There are 2 major disability programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). They are both very similar, and very different.
There is widespread confusion about these 2 major programs for disabled Americans. The confusion may arise because they are completely different in some areas, and exactly the same in other areas.
First the differences. It helps to know that SSDI is an “entitlement” program whereas SSI is a welfare program. SSDI is not “needs based”, but a right based upon payroll tax contributions. SSDI does not consider income or resources in determining benefit payment amounts, but SSI benefits are not available to those with more than $2000 in “resources” and is reduced dollar-for-dollar because of any income. In short SSI is limited to the “indigent”. But if Dallas billionaire Mark Cuban became disabled he could collect SSDI benefits.
There are more odd differences between SSDI and SSI: Medicaid benefits are available to SSI recipients, and Medicare is available to SSDI recipients.
So how are SSDI and SSI similar? But have the same standard for what it means to be “disabled” and entitled to benefits.
Your medical condition must be chronic and long-term to qualify for social security disability. There is a 12-month duration requirement.
If you have listened to ultra-conservative media you might think qualifying for social security disability is a piece of cake. Many are surprised that in order to qualify for disability benefits you must have been disabled for at least 1 year or your disability is expected to last at least 1 year. This requirement often discourages those recently out of work due to a disability from filing. Many wrongly assumed that they must wait until 12 months have passed to file their disability claim.
The problem with this decision is that it takes a long time to qualify for disability benefits – typically around 2 years! Waiting until the 12-month duration requirement is met means you were be even further behind in receiving the financial relief you need.
The odd reality is that disability applications within a year of leaving work due to a disability are routinely denied based upon the “duration requirement”. Due to the lengthy approval time, however, it makes sense to file a claim for social security disability unless your doctor expects a swift recovery and return to work.
Here are some indicators that it may be time for file a claim for social security disability:
- You have been battling your chronic health conditions which have steady gotten worse despite medical treatment and finally resulted your leaving work
- Your doctor advises you to file a claim for social security disability
- Even if your illness came on suddenly, and even though doctors have tried different things your condition is not improving much
- You doctor is starting to say things like “you may have to live with it..” or “this may be a good as it is going to get..”
SSDI eligibility will also provide Medicare. But there is a 24 month waiting period.
For many disabled workers applying for SSDI benefits, the entitlement to Medicare can be as if not more important as the monthly benefit checks. Yet Americans are surprised to learn that there is a 24 month waiting period for Medicare benefits. This unfortunate feature of the law seems counterproductive, as early medical treatment can often mean a return to work. What is even odder is that Medicaid eligibility under the SSI program has no waiting period.
SSDI benefits have a 5 month waiting period for payment of monthly benefits.
There are no disability benefits payable for the first 5 months of disability. This feature can be analogized to a medical insurance deductible, and is certainly not consistent with the Fox News portrayal of disabled Americans “living large” on the program.
Social security disability insurance benefits are “offset” in most states by worker’s compensation benefits received.
As pointed out above, SSDI benefits do not take income or resources into account in determining monthly benefits. The one odd and puzzling exception is when an SSDI applicant is receiving state Worker’s Compensation benefits. Worker Compensation over a given amount -an amount which is determined in relation to the claimant’s projected SSDI benefit amount- reduce the SSDI benefit payable on a dollar-for-dollar basis. This often leads disabled Americans workers to wait to file for social security disability until the Worker’s Compensation has ended. Just like the decision to wait for 12 months mentioned above, this is an unwise strategy. A better choice is to have disability entitlement “in place” (i.e., secure an approval of disability benefits) while continuing to receive Worker’s Compensation. Though no disability benefits are being paid due to the Worker’s Compensation, once the latter benefits stop, payment of social security disability benefits can begin. Unfortunately, because social security disability attorney payment is based upon past due benefits, it is harder for those getting Worker’s Compensation to retain an attorney on their social security disability case.