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What Is Social Security Disability Insurance

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What Is Social Security Disability Insurance Benefit

What is Social Security Disability Insurance?

Before you can get any further as to whether you are eligible for the funds or not, you need to know what the fund is all about. This fund is set aside by the Federal government and administered by the Social Security Administration. 

The fund is used to pay disability benefits for people who are unable to work. These are people who have been working before, but due to an injury or a severe medical condition, they are unable to work any longer. 

The medical condition or injury should keep you from working for at least 12 months. This will have to be signed off by a qualified doctor as the government will need to see proof you cant work. The medical condition or injury may also be a terminal one this too will result in you getting the fund. 

It can also be a member of your family who has worked long enough and has a medical condition. If they were the primary provider for the family, then they are eligible for the fund. 

Can You Do Any Other Type Of Work

If you cant do the work you did in the past, we look to see if there is other work you could do despite your medical impairment.

We consider your medical conditions, age, education, past work experience, and any transferable skills you may have. If you cant do other work, well decide you are disabled. If you can do other work, well decide that you dont have a qualifying disability and your claim will be denied.

The Facts On Social Security Disability Insurance And Supplemental Security Income For Workers With Disabilities

Endnotes and citations are available in the PDF and Scribd versions.

Nearly one out of every six working-age Americans29.5 million peoplehas a disability, making them much more likely to experience economic hardship than people without disabilities. Many people with disabilities are able to work, although they face greater challenges finding work than people without disabilities. But many individuals with severe and long-lasting disabilities have no or only limited capacity to work and are particularly vulnerable to economic hardship.

For roughly 12 million people with disabilities, Social Security Disability Insurance and Supplemental Security Income, both core components of our nations Social Security system, provide critical lifelines. The modest but vital assistance that Disability Insurance and Supplemental Security provide makes it possible for individuals with severe disabilities and health conditions to live independently, keep a roof over their heads and food on the table, and pay for needed, often life-sustaining medications and other basic expenses.

This issue brief answers some of the common questions about Disability Insurance and Supplemental Security. Our focus in this brief is on nonelderly adults with severe disabilities. It is important to note, however, that Supplemental Security also provides vital support to some 1.2 million children with severe disabilities, as well as more than 2 million low-income seniors.

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Social Security Disability Evaluation Process

While there are some conditions that the Social Security Administration considers so severe that they automatically render an applicant disabled, many conditions require careful screening, including answering these five questions:

  • Are you currently working? If you are working, you are not blind, and your earnings average more than $1,310 per month in 2021, then you will not be considered disabled. If you are not working, or if your income falls below Substantial Gainful Activity limits, move on to question two.
  • Is your condition severe? If Social Security determines that your condition does not interfere with basic work-related activities, then you will not be considered disabled. If your condition does interfere with basic work-related activities, move on to question three.
  • Is your condition found in the list of disabling conditions? Social Security maintains a list of disabling medical conditions that automatically qualify you as disabled. If your condition is not one of these, then Social Security will determine if it is severe enough to qualify. If so, you will be considered disabled, and your application will be approved. If not, move on to question four.
  • Can you do the work you did previously? If your condition does not interfere with your ability to do the work that you used to do, then you will not be considered disabled. If it does, move on to question five.
  • In addition, qualifying conditions must be expected to last at least one year or result in death.

    Likelihood Of Receiving Benefits

    Social Security Disability Insurance Work Programs

    Considering all levels of adjudication, about 4 in 10 SSDI applicants are awarded benefits. Slightly more than 50 percent of applicants who meet technical requirements of eligibility are determined to be medically eligible.

    The number of cases and percentage allowed at each stage of adjudication for all types of disability cases in fiscal year 2020 are as follows:


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    Who Is Eligible For Benefits

    SSDI applicants must first establish a sufficient and recent work history to qualify for benefits. The Social Security Administration uses a credit system to determine benefit eligibility. In 2014, a worker earned one credit for every $1,220 of wages or self-employment income received, up to a maximum of four credits for the year. An annual income of $4,880 satisfies the full credit requirements for one year. Most disability applicants need between 20 and 40 credits, or between five and 10 full years of work, to qualify for benefits, with at least 20 credits earned in the ten years immediately before the onset of the disability. The number of total required credits scales by age, with workers aged 31 to 42 needing at least 20 credits; those aged 43 to 62 needing one additional credit for every year of age; and those aged 62 and older needing 40 credits. Nearly 80 percent of SSDI beneficiaries are 45 or older.

    Special exceptions are in place for workers who become disabled before the age of 31. In general, these individuals need an amount of credits equal to the difference of their age at the onset of disability and 21, times two. For example, if a worker becomes disabled at age 28, he needs 14 credits to qualify for disability benefits.

