Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) are among the various benefits programs that provide financial assistance to seniors and persons living with disabilities.
If you, or a family, are living with a disability, you might be wondering what are the eligibility requirements for disability benefits, and what the application process looks like.
In this article, we’ll cover everything you need to know about the process of getting approved for SSI and SSDI benefits.
We’ll cover the 5-step evaluation process, how you’ll be notified about your eligibility, what to do if you want to appeal the decision, and a lot more.
But first, let’s take a little bit of a closer look at the differences between SSI and SSDI, and who each program is designed for.
The difference between SSI and SSDI
Both Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) are designed to provide benefits to seniors and those living with a disability.
But there are a few differences when it comes to who can qualify for SSI and SSDI. Let’s take a look.
Supplemental Security Income (SSI)
SSI is designed to provide basic financial assistance to two groups with limited income and assets.
- Older adults above the age of 65
- Persons with disabilities regardless of age
The federal government administers SSI benefits, but oftentimes, your state may have programs that also supplement the benefits. For example, as an SSI recipient, you can also qualify for Medicaid in most states.
Social Security Disability Insurance (SSDI)
SSDI benefits are also geared towards people that are living with disabilities.
But unlike SSI, which is based on age and/or income, SSDI is based on your qualifying work history. You could also qualify through a family member’s (parent or spouse) eligible work history.
Another difference is that with SSDI, after 24 months of receiving benefits, you’ll automatically qualify for Medicare.
The only exception is that if you have amyotrophic lateral sclerosis (ALS), you will qualify for Medicare immediately, assuming you’re eligible for SSDI.
To qualify for either SSI or SSDI because of disability, you’ll have to meet the Social Security Administration’s (SSA) definition of disability.
How the Social Security Administration (SSA) defines disability
The SSA defines disability in a different way when compared to most other programs. You will only get benefits if they deem that you have a total disability. You won’t qualify for benefits if the SSA determines that you have a partial or short-term disability.
Note that we’re only talking about qualifying through disability here. You can still qualify for SSI based on age (65+) and income.
But if you want to qualify for benefits because of a disability, you have to meet all of the following criteria according to the SSA guidelines:
- You’re no longer able to do the work you did before your disability
- You’re not able to switch jobs or do other work because of your disability
- Your disability is long-term (it has lasted one year, or expected to last at least one year, or might result in death)
If the requirements seem somewhat stringent, it’s because the SSA assumes that for short term disability, you’d have access to other forms of support. For example, help from family members or the community, savings accounts, private insurance, or worker’s compensation.
In the next section, let’s take a look at the SSA’s 5-step sequential evaluation process to determine if your SSDI or SSI claim will be approved.
The SSA’s 5 step process to determine disability
You will have to go through a 5 step process for the SSA to determine if you qualify under their definition of disability.
1. Are you working?
To be considered for disability, you have to first meet the following requirements.
If you’ve worked in 2020, and your average monthly income has been higher than $1,260, you’re unlikely to qualify for disability.
If you’ve not worked in 2020, your application will be sent over to the Disability Determination Services (DDS) for further evaluation.
The DDS will use the next four steps to make a decision.
2. Is your condition severe?
You must have a disability or condition that prevents you from performing basic tasks like the following:
- Basic cognitive functions like memory
Also, your condition must be severe enough that you’re expected to have trouble with these tasks for at least 12 months.
Assuming your disability is deemed significant enough by the DDS, they will move on to the next step in the evaluation process.
3. Is your disability found in the SSA’s list of disabling conditions?
The SSA maintains a list of medical conditions that they consider to be severe enough to prevent you from performing basic work-related tasks.
The list includes eligible conditions for each major body system, such as respiratory system, cardiovascular system, musculoskeletal system, mental disorders, neurological disorders, and many more.
You can access the list (both for adults and children) here.
If your condition is not on the list, then you won’t be able to qualify. If your disability qualifies, then the process moves on to step 4.
4. Are you able to do the work you did before your disability?
The next step in the evaluation process is to decide if your disability prevents you from performing the job you previously did at a reasonable level.
The SSA has a system in place to help them evaluate your capacity to perform job-related tasks.
They will look at your relevant work history throughout the previous 15 years, which includes all the activities that you’ve done for pay. So it excludes any hobbies or volunteer work.
They’ll make their decision based on the following four factors.
Job descriptions – Your job descriptions from relevant work history will include the tasks you’ve performed, as well as your average weekly workload. It will also include the skills you needed to perform the job, and a description of the environment you worked in.
Physical requirements of the jobs – This portion of the evaluation will determine the physical demands of the job. For example, if it was primarily a desk job, or if it involved manual labor like climbing, lifting, or extensive walking.
They will also look at any equipment you had to use on the job, and if your disability affects your ability to use it now.
Any difficulties that you faced – Your difficulties might include reduced hours due to your disability, or having to take frequent leaves because of your health. They might ask if you needed a lot of help from your coworkers due to your condition.
