Disability Benefits - SSI and SSDI

Patient Expert

The Social Security Disability I

The Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) disability programs are the largest of several Federal programs that provide assistance to people with disabilities. There is often confusion about which of these programs is most appropriate for an individual. Let's take a look at the basics about both programs.

While these two programs are different in many ways, both are administered by the Social Security Administration (SSA) and only individuals who have a disability and meet medical criteria may qualify for benefits under either program.

Social Security Disability Insurance (SSDI) is a program financed with Social Security taxes paid by workers, employers and self-employed persons. In order to be eligible for a Social Security benefit, the worker must earn sufficient credits based on taxable work. Disability benefits are payable to disabled workers, disabled widow(er)'s or adults disabled since childhood, who are otherwise eligible. Auxiliary benefits may be payable to a worker's dependents, as well. The monthly disability benefit payment is based on the Social Security earnings record of the insured worker on whose Social Security number the disability claim is filed.

Supplemental Security Income (SSI) is a program financed through general tax revenues. SSI disability benefits are payable to adults or children who are disabled or blind, who have limited income and resources, who meet the living arrangement requirements, and are otherwise eligible. The monthly payment varies up to the maximum federal benefit rate which is standardized in all States, but not everyone gets the same amount because it may be supplemented by the State or decreased by other countable income and resources.

When you apply for either program, the Social Security Administration collects medical and other information from you and makes a decision about whether or not you meet Social Security's definition of disability.

Social Security's definition of disability:

The definition of disability under Social Security is different than other programs. Social Security pays only for total disability. No benefits are payable for partial disability or for short-term disability.

Disability under Social Security is based on your inability to work. You are considered disabled under Social Security rules if you cannot do work that you did before and they decide that you cannot adjust to other work because of your medical condition(s). Your disability must also last or be expected to last for at least one year or to result in death.

This is a strict definition of disability. Social Security program rules assume that working families have access to other resources to provide support during periods of short-term disabilities, including workers' compensation, insurance, savings and investments.

How does the SSA determine if you are disabled? To determine disability, they use a series of five steps:

  1. Are you working? If you are working in the current year, and your earnings average more than $810 a month, you generally cannot be considered disabled. If you are not working, we go to Step 2.

  2. Is your condition "severe"? Your condition must interfere with basic work-related activities for your claim to be considered. If it does not, the SSA will find that you are not disabled. If your condition does interfere with basic work-related activities, they go to Step 3.

  3. Is your condition found in the list of disabling conditions? For each of the major body systems, the SSA maintains a list of medical conditions that are so severe they automatically mean that you are disabled. If your condition is not on the list, they have to decide if it is of equal severity to a medical condition that is on the list. If it is, they will find that you are disabled. If it is not, then then go to Step 4.

  1. Can you do the work you did previously? If your condition is severe but not at the same or equal level of severity as a medical condition on the list, then the SSA must determine if it interferes with your ability to do the work you did previously. If it does not, your claim will be denied. If it does, they proceed to Step 5.

  2. Can you do any other type of work? If you cannot do the work you did in the past, the SSA see if you are able to adjust to other work. They consider your medical conditions and your age, education, past work experience and any transferable skills you may have. If you cannot adjust to other work, your claim will be approved. If you can adjust to other work, your claim will be denied.

Special situations: Most people who receive disability benefits are workers who qualify on their own records and meet the work and disability requirements described above. However, there are some special situations:

  • People who are blind or have low vision: The SSA considers you to be legally blind under Social Security rules if your vision cannot be corrected to better than 20/200 in your better eye, or if your visual field is 20 degrees or less, even with a corrective lens. Many people who meet the legal definition of blindness still have some sight, and may be able to read large print and get around without a cane or a guide dog. If you do not meet the legal definition of blindness, you may still qualify for disability benefits if your vision problems alone or combined with other health problems prevent you from working. There are a number of special rules for people who are blind that recognize the severe impact of blindness on a person's ability to work. For example, the monthly earnings limit for people who are blind is generally higher than the limit that applies to non-blind disabled workers. This amount changes each year. In 2004, it is $1,350.
  • Benefits for widows or widowers who are disabled: If something happens to you, benefits may be payable to your widow or widower with a disability if the following conditions are met:

    • He or she is between ages 50 and 60.

