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Understanding Social Security Disability (SSDI) and Supplemental Security Income (SSI)
www.socialsecurity.gov/disabilityfacts
Presenters:
Marie Grove, Technical ExpertVonda VanTil, Public Affairs SpecialistSocial Security Administration
Disability Programs
Title IISSDISocial Security Disability Insurance
Medicare
Title XVI SSI Supplemental SecurityIncome
Medicaid
Social Security’s Definition of Disability
A medical condition or combination of impairments preventing substantial gainful activity for at least 12 months, or expected to result in death. The determination also considers age, education & work experience.
What is Substantial Gainful Activity?
• Work is “substantial” if it involves doing significant physical or mental activities or a combination of both.
• If your impairment is anything other than blindness, earnings averaging over $1,090 a month generally demonstrate SGA.
Eligibility Requirements
SSDI• Be Medically Disabled
• Have worked long enough in jobs covered by Social Security or be a widow or a disabled adult child.
SSI• Be Medically Disabled
• Needs based, i.e. limited income and resources
SSDI• Funded by FICA Taxes
• Generally unaffected by other income, resources or living arrangements
SSI• Funded by General Tax
Revenues
• Affected by changes in income, resources and living arrangements
Distinctive Features
Distinctive Features
SSDI• Benefit amount is
based upon level of earnings over working years
• Medicare coverage starts after 24 months of entitlement
SSI• Amount of payment is
based upon income and living arrangement
• Immediate Medicaid
Social Security Disability Insurance (SSDI)
To qualify, the disabled person must have a recent work history
Special rules apply to younger persons who need less work to qualify
Work Requirements
The amount of work you need depends on your age at the time disability starts
Before age 24
1-1/2 years of work in a three-year period before becoming disabled
Age 24-31
work during half the time between age 21 and the time the disability began
Age 31 or older
work during five out of the 10 years before the disability began
Work Credits
When you work and pay Social Security taxes, you earn up to a maximum of 4 work credits each year.
The work credits are based on the total amount of your wages or self-employment income during the year.
For each $1,220 in gross earnings you get one credit, max. of 4 credits per year
Earn $4,880 to earn 4 credits in 2015
Amount of Benefit
• Benefits are calculated based on your entire work history
• If your Social Security benefit amount is lower than the full SSI payment, you may be eligible to receive both Social Security and SSI
Onset DateOnset Date
The Onset Date is the first day the individual meets the definition of disability.
The Alleged Onset Date is always the date the applicant alleges they became unable to work because of their medical condition. This is a starting point for Social Security. The date could change due to other circumstances.
If there’s work activity after that date, the onset date may be different.
Sometimes, in that instance, a Work Activity Form may need to be completed to evaluate the work.
Onset Date questions on applicationOnset Date questions on application
If applicant stopped working.
If applicant never worked.
A five-month waiting period applies to all SSDI beneficiaries
Payment begins the sixth full month after the date we find your disability began
For example, if your disability began on June 15, 2014, your first benefit would be paid for the month of December 2014, the sixth full month of disability.
Benefits are paid a month behind. So, the December benefit would be paid in January 2015.
Five Month Waiting PeriodFive Month Waiting Period
Social Security Benefits for Adults Social Security Benefits for Adults Disabled Since ChildhoodDisabled Since Childhood
A person may be eligible for up to 12 months of retroactive benefits
Example:
Disability began on 09/10/2012. Five month waiting period makes the first month of eligibility 03/2013. However, beneficiary doesn’t file until 01/22/2015. If approved, we cannot pay all the way back to 03/2013, only back one year to 01/2014.
RetroactivityRetroactivity
Medicare
Medicare coverage automatically begins after being entitled to disability benefits for 24 months.
Example: Month of eligibility is 09/2014 – Medicare A&B effective 09/2016
We will send you information about Medicare several months before your coverage starts.
Note: People who have permanent kidney failure requiring dialysis or a transplant or have amyotrophic lateral sclerosis (Lou Gehrig’s disease) may qualify for Medicare almost immediately.
