There are other considerations besides medical paperwork and requirements that need to be considered when applying for disability benefits.
There are two types of disability you can potentially apply for: Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). The two programs are different. SSI is a financial supplement designed to provide basic funding for individuals and families who earn low- or no income. SSDI is designed to provide disability benefits to people who have worked and paid into the social security system through their work history.
Each program has different eligibility requirements. Upon receiving your application, the Social Security Administration (SSA) evaluates the claim to determine your eligibility for either program. People aged 18 or over may qualify for SSDI benefits, but you have to have worked long enough to have contributed to social security to earn enough work credits, and you also must have a disability severe enough to prevent you from working. SSA will require that you submit your employment history as far back as you can. You must list all previous employers and your earnings history at each place of employment.
For SSDI, the main qualification is that you must have worked and paid Social Security taxes. Determining the number of work credits you have is the most important criteria. After you’re eligible, that’s when it is time to start pulling your medical documentation together to prove that your disability keeps you from being gainfully employed.
SSI is for people who likely don’t qualify for SSDI. As a federal program, it is paid for from general tax revenues and not from the social security fund. SSI helps low income, disabled and elderly people with basic funds for food, clothing and shelter. The program is needs-based, and it is important for you to know that you must meet very low income requirements in order to qualify. SSA counts any income, asset ownership, and any free services you are receiving (food or shelter donations, etc.)—there are very strict limitations. Under SSI, you are only allowed to own a single home and single automobile.
The SSA will evaluate your income and assets for this needs-based disability benefit. If you are not a U.S. citizen and you are applying for SSI, the SSA will first ensure that you are in a qualifying illegal alien category.
For both programs, most states do provide additional funds above the federal funds you will receive. Please note that some states–Arkansas, Arizona, Georgia, Mississippi, Oregon, Tennessee, Texas and West Virginia—do not provide the additional funds.
For either program you apply to, the SSA will require that you submit the following information: Social Security ID (SSN), date and place of birth, and proof of US citizenship. You must also provide this information for present and past spouses and all dependent children.
After you submit your claim, a SSA claims representative will review the claim. The claim agent will first look at your non-medical eligibility—things like income, work credits and the other requirements we’ve outlined above. If you appear to be eligible for either SSDI or SSI, the claims representative will then transfer your file claim to your local Disability Determination Services (DDS) where another claim examiner specific to either SSDI or SSIs will take the reins and process it from there. From this point, the claim examiner will now start to review the medical evidence to decide whether you meet the eligibility for disability benefits from a medical point of view.
SSDI claims are denied if you don’t have enough work credits, meaning you haven’t worked long enough to draw social security disability; basically it means that you haven’t paid in enough to receive disability payments.
SSI applicants are typically denied because they earn too much money or have too many assets.
Both of these are considered technical denials, and in both cases, you get your notice fairly quickly.
For SSDI, the examiner will look at whether you are currently employed and earning an income. It is definitely a factor, because if you’re currently employed, you will likely be given a technical denial by SSA because your disability will appear not serious enough to keep you from working.
After you meet these initial non-medical requirements, both programs will require different medical information. SSI requires less information because it is in place to provide basic needs. SSDI does require detailed medical information because the benefit is based on your inability to work. As such, your SSDI application requires medical information such as records of medical diagnosis, tests performed, hospitalizations, medications prescribed, and any other pertinent detailed medical notes.
Any other benefits you might be receiving, such as military veteran benefits, worker’s compensation or any other similar benefit, will be factored into SSA’s evaluation of whether you will receive SSDI or SSI.
If you’re trying to determine which program you qualify for,give us a call today and we will help you determine your eligibility.