How your condition affects you – The final part of this step is to determine how your current physical condition affects your ability to perform the job. The SSA will consider when your disability began to affect your ability to perform your job and when you had to stop completely.
After considering all the four factors here, if they decide that you’re unable to perform your past jobs, the next step is to evaluate if you can perform another type of job.
5. Are you capable of performing another type of job?
In this final part of the 5-step evaluation process, the SSA will determine whether you can perform another type of job that you’re qualified for, despite your disability.
They’ll consider your age, education, past experiences, and any skills that could transfer to another job. They will also consider if your medical conditions would affect your ability to perform tasks at another job that you might be qualified for.
Now that we’ve covered the evaluation process to determine disability according to the Social Security Administration (SSA), let’s look at how you can get the application process started.
What are the other criteria to be approved for SSI?
For SSI, you can qualify either through disability, as described above, or if you’re blind, or above the age of 65.
Additionally, you must meet the following requirements.
- You’re a U.S. citizen or legal resident
- Your income and assets are limited
In 2020, the income limit for SSI is up to $783/month if you’re single, or $1,175/month as a married couple.
What are the other criteria to be approved for SSDI?
Besides disability, the main other category to be eligible for SSDI is having a long enough work history, and paying into social security benefits through your taxes.
The SSA will determine your eligibility for SSDI based on a credit system.
Work history and credits for SSDI benefits
Whether you’ve worked enough to earn SSDI benefits will depend on your age when disability begins, your income prior to disability, and the number of years you’ve been paying taxes.
You get work credits based on your annual income, but you can only get a maximum of four credits per year.
In 2020, if you earn $1,410 during the year, you will get one credit. So, as long as you earn more than $5,640 ($1,410 X 4), you will earn all four credits.
It doesn’t matter if you earn that income in one month, or over the entire year.
Note that it is not about how much you pay into social security per year, but the credits are based on how much you’ve earned.
How many work credits to qualify for SSDI?
The number of work credits you’ll need to qualify for SSDI will depend on your age. The older you are, the more work credits are required.
There are two ways that the SSA qualifies you for work credits. The “recent work” test and the “duration of work” test.
The recent work test
The first test looks at your work history immediately prior to when your disability began.
Here are some of the guidelines based on when your disability began.
Under the age of 24 – You can qualify if you’ve earned 6 credits in the 3 years previous to when your disability starts. 6 credits could be approximately 1.5 years of work, assuming you earn the max 4 credits per year ($5,640 per year).
Between the ages 24 to 31 – The general rule is that you had to have worked half the time between since you turned 2, and when you apply for disability.
For example, if you’re 28 when your disability began, that’s 7 years since you turned 21. So that means you should have worked 3.5 of those years to be able to qualify for SSDI. You should also have around 14 credits (3.5 X 4 credits per year)
Age 31 or older – After the age of 31, it is expected that you have 20 credits accumulated in the previous 10 years. That’s 5 out of the 10 years since you turned 21, at 4 credits per year.
The duration of work test
In addition to the recent work test, you will also need to pass the duration of work test to qualify for disability benefits through SSA.
The duration of work test measures your total work over the course of your life. This is different from the recent work test which only looks at the years immediately prior to disability.
For this test, the work does not need to fall within a certain window.
If you’re statutorily blind, you only have to meet the duration of work test over your lifetime, and not the recent work test.
For other applicants, you have to meet both the recent work test, as well as the duration of work test.
If you’re younger, below the age of 40, then you’ll most likely automatically meet the duration of work test if you meet the requirements for the recent work test.
Are family members eligible for SSDI?
If you don’t have enough work credits to qualify for SSDI, you can still be eligible through a family member.
If your parents are eligible for SSDi benefits, you can qualify through them if you have a disability, even if you’ve never worked yourself. You can also receive benefits through your spouse, or ex-spouse.
Disability benefits for children
If you have children under the age of 18, they can qualify for benefits through your work credits. But the child’s benefits generally stop when they reach the age of 18.
The only exception is that if your child is a full-time elementary or high school student, and then the benefits can continue till they are 19.
Disability benefits for young adults (under the age of 22)
If you have an adult child (over the age of 18 but under 22) with a disability, then might still be able to receive disability benefits through your work credits.
They can receive benefits if a parent is deceased ,or if the parent starts earning retirement or disability benefits.
It is a “child” benefit because it is paid through the taxes and earnings of the parent.
The child must be single, and the disability must have started before the age of 22. They also have to go through the evaluation of disability like other adults.
The child can also be a stepchild, grandchild, or step grandchild.
How long do SSDI applications take to get processed?
Every application varies, but in general you should expect that the application process could take around 3-5 months.
If you have a severe disability, you might fall under the SSA Compassionate Allowances (CAL) classification, in which case you will receive expedited processing of your disability benefits application.
How are you notified of your approval or disapproval?
Once the SSA determines your eligibility for disability benefits, they will mail you a letter to notify you about their decision. Your online account will also be updated with the current status, so be sure to check that periodically.
