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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:
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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.
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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.
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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.
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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.
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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:
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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.
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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:
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He or she is between ages 50
and 60.
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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.
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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:
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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:
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Online at
https://s3abaca.ssa.gov/pro/isba3/wwwrmain.shtml
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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.
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By going to your local Social
Security office.
SSI applications are not
taken online. You may apply:
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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:
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Getting information from your
Social Security file;
-
Helping you get medical records
or information to support your claim;
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Coming with you, or for you, to
any interview, conference or hearing you have with the SSA;
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Requesting a reconsideration,
hearing or Appeals Council review; and
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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.
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