    There are five questions to ascertain eligibility, explained below and presented in flowchart format in Appendix B:

    What Is Ssdi Program

    The SSDI Program pays disability benefits to an insured person and certain family members. Being insured in the SSDI program means that the individual has worked long enough , recently enough and has paid Social Security taxes on their earnings.

    This clearly means that you are not eligible for SSDI benefits if you were not employed for a specified time period before acquiring a disability. Social Security Administration calculates Social Security Credits based on the earnings of a person to determine their earning eligibility for SSDI benefits.

    SEE ALSO:How to Apply for SSDI

    In general, the benefits are paid on monthly basis to individuals who are unable to work for a year or more due to a disability or the disability results in death.

    The payment under SSDI continues until the beneficiary is able to work again on a regular basis. There are some special rules called work incentives to provide continued disability benefits and health coverage to help the beneficiary in a smooth transition back to work.

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    What Is The Difference Between Ssi And Ssdi

    SSI eligibility is determined based on age, disability and available resources, while SSDI is based on a persons disability and work credits.

    For most people, medical requirements that will allow you to receive disability payments are the same for both, and disability is determined using the same process. Both SSI and SSDI are managed by the Social Security Administration as well.


    Location and monthly income

    Record of earnings

    The most notable difference between SSI and SSDI is that SSDI is only available to people who have accumulated enough work credits, while SSI is available to low-income individuals who have not accumulated enough work credits or who have never worked. In addition, SSDI is based on your work history, but SSI is strictly based on a financial situation of considerable need.

    Additionally, SSI benefits begin on the first of the month that a social security disability application is submitted and approved, but for SSDI there is a five-month waiting period. People who qualify for SSI can also receive Medicaid benefits.  After receiving SSDI benefits for two years, a disabled person will be eligible for Medicare benefits. The amount of SSI benefits depend on where a person lives and what their monthly income is, while SSDI benefit amounts are dependent on a persons earnings record.

    The Basics About Disability Benefits

    What is Social Security Disability Insurance (SSDI) BACK PAY?

    The SSDI program pays benefits to you and certain if you are insured. This means that you worked long enough and recently enough – and paid Social Security taxes on your earnings. The program pays benefits to adults and children with disabilities who have limited income and resources.

    While these two programs are different, the medical requirements are the same. If you meet the non-medical requirements, monthly benefits are paid if you have a medical condition expected to last at least one year or result in death.

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    How Do I Compare Social Security Disability Insurance And Private Disability Insurance

    You dont have to choose between one or the other you can plan to simultaneously use Social Security Disability Insurance and private disability insurance. But, your private disability insurance typically reduces your monthly payments by any amount you receive from Social Security disability.

    If you can afford a private disability plan, you can typically expect a higher monthly benefit. But youll have to pay for premiums out of pocket each month for a benefit you may never use.

    Whereas if you plan to rely on SSDI in case of a disability, know that requirements are strict and only about a third of people who apply actually get approved. And if youre a high-income earner, your monthly benefit amount may not be enough.

    Disability Application Starter Kit

    To assist you in creating your application, Social Security has developed a Disability Starter Kit that provides information about the documents and information that you will be requested to provide.  Because an application can be complicated and lengthy, this is a good place to start and to keep you organized. The kit also explains how Social Securitys disability programs work and what decision-making processes are used to determine your eligibility.

    Social Security offers two kits, one for adults and another for children. The adult Disability Starter Kit can be found here. And the child Disability Starter Kit can be found here.

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    What Is Social Security Disability Insurance

    All working Americans participate and are covered in a long-term income protection insurance program. Social Security Disability Insurance and it is a federal program mandated for all working Americans who suffer a long-term disability. The program defines disability as, Your condition must significantly limit your ability to do basic work such as lifting, standing, walking, sitting, and remembering for at least 12 months.

    You may read that sentence and think Awesome,  Ive got insurance, Im going to close this and go binge Game of Thrones but we wouldnt recommend that because as fantastic as it is that we have access to this program, its notorious for being incredibly hard to obtain. Just to qualify for the program you need to have worked and paid into the program for five of the last 10 years. To learn more about the work credit system from SSDI check out this description on the Social Security Administration website.

    Lets say you are hurt or sick and youve been working long enough and youve decided to apply for Social Security Disability Insurance, this is where it gets frustrating. Just for your initial claim, it can take anywhere from 3-5 months to get an initial decision and 68% of people filing initial disability applications are denied.

    The program was designed to provide subsistence level benefits in the event of a serious and long-term disability, not to insure your lifestyle or hard earned savings.

    How To Apply For Social Security Disability Benefits

    Social Security Disability Insurance by Johnny Watson

    Once you are eligible and have gone through the screening process, and are 100% convinced you are eligible, you need to apply. You can easily apply for the service at the comfort of your home. This process is quickly done online

    After you have filled out the form, you need to check a while to check the status of your application. If your application goes through, theres a five-month wait period. 

