What Are Social Security Disability Benefits?

--by Jason Van Steenwyk

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Social Security Disability Statistics

  • 10 million

    Number of Americans receiving Social Security Disability Assistance

  • 55

    Average age of Social Security Disability recipients

  • $1,233.70

    Average monthly disability benefit

  • 1 out of 4

    A 20-year-old's chance of becoming disabled before reaching retirement age

  • Most common cause of disability

    Musculoskeletal and connective tissue disease, accounting for more than 1 out of 3 qualifying disabilities

To contact the Social Security Administration regarding their disability programs, call 1-800-772-1213. Those with hearing impairments can call the Social Security TTY number, 1-800-325-0778.

Resources: The Social Security Handbook

Source: Social Security Administration, Annual Statistical Report on the Social Security Disability Program, 2018. Released: October 2019.

Social Security Disability Benefits

Overview

Disability can strike anyone at any time. According to the Social Security Administration, one in four of today's 20-year-olds can expect to become disabled by the time he or she reaches retirement age.

The loss of income can be devastating to affected individuals and their families. The Social Security disability programs are an important part of the safety net protecting the most severely disabled.

Generally, the Social Security Administration pays a modest monthly cash benefit to qualified U.S. citizens or residents who 1) have had enough qualified employment, 2) are younger than their full retirement age, and 3) who are demonstrably unable to work for at least a year due to a qualifying disability.

Unlike Social Security retirement benefits, disability benefits are not automatically approved. You must prove that you meet the criteria for benefits.

The benefits continue as long as you are disabled and unable to work again on a regular basis. However, there are some programs that allow beneficiaries to do a limited amount of work while receiving benefits. These are called "work incentives" and are designed to help disabled individuals manage a gradual return to the workforce.

The qualification process isn't easy. There's a lot of documentation required. Most claims from individuals who are not obviously and incontrovertibly severely disabled are initially turned down.

SSDI vs. SSI – What's the Difference?

While both programs are disability insurance programs administered by the Social Security Administration, there are some crucial differences.

Supplemental Security Income, or SSI, is designed for poor or indigent individuals with disabilities. This benefit is means-tested: Applicants must meet stringent tests on income and assets in order to qualify. Additionally, you don’t need to have met past work requirements to receive SSI. Many children and adults with lifelong disabilities receive SSI even though they have never been employed.

Social Security Disability Insurance, or SSDI, is not means-tested, but you do need to have met a work history requirement, discussed below.

You can qualify for SSDI even if you have significant income from sources other than work, and even if you have significant assets. SSDI is determined based on your disability and your past history of employment.


Qualifying for Disability Assistance

Definition of Disability

Understanding the definition of disability that the Social Security Administration uses is critical. For the purposes of qualifying for Social Security disability benefits under either SSI or SSDI, the SSA defines a qualifying disability as the "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months."

Applicants should understand that the definition of disability here is strict: Only total disability will qualify. Unlike the Veterans Administration and some private disability insurance policies, the Social Security Administration doesn’t approve applications for partial benefits.

So if you're still able to work part-time, for example, you won't qualify for disability benefits under either SSI or SSDI.

"The Social Security Administration looks for reasons to reject your claim," warns David Henson, an attorney with Henson Fuerst in Raleigh, N.C.

There's also no provision for short-term disability under either federal program, except if the condition is expected to result in death. To qualify, your certifying physician will have to verify that you are 100 percent disabled and that your disability will not improve within 12 months, or is expected to result in death.

Definition of Blindness

The Social Security Administration considers an applicant blind if his or her vision cannot be corrected to better than 20/200 in the better eye, or if his or her visual field is 20 degrees or less, even with a corrective lens. Being blind may qualify you for a higher benefit.

Non-citizens

You don't have to be a citizen to qualify for benefits. Details on eligibility for non-citizens are available here.


SSDI

How to Qualify

Generally, you can only qualify for SSDI if you are totally disabled, and you can no longer perform any work that you have done previously. Disability payments from private sources, such as private pension or insurance benefits, do not affect Social Security disability benefits. But workers' compensation and other public disability benefits may reduce them. These benefits include Veterans Administration disability benefits, state benefits and SSI.

