Social Security Disability FAQs


Q. Who is eligible for Disability benefits?
A. To be eligible for benefits, a person must be unable to do any kind of substantial gainful work because of a physical or mental impairment (or a combination of impairments), which is expected either to last at least 12 months or to end in death.

  • Disability Insurance Benefits–based upon FICA wages of the disabled wage earner;
  • Widow/Widower Benefits–payable to disabled surviving spouses between the ages of 50 and 60 based upon the FICA wages of a deceased spouse;
  • Adult Disabled Child’s benefits–payable to a dependent adult child of a wage earner who is retired retired, disabled or deceased. The disability has to have a disabling onset prior to the child turning age 22. Also the child must be unmarried.
  • Supplemental Security Income–requires a disability and a financial need. SSI is kin to a welfare type program since entitlement is income and asset sensitive.
  • Child’s Supplemental Security Income–payable to parents of disabled children who meet certain family income standards.

The Social Security program pays benefits to disabled or retired workers and their families and to the families of deceased workers. To be eligible for Social Security disability insurance benefits, you must be disabled and must have earned a minimum number of credits from work covered under Social Security (FICA or self employment tax). The required number of credits varies depending on your age at the time you became disabled. You also need a certain number of recently earned credits to be qualify for payment. For an individual over the age of 30, the required number of credits is 20 credits within the 40 quarters prior to the onset of disability.

The SSI program provides monthly income to people who are age 65 or older, or are blind or disabled, and have limited income and financial resources. Effective January 2004, the SSI payment for an eligible individual is $564 per month and $846 per month for an eligible couple. If you are married, and only one person is eligible, a portion of your spouse’s income may be counted. In addition, your financial resources (savings and assets you own) cannot exceed $2,000 ($3,000 if married). You can be eligible for SSI even if you have never worked in employment covered under Social Security. You may also be entitled to SSI if your disability benefit is low (i.e. below the SSI maximum).

Generally, to be eligible for SSI, an individual also must be a resident of the United States and must be a citizen or a non-citizen lawfully admitted for permanent residence. Also, some non-citizens granted a special status by the Immigration and Naturalization Service may be eligible.


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Q. What is the difference between Social Security disability and SSI?
A.
Social Security disability insurance is a similar to a private disability program. We pay are premiums by pay FICA tax or self employment tax. The more we earn and the longer we earn or stay in the workforce the higher the monthly benefit. As a result the amount of the monthly benefit varies since it is based on your work history and your earnings.

SSI is a program financed through general tax revenues-not through Social Security trust funds. SSI disability benefits are paid to people who have a disability and who have limited assets own much nor have a lot of income.


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Q. What are the disability requirements for an adult?
A. The definition of disability in the Social Security law is a strict one. To be eligible for benefits, a person must be unable to do any kind of substantial gainful work (a term defined by Social Security) because of a physical or mental impairment (or a combination of impairments), which is expected either to last at least 12 months or to end in death.
If, because of a medical condition, a person cannot do the work that they performed within the past 15 years, then age, education, and past work experience must be considered in determining whether the person can do other work. If the evidence shows that the person can return to his or her past work or can do other work, even if it involves different skills or pays less than their previous work, the individual cannot be considered disabled for Social Security purposes.
The SSA uses a step-by-step process to determine whether you will qualify as being disabled. We call this a sequential evaluation. The process includes the following five questions:

  1. Are you working? If you are and your earnings average more than the current level defined as substantial gainful activity (SGA), you generally cannot be considered disabled. In 2004 SGA is defined as $810 per month for non blind and $1350 for blind individuals.
  2. Is your condition severe? Your impairments must interfere with basic work-related activities for your claim to be considered.
  3. Is your condition found in the list of disabling impairments? The SSA maintains a list of impairments for each of the major body systems that are so severe they automatically mean you are disabled. If your condition is not on the list, the SSA will decide if your impairment is of equal severity to an impairment on the list. If it is, your claim is approved. If it is not, the SSA will go to the next step.
  4. Can you do the work you did previously? If your condition is severe, but not at the same or equal severity as an impairment on the list, the SSA must determine if it interferes with your ability to do the work you did in the last 15 years. If it does not, your claim will be denied. If it does, your claim will be considered further.
  5. Can you do any other type of work? If you cannot do the work you did in the last 15 years, the SSA looks to see if you can do any other type of work. The SSA considers your age, education, past work experience, and transferable skills, and they review the job demands of occupations as determined by the Department of Labor. If you cannot do any other kind of work, your claim will be approved. If you can, your claim will be denied.

For the listing of all disabling impairments it can be found in Title 20 of the Code of Federal Regulations The listings can be found with a little effort at Social Security Online (www.ssa.gov).


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Q. I receive Social Security disability benefits. Will my Social Security benefits change when I turn age 65?
A.
When you turn age 65, nothing will change, except for Social Security purposes, your benefits will be called retirement benefits instead of disability benefits. A person over the retirement age (65) can not be paid disability insurance benefits.


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Q. How do I apply for Social Security disability benefits?
A. You can apply for one or more of the programs by going into or calling your local Social Security Office. A representative will schedule an appointment for you. You can apply in person, over the phone (800-772-1213) or online at www.ssa.gov. You should apply as soon as you become disabled. However, Social Security disability benefits will not begin until the sixth full month of disability. This waiting period consists of the month of onset and five (5) full months thereafter. Remember Social Security pays a month in arrears which extends the date of first payment. Also you can not be paid benefits in excess of twelve (12) in advance of your application for disability insurance benefits. SSI benefits can be paid no earlier than the first full month following the month of application. So for SSI it benefits a person to apply as early as possible. Your disability still has to be expected to last the twelve (12) month durational requirement.


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Q. Will I get medical insurance when Social Security finds me disabled?
A.
A recipient of disability insurance benefits becomes Medicare eligible in the 25th month of payment. Within the State of Indiana qualifying for SSI does not automatically entitle the recipient to Medicaid. You must apply for Medicaid separately through a county welfare office.


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