A Guide to Social Security Disability Benefits

A Guide to Social Security Disability Benefits

The financial impact of a disability can be challenging. It's hard to pay bills when you're unable to work, but you may be eligible for relief in the form of Social Security disability benefits. After qualifying for benefits, you receive helpful monthly payments, and if you're able to return to work eventually, you can gradually transition from benefit payments back to your regular income from work.

The Social Security Administration (SSA) provides two programs for when you're unable to work:

  • Social Security Disability Insurance (SSDI) offers the highest monthly income, but you need a sufficient work history to qualify for benefits.

  • Supplemental Security Income (SSI) is available to those with limited financial resources and is not based on your work record.

For maximum protection, it's best to have private disability insurance coverage, but Social Security can act as an additional safety net.

How To Qualify

To be eligible for benefits, you must meet the SSA's definition of disability:

  1. You must be unable to do any substantial work.

  2. The disability must be expected to last for one year or lead to your death.

You'll need to prove that you have a disability by providing medical records to the SSA. This may be relatively straightforward if your disability is easy to document, such as a spinal injury, but it can be more complicated for matters like mental health conditions or headaches.

Whatever your condition is, it's critical to seek medical guidance regularly. Doing so demonstrates to the SSA that you currently have a disability and are taking all possible steps to manage the condition. Even if you don't think treatment would help, it's best to show you're being proactive and following your doctor's instructions. Every doctor's visit results in a medical record that may help prove your case.

Qualifying for SSDI

SSDI benefits are based on your work history. You must have at least 40 work credits, which are typically earned by working at a job for a quarter year. This means you can potentially earn four credits each year. However, there are exceptions and additional rules. For example, people who are disabled before age 22 may be able to claim based on a parent's work record.

Qualifying for SSI

If you cannot qualify for SSDI, you might be eligible for benefits under SSI. You'll need to have a limited income, and the exact amount of allowable income depends on your state. You must also have limited resources.

Your home and your car generally don't count toward the limit, but the value of most other assets you own can't exceed $2,000 (or $3,000 for a married couple living together). Cash in bank accounts and investments count toward that limit.

What Benefits Do You Get?

Social Security disability programs pay monthly income and typically include access to health care benefits. The actual amount you receive may vary depending on where you live, your earnings and who else lives in your household.

SSDI

Your SSDI payments depend on your earnings history. When you work for an employer who pays into Social Security, payroll deductions from your earnings help fund the disability payments.

The average monthly benefit in 2019, for example, was $1,234 (which equates to almost $15,000 per year), according to the latest figure available from the SSA. After being on SSDI for two years, you generally qualify for Medicare. Or, if you're in a waiting period before Medicare is available to you, you may be eligible for Medicaid.

SSI

The basic SSI payment for an individual is $841 in 2022 (or $1,261 for a married couple that qualifies). That's roughly $10,000 per year, which is significantly less than you get from SSDI. However, it may be possible to get payments from both programs, if you qualify.

Once you get approved for SSI, you may automatically qualify for Medicaid — you don't even need to apply for Medicaid benefits in many states.

How To Apply for Disability Benefits

Submit an application to the SSA to begin the process. You can start the process online, in person or by phone.

When applying for benefits, you need to provide information about yourself, including:

  • Medical conditions

  • Health care providers

  • Family members

  • Work history

The SSA provides a checklist that can help you gather the details necessary to complete an application. After a high-level review of your eligibility, the SSA forwards the request to a Disability Determination Services office in your state. That agency makes a final decision on which benefits are available to you.

What To Expect

The initial review process often takes three to five months, but it's not uncommon to get denied on your first attempt. To improve your chances of a success, be sure to submit a complete application and include sufficient medical evidence.

If your request is denied, you can appeal it. This might involve providing more information about your ability to work. However, the process can take several more months, and your appeal may not be successful. If the appeal doesn't work, you can request a hearing with a judge, which can provide the opportunity to make your case in person.

Ultimately, the total time for approval depends on how early in the process you get approved and how quickly your state moves. If there is a backlog of applicants, it can take a surprisingly long time to get benefits. Fortunately, if you eventually qualify for SSDI, the SSA can provide retroactive payments for up to 12 months before your initial application. If you think you might be eligible for benefits, consider applying as soon as possible after a disability begins.

Some law firms specialize in helping people get disability benefits from Social Security. While you aren't required to hire an attorney, it's worth evaluating the pros and cons of doing so. An attorney can provide helpful guidance and make the process smoother. However, there's always a cost for hiring help. In many cases, attorneys take a portion of your retroactive payments (up to a limit set by the SSA).

Can You Return to Work?

The SSA encourages you to return to work — if that's feasible — by allowing you to earn income and receive benefits at the same time. Eventually, you might be able to earn more from work than you get in benefits.

For example, if you get SSDI benefits, you can try working and see how it goes. The SSA allows you to work for up to nine months within a 60-month window without any reduction in benefits, and if you earn below a specific limit each month, that month won't count toward your nine months.

After completing nine months, you begin a 36-month extended period of eligibility (EPE). During that time, if your countable earnings exceed certain limits, your SSDI income for a given month might be withheld. But if you're unable to work because of a disability or you earn less than the threshold, you can still receive SSDI benefits without submitting a new application.

Key Takeaways

Social Security disability benefits can provide a safety net if you're unable to work. However, qualifying for benefits can be difficult, and the process takes time, so it's best to apply as soon as you know you'll need benefits. You may eventually get monthly payments to help cover expenses, and if you're able to return to work, there's a transition process to help you get back to earning a regular income.

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