Frequently Asked Questions for Social Security Disability Insurance Benefits (Disability Insurance Benefits)
- How do I qualify for Social Security Disability Insurance Benefits?
- You qualify for benefits if you have earned enough "quarters of coverage" over the course of your work history. You need at least 40 quarters of coverage to qualify for Social Security Disability benefits. If you work full-time, you should have 4 quarters of coverage every year. Therefore, if you have 10 or more consecutive years of work, you should be "fully insured" for benefits. If you have enough work credits, you are technically eligible for benefits and a medical decision must be issued on your claim. If you are not insured for benefits, then you will receive a technical denial from the Administration and you will be unable to receive benefits under the Social Security Disability program. You may, however, be entitled to Supplemental Income benefits (SSI).
- What is my date-last-insured?
- Your date-last-insured is the very last date that you have to prove disability. This is usually 5 years after you last worked, if you are fully insured for benefits (see above). For example, if you last worked in February 2005, your date-last-insured would be December 31, 2010. Thus, you must prove disability before December 2010 in order to be entitled to benefits.
- Okay, I qualify for benefits technically, now what happens?
- Your claim begins at the Initial Application level. Once it is decided that you are technically eligible for benefits, your claim is transferred to the State Agency so that a medical determination may be issued. At that time, the Social Security Administration (SSA) may need to send you to one of their doctors if they feel they do not have enough evidence to make a decision based on your own medical records.
- How long will it take to receive a decision at the Initial Application level?
- It can take a minimum of 5 to 7 months to get a decision at the Initial Application level. The amount of time can vary depending on several factors, but primarily on:
- the nature of your disability;
- how quickly medical evidence is obtained from your doctor or other medical source;
- whether it is necessary to send you for a medical examination in order to obtain evidence to support your claim; and
- If your claim is randomly selected for quality assurance review of the decision.
- How does the Social Security Administration decide I am disabled?
- Disability under Social Security for an adult is based on your inability to work because of a medical condition. To be considered disabled:
- You must be unable to perform your prior work (this is called your "past relevant work") and the SSA must decide that you cannot adjust to other work because of a medical condition.
- Your disability must last or be expected to last for at least one year or result in death.
- I was denied at Initial Application and have requested a hearing. How long will this take?
- It can take a year and a half to two years to be scheduled for a hearing. The process to get a hearing has always been lengthy, however, it has increased even more in recent months (see New York Times Article). The hearing is your chance to explain why you should be entitled to benefits before an Administrative Law Judge. If you are approved, you will receive a Fully Favorable decision in the mail. If you are denied, you will receive an Unfavorable Decision in the mail.
- I've been denied at Hearing Level, is there anything I can do?
- If you have been denied at the Hearing Level, we will request a review by the Appeals Council. The Appeals Council will review your case and the judge's decision and determine whether they should uphold the decision, or vacate and remand the decision. If the decision is vacated and remanded, then it is sent back to an Administrative Law Judge for further adjudication.
- I've been awarded benefits. Is there a waiting period?
- There is a standard five-month waiting period, from the date you are found disabled, before payments can begin. This waiting period ensures that during the early months of disability, the SSA does not pay benefits to persons who do not have a long-term disability. Social Security disability benefits can be paid only after you have been disabled continuously throughout a period of five full calendar months. Therefore, Social Security disability benefits will be paid for the sixth full month after the date your disability began. You are not entitled to benefits for any month in the waiting period.
- Do I have to pay income tax on my Social Security benefits?
- Some people who get Social Security will have to pay taxes on their benefits. Less than one-third of current beneficiaries pay taxes on their benefits.
You will have to pay federal taxes on your benefits if you file a federal tax return as an "individual" and your total income is more than $25,000. If you file a joint return, you will have to pay taxes if you and your spouse have a total income that is more than $32,000. - I am receiving Social Security disability benefits. Will my benefits be affected if I return to work and earn money?
