these rules seem complicated, that’s because they are. The Elder Law and Special Needs attorneys at Mandelbaum Barrett PC are here to discuss the disability application process before you apply so you can have an accurate picture of what is needed and what your chances are before you begin.