ASKED QUESTIONS REGARDING
SOCIAL SECURITY DISABILITY INSURANCE (SSDI) BENEFITS
AND SUPPLEMENTAL SECURITY INCOME BENEFITS (SSI)
Am I eligible
for Social Security Disability Insurance benefits (SSDI)?
Eligibility for SSDI benefits is based upon a formula of earned
credits and your age at the time of onset of disability. You earn
social security credits when you work in a job in which you pay
social security taxes. Credits are based on your earnings in each
quarter of a calendar year. For example, in 2003, for each quarter
of the year that you earn $890.00, you receive one (1) credit, up
to a maximum of four (4) credits.
How many credits
do I need for SSDI benefits?
This depends on your age at the time you become disabled.
If you become disabled
before age twenty-four (24), you generally need six (6) credits
by the quarter when your disability begins.
If you are twenty-four
(24) through thirty (30), you generally need credits for half of
the period between age twenty-one (21) and the time you become disabled.
If you are disabled
at age thirty-one (31) or older, you need at least twenty (20) credits
in the ten (10) years immediately before you became disabled.
What is my Last
Date of Insured Eligibility (LDIE)?
This date is the last date you would have twenty (20) credits in
the ten (10) years before that date. If that date is before the
date you file for benefits, then the medical evidence must show
you were eligible for benefits on that date.
If I am not
eligible for SSDI benefits, are there other benefits for which I
may be eligible?
If you meet disability requirements for SSDI benefits, but you do
not meet the credit requirements, you may be eligible for Supplemental
Security Income (SSI) benefits. These benefits are available for
individuals who meet the same disability requirements as SSDI beneficiaries
plus meet minimal household income requirements and have limited
resources. These requirements are too complex to be detailed here.
We recommend you contact your nearest Social Security Administration
(SSA) office and inquire if you qualify.
In general, what
does the SSA consider when determining if my disability qualifies
me for SSDI benefits and/or SSI benefits?
You will be considered disabled if you cannot do work you did before
the onset of your disabling condition(s) and based upon SSA criteria,
they determine you cannot adjust to other work because of your medical
condition(s). Your disability also must last or be expected to last
for at least a year or to result in death. However, the condition
cannot be caused by or substantially aggravated by street or prescription
drug use or alcohol abuse.
Does the SSA
have a procedure for evaluating if one’s disability qualifies them
for SSDI benefits or SSI benefits?
Yes. It is a five step sequential procedure:
1. Are you working?
If you are and your
earnings average more than $830.00 a month, you generally cannot
be considered disabled. If you are not working, they go to the next
2. Is your condition
Your condition must
interfere with basic work-related activities for your claim to be
considered. If it does not, they will find that you are not disabled.
If it does, they will go to the next step.
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, SSA has to decide if it is of equal severity
as an impairment on the list. If it is, they will find that you
are disabled. If it is not, they 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, then SSA determines 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 go to the next step.
5. Can you do
any other type of work?
If you cannot do the
work you did in the past, SSA evaluates 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 they decide you cannot adjust to other work, your claim
will be approved. If they decide you can, your claim will be denied.
How does the
SSA go about evaluating a claim?
The SSA contracts with the State of Michigan Disability Determination
Service (DDS) to evaluate initial claims using SSA guidelines.
This agency also processes
claims for the Family Independence Agency (FIA). They contract with
doctors to evaluate medical records submitted. Also, they have the
authority to have a claimant evaluated by a doctor if the case manager
feels the medical records are not adequate.
How does the
SSA calculate my SSDI benefits?
Your SSDI benefit is the “old age” insurance benefit you would be
eligible to receive if you were sixty-five (65) years old at the
date of your onset of disability.
If I am awarded SSDI benefits or SSI benefits, do I also get Medicare or Medicaid benefits?
Two years (24 months) after your date of onset of disability for SSDI benefits, you become eligible for Medicare benefits. Alternatively, recipients of SSI benefits are eligible for Medicaid benefits as of the date of onset.
If I am awarded
SSDI benefits, would my spouse and/or children receive a separate
Only dependent children are eligible for a separate benefit until
they are sixteen (16) or until they graduate from high school, whichever
If I have dependents
receiving benefits under my SSDI, are they eligible for Medicare
No. There are no medical benefit programs for dependents of SSDI
Can I apply
for SSDI benefits if I am receiving Early Old Age Insurance Benefits?
Yes. If for financial reasons, you need to collect your “old age”
insurance benefits after your 62nd birthday, while your application
for SSDI benefits is pending, you are not penalized. When your SSDI
benefits are approved, you will receive the accrued difference between
the two benefits, which is the difference between your befits at
age sixty-two (62), and the amount you would have received had you
waited to the age of sixty-five (65+). (Note, you may also apply
after you are receiving early benefits if you subsequently become
Can it cost
me money out of my pocket to retain an attorney to assist me in
obtaining SSDI or SSI benefits?
No. Attorney fees are regulated by statute and the SSA. An attorney
cannot charge a fee for his services without it first being approved
by the SSA. The SSA allows an attorney to charge a fee of twenty-five
(25%) percent of accrued benefits, up to a maximum of $5,300.00.
An attorney may also charge for out of pocket expenses in obtaining
medical records from the required medical care providers. There
is no attorney fee charge on future benefits.
What are my
SSDI benefits are considered long term benefits, not short term
benefits. When awarding benefits, the SSA determines your “onset
date.” This is the date which medical evidence establishes that
you qualify for SSDI benefits. Benefits are not paid for the first
five (5) months from that date and begin the first of the next month.
However, the SSA can only calculate your accrued benefits back one
(1) year from the date you file for SSDI benefits with the SSA.
Thus, if you file for SSDI benefits more than seventeen (17) months
from the “onset date,” you will not receive all possible accrued
If I am awarded
SSDI benefits or SSI benefits, do I also get Medicare or Medicaid
Two years (24 months) after your date of onset of disability for
SSDI benefits, you become eligible for Medicare benefits. Alternatively,
recipients of SSI benefits are eligible for Medicaid benefits as
of the date of onset
If I have been
self-employed, can I get Social Security Disability Insurance if
I become disabled?
Self-employed people who become disabled can get Social Security
Disability Insurance if they have paid the government enough self-employment
tax and/or FICA tax to qualify for Social Security Disability Insurance
coverage. However, many self-employed people neglect to pay the
tax and do not qualify. Get two free booklets from SSA: "Social
Security: How You Earn Credits," SSA Publication No. 05-10072;
and "If You're Self-Employed," SSA Publication No. 05-10022.
Will my spouse's
income affect my Social Security Disability Insurance?
Your spouse's income will not affect your Social Security Disability
Insurance benefits. SSA considers your work capacity -- not the
income or resources of your spouse. Your savings and investments
also will not disqualify you.
However, a spouse's income
could disqualify you from SSI or reduce your SSI benefits. SSI is
not insurance like Social Security Disability Insurance; it is a
welfare type program limited to people with very little income and
resources. The government may reduce SSI benefits or end them if
the beneficiary, the spouse, or anyone contributing to their support
has significant income or resources. See the free booklet "Supplemental
Security Income," SSA Publication No. 05-11000