- The SSA has special rules called "work incentives" that help you keep your cash benefits and Medicare while you test your ability to work. For example, there is a trial work period during which you can receive full benefits regardless of how much you earn, as long as you report your work activity and continue to have a disabling impairment.
The trial work period continues until you accumulate nine months (not necessarily consecutive) in which you perform what they call "services" within a rolling 60-month period. Your work is considered to be "services" if you earn more than $670 a month in 2008. For 2007, this amount was $640.
After the trial work period ends, your benefits will stop for months your earnings are at a level considered "substantial," currently $940 in 2008. For 2007, this amount was $900. Different amounts apply to people who are disabled because of blindness. The monthly substantial amount for statutorily blind individuals for 2008 is $1,570; for 2007 this amount was $1,500.
For an additional 36 months after completing the trial work period, the SSA can start your benefits again if your earnings fall below the "substantial" level and you continue to have a disabling impairment. - What is the difference between Social Security Disability and SSI disability?
- The Social Security Administration is responsible for two major programs that provide benefits based on disability: Social Security Disability Insurance Benefits (SSDI), also known as Disability Insurance Benefits (dib), which is based on prior work under Social Security, and Supplemental Security Income (SSI). Under SSI, payments are made on the basis of financial need.
Social Security Disability Insurance Benefits (SSDI), is financed with Social Security taxes paid by workers, employers, and self-employed persons. To be eligible for a Social Security benefit, the worker must earn sufficient credits based on taxable work to be "insured" for Social Security purposes. Disability benefits are payable to blind or disabled workers, widow(er)s, or adults disabled since childhood, who are otherwise eligible. The amount of the monthly disability benefit is based on the Social Security earnings record of the insured worker.
Supplemental Security Income (SSI) is a program financed through general revenues. SSI disability benefits are payable to adults or children who are disabled or blind, have limited income and resources, meet the living arrangement requirements, and are otherwise eligible. The monthly payment varies up to the maximum federal benefit rate, which may be supplemented by the State or decreased by countable income and resources. - Can I receive Social Security benefits and SSI?
- You may be able to receive SSI in addition to monthly Social Security benefits, if your Social Security benefit is low enough to qualify.
The amount of your SSI benefit depends on where you live. The basic SSI check is the same nationwide. Effective January 2008, the SSI payment for an eligible individual is $637 per month and $956 per month for an eligible couple. However, many states add money to the basic check.
Following is a list of some States that supplement the basic SSI amount:
California, Hawaii, Massachusetts, Nevada, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Washington D.C.
If you get SSI, you also may be able to get other help from your state or county. For example, you may be able to get Medicaid, food stamps, or some other social services. For information about all the services available in your community, call your local social services department or public welfare office. - Is there a time limit on Social Security disability benefits?
- No. Your disability benefits will continue as long as your medical condition has not improved and you cannot work. Your case will be reviewed at regular intervals to make sure you are still disabled.
If you are still receiving disability benefits when you reach full retirement age, they will automatically be converted to retirement benefits. - Am I entitled to Medicare benefits if I am found disabled under SSDI?
- Yes, you will automatically be enrolled in Medicare after you get disability benefits for two years. The SSA starts counting the 24 months from the month you were entitled to receive Disability, not the month when you received your first check.
People with amyotrophic lateral sclerosis (Lou Gehrig's disease) get Medicare beginning with the month they become entitled to disability benefits.
Medicare has two parts - hospital insurance and medical insurance. Hospital insurance helps pay hospital bills and some follow-up care. The taxes you paid while you were working financed this coverage, so it's premium free. The other part of Medicare, medical insurance, helps pay doctors' bills and other services. You will pay a monthly premium for this coverage if you want it. - How do workers' compensation payments affect my disability benefits?
- Disability payment you receive from workers' compensation and/or another public disability payment may reduce you and your family's Social Security benefits.
Your Social Security disability benefit will be reduced so that the combined amount of the Social Security benefit you and your family receive plus your workers' compensation payment and/or public disability payment does not exceed 80 percent of your average current earnings. (Note that the unreduced benefit amount is counted for income tax purposes).