Additionally, you need to show that there is no work available that you can reasonably do, or be retrained to do. Your age, education level, and physical condition are all factors in this determination for SSDI. Applications from younger and more educated individuals will receive stricter scrutiny from SSA officials before getting approved.

For more information on how your age and education level may affect your ability to qualify for disability benefits, click here.

Work Credits

To qualify for benefits, you must have accumulated sufficient work credits during your work or self-employment history. As of 2019, workers get one credit for each $1,360 in income for the year. You can earn up to four credits each year.

Most applicants over age 62 will need to show that they have accumulated at least 40 credits, or 10 years' worth of credits. At least 20 of those credits must have been earned within the 10 years prior to the year in which you became disabled. However, younger workers who haven't had a chance to accumulate 40 credits may qualify for an exception:

  • Before age 24:

    You must have earned six credits in the three-year period ending when your disability starts.

  • Age 24 to 31:

    You must have earned credits for working at least half the time between age 21 and the time you became disabled. For example, if you become disabled at age 27, you would need to have earned credit for at least three years of work (12 credits) out of the six years that have elapsed since you turned 21.

  • Age 31+:

    See the chart below:

Age at which applicant became disabled Number of Credits Required to Qualify
31 through 42 20
43 21
44 22
45 23
46 24
47 25
48 26
49 27
50 28
51 29
52 30
53 31
54 32
55 33
56 34
57 35
58 36
59 37
60 38
61 39
62 40

For a full explanation of how SSDI work credits are earned and credited, click here.

How Much You May Receive

Your monthly SSDI payment is based on your lifetime average covered earnings. The maximum benefit is capped at 80 percent of your pre-disability income. However, the Social Security Administration may lower your benefit if you are also receiving workers' compensation benefits or other disability benefits from public sources.

You won't get your SSDI benefit docked because you have income from other sources, such as investments or a pension.

The monthly benefit is generally adjusted for cost-of-living each year.


SSI

How Much You May Receive

The SSI benefit amount is based on the Federal Benefit Rate (FBR). As of 2019, the FBR is $771 per month for a qualified individual. If a couple qualifies together, the FBR for the couple is $1,157.

But that's not the amount you receive. That's just a starting point for the calculation.

The Social Security Administration will then subtract any countable income (income from non-exempt sources). See the section below for a discussion on countable vs. non-countable income.

SSI Countable Income and Assets

SSI is means-tested. Your income and countable assets cannot be above certain amounts in order to qualify for SSI. There is no work credit requirement to qualify for SSI benefits. However, you do have to be low-income, with very limited assets, in order to get approved.

The general limit for countable resources for SSI is $2,000 for an individual and $3,000 for a couple.

However, certain assets are exempt, or non-countable, when calculating whether an SSI applicant qualifies. These assets won’t count against you when determining eligibility:

  • Home equity in your personal place of residence, as well as the land
  • One automobile, with no value limit, if actually used for transportation for the SSI claimant or a member of his or her household
  • Household goods and furniture, without limit
  • Personal effects, including jewelry, art, collectibles, etc., as long as the applicant is actually using these items
  • Burial spaces for yourself or immediate family members
  • Up to $1,500 each for yourself and your spouse in burial funds
  • Life insurance policies with a combined face value of $1,500 or less
  • Up to $100,000 in an Achieving a Better Life Experience (ABLE) account
  • Money saved in an Individual Development Account
  • Up to nine months of retroactive SSI or Social Security Payments
  • Grants, gifts, scholarships, and fellowships for educational expenses for within nine months after receipt of funds
  • Health flexible spending accounts (FSAs)
  • State or local relocation assistance payments (for up to 12 months)
  • Crime victim's assistance (for up to nine months)
  • Earned income tax credit payments (for up to nine months)
  • Property necessary to self-support, such as service animals, adaptive technology, etc. This also includes devices, technology and other possessions that a blind or otherwise handicapped individual may need to achieve self-support
  • Dedicated accounts for blind or disabled children
  • Federal tax returns (for up to 12 months after receipt)
  • Disaster relief assistance that is not counted as income
  • Up to $2,000 in compensation per calendar year for participation in certain clinical trials
  • Assets in certain trusts

What to Do if You Are Too Wealthy to Qualify for SSI

If you have assets that put you over the $2,000/$3,000 cap on countable assets, you may be able to receive provisional benefits for up to nine months while you work on selling them. You can sell non-residential real estate, for example (you don’t have to sell the home you live in, since it’s not a countable asset), or personal property, such as a second car.