Benefits for the Family
SpouseAt age 62At any age if caring for child under 16 or disabledDivorced spouses may qualify
ChildNot married under age 18 (under 19 if still in high school)
Not married and disabled before age 22
What is Supplemental Security Income?
Supplemental Security Income (SSI) pays disabled individuals who are unable to work and have limited income and resources
It is designed to help aged, blind, and disabled people, who have little or no income and
It provides cash to meet basic needs for food, clothing, and shelter
Who can get SSI?
Aged - 65 or older Blind - any age Disabled - any age
Payments begin with the month after the month of filing
Medicaid begins immediately
Must meet medical and non-medical requirements
Supplemental Security Income - SSI
Payment amount is based on income, living arrangements and the state in which he/she lives.
Unlike SSDI, SSI has “No Waiting” periods to initially receive benefits.
In Michigan, automatic entitlement to Medicaid
Benefits are not immediately subject to cessation if a claimant returns to work, but SSI will be reduced for each additional income.
SSI Eligibility Requirements
Have little or No Resources
Be Disabled
Have limited income
Be a U.S. Citizen or
“Eligible alien”
Reside in the U.S.
What is Resources?
Individual Limit$2,000
Included Resources
Bank Accounts (CDs, IRAs) Stocks, Bonds, 401Ks
(Liquid Assets) Second Car Life Insurance Property other than where
you live
Excluded Resources
Home in which you live First car Burial plots for self & family Some resources set aside for
burial
Couple’s Limit$3,000
What is Income?
Earned
Wages Self-employment Payment for services
in sheltered workshop
Unearned
SSA benefits Veterans benefits Unemployment benefits Interest Pensions Cash from family/friends
Living Arrangements
Living arrangement is another factor used to determine how much Supplemental Security Income (SSI) a person can get.
This means your SSI benefits may vary depending on where a recipient live:
In someone else’s household In an institution
generally $30/month maximum
In a group care or board and care facility
SSI Benefits for Children
Disabled children living in limited income and resources households may be eligible to receive (SSI) benefits.
For eligibility, we look at the income and assets of the disabled child and parent(s) living in the household and those of the child who is disabled.
Deemed Resources
Sometimes we “deem” a portion of the resources of a spouse, parent, parent’s spouse, sponsor of an alien or sponsor’s spouse as belonging to the person who applies for SSI. We call this process the deeming of resources.
Example:
If a child under age 18 lives with one parent, $2,000 of the parent's total countable resources does not count. If the child lives with 2 parents, $3,000 does not count. We count amounts over the parents’ limits as part of the child's $2,000 resource limit.
SSI Benefits for Children
Resource Limits
$4,000 if living with 1 parent $5,000 if living with 2 parents $2,000 if living with other than parents
We count Bank accounts (including CDs & IRAs) Second car Stocks and bonds, 401Ks Liquid assets Property other than where you live
Children’s Income
Examples:
Child supportSocial Security auxiliary benefitsGifts
Disability Determination for Children under Age 18
Must have a physical or mental impairment (or combination) that results in marked and severe limitation in functioning
Condition must be expected to last at least 12 months or result in death
Disability Determination for Children under Age 18
We no longer count the income and resources of parent(s) for eligibility.
If the child continues to live with parent(s) but does not pay for food or shelter, a lower SSI payment may apply
We make a new disability determination using the adult rules.
How to Apply for Social Security Disability Benefits – Adults (Age 18 and older)
Online at www.socialsecurity.gov/applyfordisability
Appointment over phone or face to face• Call -800-772-1213 (TTY • 1-800-325-0778) from 7 a.m. to 7 p.m.,
Monday through Friday to make appointment
How to Apply for Supplemental Security Income (SSI) for Disability – Adults (Age 18 and older)
We do not have an SSI application online. To apply for SSI benefits for an adult with a disability:
Schedule an appointment by calling 1-800-772-1213 (TTY 1-800-325-0778) from 7 a.m. to 7 p.m., Monday through Friday or contacting your local Social Security office; or Fill out the online Disability Application at www.socialsecurity.gov/applyfordisability to get the process started. A Social Security representative will contact you for additional information.