The letter will inform you about the disability conditions that you were approved for, and how often you can expect a medical review for the continuation of your benefits.
It will list your onset date for your disability, which is used to determine your back-pay. Note that the SSA might decide on a different onset date based on their evaluation than what you might consider as the beginning of your disability.
What happens after I am approved for disability?
After you get approved for disability benefits, you will also get notified about your monthly award amount, as well as the amount of your back-pay, depending on your official onset date of disability.
You can choose to receive your benefits via a SSA issued debit card, or have it deposited directly into your checking account.
Generally, it takes around 30-90 days after your approval to get your back-pay, as well as your first monthly check.
What to do if you disagree with the decision?
If you were denied disability benefits, and you disagree with the decision, you can request an appeal.
You have to file your appeal within 60 days of when you received the notification. There are four levels to the appeals process.
- Hearing by an administrative law judge
- Review by the Appeals Council
- Federal Court review
For detailed information on each level, visit the SSA page on the appeals process.
If you have to go through an appeals process, it can unfortunately delay your benefits significantly. Below, we’ve added a section with some ideas on how to survive financially while waiting for the decision, and in some cases, the appeals process.
Is there a cap on disability back pay?
There is no cap on the disability back-pay that you’re deemed eligible for.
If approved, you become eligible for disability benefits from the day of your official disability onset, as determined by the SSA.
So, let’s say your application appeals process ends up taking 6 months to get processed, then you’ll receive a lump sum check with those 6 months of disability benefits.
Note that there is typically a large backlog of disability claims. So you should plan for the process to take a while. On the positive side, when everything does get processed, you will get all the money you’re entitled to, since there is no cap.
How do you survive while waiting for disability approval?
The disability approval process can take months, especially if there are disputes and you have to appeal the decision.
The good news is that if you do get approved eventually, you will end up getting a large back-pay check in the mail.
SSI recipients get benefits from the day of their application, once approved. SSDI recipients get an additional one year of retroactive benefits, if your disability affected your ability to work long before you applied.
Nonetheless, if you’re currently unable to work, and you’re stuck waiting for the approval, it can cause financial strain, especially if you have medical or care expenses.
Here are some ideas to help you get through the approval period.
Support from family
Consider asking your family for financial support if you are in a position to do so.
Let them know about the status of your application, the timeframe you expect to get approved, and how much support you might need in the meantime. If it helps, offer to pay them back when you do get approved.
You can also let them know that they shouldn’t feel obligated to say yes if they’re not in a position to do so, and that you can explore other options if necessary.
A new credit card
You can also consider signing up for a new credit card. If it’s only a matter of a few months, you can charge your expenses to the new card, and then pay it all off when you get your disability check.
If you decide to go this route, be sure to shop for cards that might offer lower interest rates for the first few months as a promotion.
Whether you decide to ask a family member for support, get a credit card, or do both, you should focus on not spending any extra money beyond the essentials.
It’s only a matter of a few months, and keeping your expenses low will help with the repayment process, and save you money also.
Go through your bank statements the past couple of months to identify any areas where you can temporarily cut costs till you get approved for your disability benefits.
Sell items online
Not all of us have the option to ask family members for help, or even sign up for a low-interest credit card.
Another thing you can do while waiting for your disability approval is to sell items on eBay or Craigslist.
You might have things lying around the house or in your garage that you no longer need or use. Chances are, there might be someone out there who could use them, and they’d be willing to pay you to buy those items.
Apply for food stamps
Food stamps, also known as Supplemental Nutrition Assistance Program (SNAP), can provide you benefits that you can purchase food with when you’re on limited or no income as you wait for your disability approval.
You can use SNAP to buy healthy food items such as fruits and vegetables, meat, fish, poultry, dairy, bread, cereal, etc. If you like to grow your own food, you can also purchase seeds with SNAP.
There are some restrictions on what you can buy with SNAP. You can’t use it for alcohol, restaurant take-out, or household items.
If you’re in New York, you can learn more SNAP here.
Medicaid and CDPAP in New York
If you’re living with a disability in the state of New York, and you qualify for Medicaid based on income and assets, you could also take advantage of CDPAP.
CDPAP is a NY Medicaid program that allows you to hire your friends or family members as caregivers to assist you with activities of daily living such as grooming, bathing, cleaning, meal preparations, and anything else you need.
The caregiver is compensated for their time and effort through Medicaid. It’s a mutually beneficial situation for both you and the caregiver.
For detailed information, including eligibility requirements, be sure to visit our CDPAP page.
How to apply for disability benefits?
If you want to get the application process started, you can apply for disability benefits in the following ways.
You can apply online here.
You can get the process started by calling the toll-free number: 1-800-772-1213. You can ask any questions, and make an appointment to submit your application at any local SSA office.
For those who are deaf or hard of hearing, there is a toll-free “TTY” number: 1-800-325-0778. You can call between 8:00 a.m. and 5:30 p.m. on Monday through Friday.
Finally, you can apply in person at a local SSA office.