Real estate sales qualify for a nine-month provisional benefit period, while personal property generally qualifies for up to three months.

Once you complete the sale, you may have to pay back benefits received out of the proceeds. But in the meantime, you will have some money for living expenses while you work on liquidating these assets.

You can find more details on selling excess assets to qualify for SSI here.

Impairment-related Work Expenses (IRWE)

If you have disability-related expenses that you pay out of pocket (and you aren't reimbursed by some other source), the Social Security Administration may exclude them from your earned income. These are called impairment-related work expenses (IRWE). That means they subtract the amount you pay from your countable income each month. This will generally mean you qualify for a higher monthly benefit.

Examples of IRWE include:

  • Cost of prescription drugs, including copays and deductibles
  • Medical expenses, copays, and deductibles
  • Assistive technology for employment-related purposes
  • Transportation expenses, including car modifications

As long as these expenses are reasonable and documented – and not reimbursed to you by another party – the SSA will exclude these expenses from your earned income. That means a bigger monthly benefit. So it pays to document!

Warning: Don't try to give away assets just to qualify for SSI. If you are caught giving away assets, or even trying to sell them fast for much less than market value, Social Security officials could disqualify you for SSI assistance for up to three years, depending on the value of the asset or assets transferred.

Individuals in Institutions

If you or your disabled loved one is in an institution (a hospital, care home, prison, etc.) you may not qualify, or may qualify for a federal SSI benefit of only $30 per month. Some states provide supplemental income for people in this situation. If the institutionalization is temporary (expected to be 90 days or less), you may qualify for your regular benefits for up to three months. See here for more details.

If you live in a public shelter, you can qualify for benefits for up to six out of every nine months you live there.


Applying for Benefits

Regardless of which program you're applying under, you'll need to gather a number of documents. Applying for benefits under federal programs like SSDI and SSI are paperwork-intensive. Applications that are missing required documents will get delayed or rejected altogether. And that can set you back months. So it's important to gather all the relevant documents when you submit the first time.

Listing-Level Conditions and Compassionate Allowance

The normal disability application process can take months--in some cases even years. But the Social Security Administration has developed a process for individuals with certain severe medical conditions to receive expedited consideration.

Some conditions are so severe and debilitating that if you have a confirmed diagnosis, you are presumptively qualified for Social Security disability. This is among the very first screens: Social Security screeners are trained to look for evidence of "listing level impairments" so that these applications can get quickly approved and paid.

These conditions are listed in the Social Security Disability Blue Book in two sections: Section A covers adult disorders, and Section B covers disorders common in children.

There are about 200 conditions that qualify under the compassionate allowance program, including many forms of cancer, adult brain disorders such as early-onset Alzheimer's, and many rare disorders that primarily affect children. You can see the entire list here.

If your condition isn’t listed, don't be discouraged. You can still qualify for benefits if you can prove your disability prevents you from working.

Application Document Checklist

  • Your Social Security number
  • Proof of age (e.g., birth certificate, public birth record recorded before age 5, a religious birth record, etc)
  • Proof of citizenship or alien status. Examples:
    • Birth certificate showing U.S. birth
    • Naturalization certificate
    • U.S. passport or passport card
    • Certificate of citizenship
    • Permanent resident card (I-551)
    • I-94 arrival/departure record
  • List of where you worked for the last 15 years and a description of your duties at each job
  • Copy of your last set of W-2s, or, if self-employed, your last federal tax return
  • Dates of military service, if any
  • Form DD 214 (Certificate of Release or Discharge from Active Duty), if any
  • Details on any other disability payments you may be receiving (VA, state benefits, insurance, etc.)
  • Medical records and points of contact
  • Records showing unearned income (not listed on your W-2, for example)
    • Bank statements
    • Award letters
    • Court orders
    • Receipts
  • Documentation of impairment-related work expenses (IRWE)

How to Get Your Application Approved

Complete, thorough medical records are critical, notes Henson. "Judges treat medical records very seriously. Whatever is written in there is taken as the Gospel truth," he notes. "On the flip side, judges assume that whatever is not in the medical record doesn't exist."