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    Adults Disabled Before Age 22

    An adult who has a disability that began before age 22 may be eligible for benefits if a parent is deceased or starts receiving retirement or disability benefits. We consider this a “child’s” benefit because it is paid on a parent’s Social Security earnings record.

    The disabled “adult child” including an adopted child, or, in some cases, a stepchild, grandchild, or step grandchild must be unmarried, age 18 or older, have a disability that started before age 22, and meet the definition of disability for adults.


    It is not necessary that the disabled “adult child” ever worked. Benefits are paid based on the parent’s earnings record.

    • A disabled “adult child” must not have substantial earnings. The amount of earnings we consider “substantial” increases each year. In 2021, this means working and earning more than $1,310 a month.

    Working While Disabled: How We Can Help

    The Bottom Line On Ssdi

    SSDI benefits are nice to have. But in most cases, they are simply not enough.

    Jack Wolstenholm is the head of content at Breeze.

    The information and content provided herein is for educational purposes only, and should not be considered legal, tax, investment, or financial advice, recommendation, or endorsement. Breeze does not guarantee the accuracy, completeness, reliability or usefulness of any testimonials, opinions, advice, product or service offers, or other information provided here by third parties. Individuals are encouraged to seek advice from their own tax or legal counsel.

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    Health Coverage For People With Disabilities

    If you have a disability, you have three options for health coverage through the government. 

    • Medicaid provides free or low-cost medical benefits to people with disabilities. Learn about eligibility and how to apply

    • Medicare provides medical health insurance to people under 65 with certain disabilities and any age with end-stage renal disease . Learn about eligibility, how to apply and coverage.

    • Affordable Care Act Marketplace offers options to people who have a disability, dont qualify for disability benefits, and need health coverage. Learn about the .

    How Do You Apply

    Social Security Disability Insurance: What are the benefits?

    When you have become disabled, it is imperative to apply for SSDI as soon as possible. This can be a daunting task as you will need to gather the appropriate and accurate documents. A person can apply through the government website at The government program also offers a phone call in application process.

    The other option to assist you is to consult with one of the expert attorneys in Social Security disability insurance at our law office. We will walk you through the process. We can provide you with the proper information you will need for your disability hearing. We will put you in the right position with our free consultation. If you choose the Law Offices of Daniel Berger to represent you in your disability process, you will need to notify the the Social Security Administration as soon as possible. Our expert attorneys can provide you with correct forms and documents to provide to the Social Security Administration.


    Once you have notified the SSA, one of our attorneys will represent you we will begin assisting you. We will help gather your medical records from your doctors and other physicians. We will attend any hearings regarding your case.


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    Appealing A Denial For Ssdi Benefits

    Most peopleâs claims for SSDI are rejected. You may be denied benefits because of one of the following reasons:

    • Your disability was not severe enough or isnât expected to last 12 months

    • You can perform your usual work or another type of work

    • You failed to provide sufficient medical documentation or follow your doctorsâ orders

    • Your impairment was caused by drug addiction or alcoholism

    However, your initial rejection can be appealed. According to the SSAâs most recent data, an average of just 23% of initial applications for Social Security disability insurance benefits are accepted, with an additional 2% of applicants being approved after reconsideration and another 9% after a hearing from an administrative law judge. The final acceptance rate over 10 years has averaged 34%.

    There are four levels of appeal:

    If You Get Ssdi Benefits And Are In A 24

    • You may be able to get Medicaid coverage while you wait. You can apply 2 ways:
    • Create an account or log in to complete an application. Answer yes when asked if you have a disability. Well forward your application to your state Medicaid agency.
    • Apply directly to your state Medicaid agency. Select your state from the menu on this Medicaid page for contact information.
  • If youre eligible for Medicaid, your Medicaid eligibility may continue even after you enroll in Medicare.
  • If youre turned down for Medicaid, you may be able to enroll in a private health plan through the Marketplace while waiting for your Medicare coverage to start. You may qualify for lower costs on Marketplace coverage based on your income and household size.
  • When asked about your income on your Marketplace application, be sure to include your SSDI income.

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    Lunn & Forro Pllc: Your Social Security Disability Insurance Attorneys

    The Social Security Disability lawyers at Lunn & Forro, PLLC work with people just like you to ensure they receive the benefits they need and deserve. The SSDI qualification and application process does not have to be confusing and frustrating. Let us use our experience, skills, and resources to help you get the monthly benefits you need. Call our office today at 888-966-6566 to schedule a time to talk to a Social Security Disability lawyer or use our online Free Case Evaluation to have an attorney review your case.

    How Does Ssdi Define Disability

    Social Security Disability

    SSDI has a stricter definition of disability than most private disability insurance policies.