    • The widow or widower meets the definition of disability for adults.

    • The disability started before your death or within seven years after your death. NOTE: If your widow or widower caring for your children receives Social Security benefits, he or she is eligible if disability starts before those payments end or within seven years after they end. The SSA uses the same definition of disability for these widows and widowers as they do for workers.

  • Benefits for children who are disabled: A child under age 18 may be disabled, but the SSA doesn't need to consider the child's disability when deciding if he or she qualifies for benefits as your dependent. The child's benefits normally stop at age 18 unless he or she is a full-time student in an elementary or high school (benefits can continue until age 19) or is disabled.

For a child with a disability to receive benefits on your record after age 18, the following rules apply:

  • The disabling impairment must have started before age 22, and;

  • He or she must meet the definition of disability for adults. NOTE: An individual may become eligible for a disabled child's benefit from Social Security later in life.

    For example, a worker starts collecting Social Security retirement benefits at age 62. He has a 38-year old son who has had cerebral palsy since birth. The son will start collecting a disabled "child's" benefit on his father's Social Security record.

Applying for Social Security Disability Benefits:

WHEN to Apply:

You should apply as soon as you become disabled. If you apply for:

  • SSDI: disability benefits will not begin until the sixth full month of disability. The Social Security disability waiting period begins with the first full month after the date the SSA decides your disability began.
  • SSI: the SSA pays SSI disability benefits for the first full month after the date you filed your claim, or, if later, the date you become eligible for SSI.

HOW to Apply:

There are several ways to apply for SSDI:

  • By telephone by calling 1-800-772-1213, Monday through Friday between 7 a.m. and 7 p.m. If you are deaf or hard-of-hearing, call their toll-free TTY number, 1-800-325-0778, Monday through Friday between 7 a.m. and 7 p.m.
  • By going to your local Social Security office.

SSI applications are not taken online. You may apply:

  • By telephone by calling 1-800-772-1213, Monday through Friday between 7 a.m. and 7 p.m. If you are deaf or hard-of-hearing, call their toll-free TTY number, 1-800-325-0778, Monday through Friday between 7 a.m. and 7 p.m.
  • By going to your local Social Security office.

If you wish, you may have someone act as a representative to help you whenever you deal with the SSA. They will work with your representative as if they were working with you once the paperwork has been completed authorizing that person to act as your representative. Once you appoint a representative, he or she can act on your behalf in most Social Security matters by:

  • Getting information from your Social Security file;

  • Helping you get medical records or information to support your claim;

  • Coming with you, or for you, to any interview, conference or hearing you have with the SSA;

  • Requesting a reconsideration, hearing or Appeals Council review; and

  • Helping you and your witnesses prepare for a hearing and questioning any witnesses.

Your representative also will receive a copy of the decision(s) the SSA makes on your claim(s). For more information about having someone act as a representative for you, click here.

More information and getting started: The SSA has a great deal of information and many forms available on their web site. One of the most helpful of these is their new Disability Starter Kit, which will help you get ready for your disability interview or online application. They have two kits available, one for adults and one for children under the age of 18. The kit provides information about the documents and information that the SSA will require from you and provides general information about the disability programs and their decision-making process. Here are links to the Disability Starter Kit as well as other valuable SSA pubications available online:

Summary: Although SSDI and SSI are both administered by the Social Security Administration, they are intended for completely different types of cases. Being sure you're applying for the correct one can save you a great deal of time, confusion, and frustration. The SSA's web site and publications can take a lot of the mystery and guess work out of the process.