For this reason, it's usually not enough to claim chronic back, shoulder, or hip pain, even if your doctor verifies that you've been complaining about it in office visits. To have a chance at approval, you need to have objective verifiable evidence of a disability: an MRI, CAT scan, X-rays, lab tests – anything any doctor who doesn’t know you can look at and verify, even if he never met you and never heard your complaints.

Get a statement from your treating physician," advises Andrew Kinney, an attorney with the Minneapolis-based law firm of Hoglund, Chwialkowski & Mrozik, who attends hundreds of disability appeals hearings each year. Have your doctor translate your medical diagnosis into its real-world impact on your ability to work. For example, your physician should specifically address the following:

  • Maximum lifting capacity
  • Projected number of days missed per month due to disability
  • Length of time the applicant can stand or sit upright
  • Maximum attention span, if impaired
  • Impact of anxiety disorders on workplace performance

Insider tip: Don’t build your case around your medical problems, advises Jonathan Ginsberg, a Social Security Disability attorney with Ginsberg Law Offices in Atlanta, Ga. “A Social Security disability case is not about your medical problems,” he says. "It's about the affect those problems have on the disabled person’s ability to work."

If you can successfully translate your disability on paper to specific work limitations that prohibit you from participating in gainful activity, you should get an approval, says Ginsberg.

Tips for Success

  • Apply as soon as you can, so you don't miss out on any benefits. There's no application fee. But don't jump the gun and apply before you have solid evidence of your disability and its effect on your ability to work.
  • Start the application with a phone call. If you call the Social Security Administration to make an appointment, and you complete your application within 60 days, the SSA can date your application as of the date of the call, rather than the date you actually applied.
  • Don’t let the lack of medical records stop you from applying. If you are disabled but don’t have medical documents to prove it, the Social Security Administration can pay for a medical exam to make the final determination. They will even make an appointment for you. In some cases, they will even pay travel costs for you to get to the appointment.
  • Comply with ongoing medical treatment plans. This means make your appointments and take medicines as prescribed. If you aren't cooperating with your own treatment plans, appeals officials and judges will assume you aren't that sick – and deny your claim.
  • Ask former supervisors and co-workers to write letters on your behalf. For example, if you were let go from your job because your disability made it impossible for you to meet the job requirements, this can be a powerful piece of evidence to help prove your claim since it relates directly to your ability to work. "That's a lot better than a letter from your best friend or your mom,” says Ginsberg.

Get Legal Help

Planners and attorneys working with disabled individuals and their families will generally try to structure finances and assets so that as little as possible falls under the “countable” category. For example, they will take care to ensure that a disabled individual receiving SSI benefits will not receive gifts or inheritances directly. Instead, most planners will recommend directing them to a special-needs trust.

These are designed so that the disabled individual can still receive the benefit of the assets without losing eligibility for SSI, Medicaid, food stamps, Section 8 housing, or other means-tested assistance.

Otherwise, you may be forced to spend down these assets before you or your disabled loved one can qualify.

It's a good idea to get an experienced special-needs planning attorney involved early in the process – as soon as you know disability is a potential issue – to preserve eligibility for benefits and to protect the family’s assets. Your Social Security office will be able to refer you to free legal assistance, if you qualify.

Appealing a Denial

Most claims – about 75 percent - are initially denied. If yours is among them, you have four levels of appeal.

  • Request reconsideration. You must request this within 60 days of your initial denial. Be sure to submit any new medical records and work history information along with your appeal.
  • A hearing by an administrative law judge
  • Review by the Appeals Council
  • Federal court review. This means filing a lawsuit against the SSA.

More information about the hearings and appeal process is available here.

Tip: Stay in close contact with your SSA rep during the process. It’s rare, but paperwork does occasionally get misfiled or misplaced. Staying in contact and taking ownership of your application may enable you to address a minor paperwork issue early on, before it becomes another denial.