    If you are working and make more than $1,220 a month, you generally cannot be considered disabled by SSDI standards. Social Security doesn’t provide temporary or partial disability benefits like workers’ compensation or veterans’ benefits do.

    If you are not working while applying for benefits, your application is sent to the Disability Determination Services office, who will evaluate your medical condition.

    DDS will assess the severity of your condition. To qualify, you must be significantly limited in your ability to do basic work such as lifting, standing, walking, sitting, and remembering. In addition, the condition must be severe enough that itâs expected to last at least 12 months and/or result in death. Otherwise, Social Security will not consider you disabled.

    In addition, DDS maintains a list of medical conditions considered severe enough to prevent a person from working. Most of the listed impairments are permanent or expected to result in death, or the listing includes a specific statement of duration.

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    Which Benefits Are Available

    Workers whose SSDI applications are approved will receive benefits after a five-month waiting period. These benefits will continue until workers reach full retirement age or exit the program for other reasons. Beneficiaries may also qualify for retroactive payments based on when their disability started and when they filed the initial application.

    Monthly benefits average about $1,150 and are determined mainly by the workers past earnings. The beneficiarys current income and assets have no effect on the amount of benefit, unless his income rises above the SGA threshold or arises from workers compensation or other public benefits. If the beneficiarys income rises above the SGA , his or her benefits will be terminated. The SSA considers workers compensation and other public benefits in a total benefit calculation and reduces SSDI benefits if the total benefits exceed 80 percent of the beneficiarys prior average earnings. Benefits may also be terminated if the beneficiarys medical condition improves , the beneficiary returns to work, or the beneficiary becomes incarcerated or is convicted of a felony.

    Benefits for Other Family Members.Certain family members of disabled workers receiving SSDI benefits may also be eligible to receive benefits. These include:

    How Does Disability Insurance Work

    When youâre unable to perform your normal job duties because of an injury, illness, or other condition â whether or not itâs permanent â disability insurance replaces a certain percentage of your gross monthly income. It wonât completely replace your pay, but it provides enough so you can afford food and other necessities without drastically changing your lifestyle.

    Like other insurance policies, you pay a monthly premium to keep your disability insurance policy active. If something happens and you cannot work, you file a claim with the insurance company so you can receive a monthly payment, called a benefit amount. The benefit amount varies by type of plan, but it is generally 60% of your gross monthly pay. Benefits will pay out for a certain length of time, called a benefit period. Your benefit period depends on the type of plan you have.

    Before you can apply for benefits, you have to go through the policyâs elimination period, also called the waiting period. The elimination period for a short-term disability is typically one or two weeks, and the most common elimination period for a long-term disability is 90 days. Policies with shorter elimination periods are typically more expensive and have higher monthly premiums. Less-expensive policies have longer waiting periods.

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    Ssdi Benefits For Family Members

    There are some criteria that may make it possible for a member of your family to qualify for benefits based on your work. 

    For example, your spouse can receive benefits if he or she is over 62 and is responsible for your care. Also, your spouse can receive payments if they look after a disabled child under 16. This is regardless of the age of your spouse. 

    In certain circumstances, even a divorced spouse could receive SSDI payments. 

    Get The Financial Assistance You Need & Deserve

    What is the Difference Between a Disability Insurance Lawyer & a Social Security Disability Lawyer?

    The disability attorneys at Ransom, Gilbertson, Martin, & Ratliff, LLP help secure benefits for people from all over Oregon who are suffering from conditions such as the following:

    • Arthritis
    • Depression, or other mental disorders
    • And many more

    If you have a medical condition that interferes with your ability to work, we can help you determine your eligibility for SSDI benefits and navigate the application process. If youve been denied, were here to fight for you through the appeals process.

    We dont charge fees for consultations, and we dont take anything from you if we dont win your case. Were on your side, and we dont back away from a challenge. Dont wait to get the help you need. Contact us to tell us about your case.

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    What Happens If My Ssdi Claim Is Denied Appeal Appeal Appeal

    If your initial SSI claim is denied, dont give up. A claim denial can be appealed within 60 days, and there are further levels of appeal and review available beyond that. The appeal process can succeed if an experienced lawyer or advocate compiles the right material, cites the right law, and presses the right arguments.

    The quality, organization, completeness, and persuasiveness of your appeal documents often dictate what decision the judge issues.

    As many as 65-70% of first-time applications are denied. There are dozens of grounds on which a claim can be denied. Claims are sometimes filed by people who simply dont qualify. Other people intentionally file deceptive claims. SSDI claims are commonly denied at the initial stage because they are incomplete, missing key medical evidence to prove the disability, or are too ambiguous for the person evaluating it the basis for the claim.

    Getting disability help from an experienced Social Security professional prevents needless delays and repetitive filings that so often occur when someone unfamiliar with the process compiles the documents. Experience is acquired through years of practice, handling different claims, and dealing with varying circumstances.

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