How to Apply for Supplemental Security Income (SSI) for Disability – Children (Under Age 18)
To apply for benefits for a child with a disability:
Schedule an appointment with Social Security. Call 1-800-722-1213 (TTY 1-800-325-0778) from 7 a.m. to 7 p.m., Monday through Friday or contact your local Social Security office; and
Complete the online Child Disability Report at www.socialsecurity.gov/childdisabilityreport.
Advantages of Applying Online for Disability
You can:
Apply for someone else;
Provide all the information at once or over several sessions, in the setting of your choice;
Use the “more info” links if you need help answering a question;
Print or save a copy of what you submit;
Send the information electronically; and
Check the status of your application online after it’s submitted.
Applying for Disability Benefits Online
You can apply online for Disability Benefits by visiting www.socialsecurity.gov and then clicking on
the “Benefits” tab and the “Apply Online for Disability” drop down link.
Start with the application
You have two Options when you are assisting someone with filing
What Happens Next
Social Security will forward the application to the state Disability Determination Services (DDS) agency
The DDS will contact the medical providers to obtain medical records
The DDS may ask for additional information about how the condition affects daily activities
If Claim is Allowed
We send an award notice that explains:
When benefits start and monthly benefit amount Reporting Responsibilities
(Examples: work activity, medical improvement) When the case will be reviewed What to do if questions
If Your Claim is Denied
We send a letter explaining our decision
The decision can be appealed within 60 days after the notice is received
At the appeal, if anything has changed the application can be updated
Internet Appeals
If an application is denied for medical reasons, the fastest way to file an appeal is online.
http://www.socialsecurity.gov/disabilityssi/appeal.html
BEST Screening Tool
http://www.benefits.gov/ssa
This screening tool helps you find out what benefits an individual may be eligible form.
It will screen for:
MedicareSocial Security Disability (SSDI)Social Security RetirementSocial Security SurvivorsSpecial VeteransSupplemental Security Income (SSI)
www.socialsecurity.gov/myaccount
my Social Security is an easy-to-access, easy-to-use portal to view and update some of your own Social Security information.
mySocial Security
my
www.socialsecurity.gov/myaccount
If you don’t get benefits, you can— View, save, and print your online
Social Security Statement.
If you do get benefits you can— Get your benefit verification letter; Check your benefit and payment
information and your earnings record; Change your address and phone number; and Start or change your direct deposit.
mySocial Security
Remember the fastest way to verify Social Security and SSI benefits
Visit: www.socialsecurity.gov/myaccount
my Social Security provides an online benefit verification letter immediately.
Disability Planner
The Faces and Facts of Disability
Ordering publicationsYou can order any of the booklets and publications or download them for free at http://www.socialsecurity.gov/pubs/
Visit the website
www.socialsecurity.gov
Call the toll-free number
1-800-772-1213 Specific questions can be answered from 7 a.m. to 7 p.m., Monday through Friday. Information is provided by automated phone service 24 hours a day. If deaf or hard of hearing, call Social Security’s TTY number, 1-800-325-0778.
Visit a local office Most offices are open to the public Monday, Tuesday, Thursday and Friday from 9 a.m. to 3:00 p.m. and Wednesdays from 9 a.m. to 12:00 p.m., except Federal holidays.
Contacting Social Security
Are you interested in staying current on Social Security disability related
issues?
If yes, email [email protected] and ask to be added to the Michigan
Updates Disability advocates distribution list.
It’s that easy!
Michigan Updates Newsletter
Contact Information
Vonda Van Til
Social Security
3045 Knapp NE
Grand Rapids MI 49525
(877)-322-5883 x18872
Next Webinar Series
Social Security Disability Programs – The Medical Decision Process
Tuesday, February 24 orThursday, March 5
You will receive your invitation soon.
