Social Security Disability Benefits (SSDI)

Disability benefits are available to qualified recipients under two programs, Supplemental Security Income (SSI) and Social Security Disability Income (SSDI).   SSI is a means-tested program for people with disabilities who have very limited means, but SSDI is an insurance program that is available to qualified workers with disabilities regardless of their resources.  As of November 2014, some 10.9 million disabled workers and their dependents were receiving SSDI benefits from Social Security.

SSDI pays cash benefits to people who are unable to work for a year or more because of a disability. Benefits continue until you are able to work again on a regular basis, or until you reach retirement age. At that point, the disability benefits automatically convert to retirement benefits, but the amount remains the same. After receiving SSDI benefits for two years, you also become eligible for health insurance coverage under Medicare. The disability program also includes a number of work incentives to ease your transition back to work.

Who is eligible?

As with retirement benefits, you must have accumulated a certain number of work credits before you can qualify for SSDI disability benefits. However, fewer credits are required to qualify for the disability program than for retirement. You can earn up to four credits per year of employment. How many credits you need to qualify for disability depends on the age you become disabled.

Before age 24 You may qualify if you have six credits earned in the three-year period ending when your disability starts.

Age 24 to 31 You may qualify if you have credit for having worked half the time between age 21 and the time you become disabled. For example, if you become disabled at age 27, you would need credit for three years of work (12 credits) out of the previous six years (between age 21 and age 27).

Age 31 or older In general, you will need to have accumulated the number of work credits shown in the chart below. Unless you are blind, at least 20 of the credits must have been earned in the 10 years immediately before you became disabled. If you are disabled by blindness, your work credits can be from any time after 1936.

Certain members of your family may qualify for disability benefits on your work record should they become disabled. The amount of these benefits depends on your earnings record. These family members include:

• Your spouse who is age 62 or older, or any age if he or she is caring for your child who is under age 16 or disabled and also receiving checks;
• Your widow or widower or divorced spouse (if the marriage lasted at least 10 years) age 50 or older should he or she become disabled. The disability must have started before your death or within seven years after your death;
• Your unmarried son or daughter, including an adopted child, or, in some cases, a stepchild or grandchild.

When is a child entitled to disability benefits?

Children under age 18 who are disabled may be eligible for childhood disability benefits if their parent has a disability or is deceased and was insured at the time of death. An unmarried disabled child who is older than age 18 may be eligible for benefits if the disability began before age 22. There is no upper age limit for childhood disability benefits.

In addition, unmarried children are entitled to child’s insurance benefits on the Social Security record of their disabled or deceased parents if the child is under age 18 or between age 18 and 19 and a full-time student.

Who is “disabled”?

The Social Security Administration uses a strict definition of disability. The program does not pay for partial disability or short-term disability. To qualify for benefits under SSDI, your disability must prevent you from doing any substantial gainful work, and it must last or be expected to last a year or to result in death.

Despite the rule that the disability must be expected to last a year, you should apply for benefits as soon as the condition becomes disabling and your doctor is willing to state in writing that it is expected to last at least a year. If it turns out that you recover sooner than expected, the SSA will not ask for its money back.

Older workers who become disabled tend to have an easier time having their claims approved. The SSA recognizes that it is more difficult for older workers to be retrained or to find new employment. In addition, the agency knows that a disabled worker who is, say, 60 years old and will be receiving retirement benefits in a few years anyway will cost it less in benefit outlays than a younger worker would.

The amount of disability payments

As with other Social Security benefits, the amount of your disability payments is based on your age and your earnings record. The calculations are the same as those for retirement benefits, although fewer work credits are needed to qualify for benefits. You can obtain the SSA’s estimate of what your disability benefits would be by requesting Social Security Statement SSA-7004 (formerly known as the Personal Earnings and Benefit Estimate Statement) from the SSA. You can request a copy by mail or online by visiting this page on the SSA Web site:

Your spouse and minor or disabled children are also eligible for benefits. The most that you and your family can receive, however, is either 85 percent of your salary before you became disabled or 150 percent of your own disability benefit, whichever is less.

In most cases, the SSA allows you to supplement your benefits with a small amount of income (in 2016, up to $1,130 a month or $1,820 for the blind).

Beneficiaries who are eligible for more than one Social Security program — say, disability and retirement benefits — cannot collect more than one Social Security benefit simultaneously. If you are eligible for two benefit programs, you will receive the higher of the two benefit amounts, but not both. The exception is Supplemental Security Income, which you can receive while collecting benefits from another Social Security program. However, you are permitted to collect disability payments from a private insurer, the Veterans Administration, or other source at the same time that you are receiving Social Security disability benefits. This holds true for workers’ compensation benefits as well, although your Social Security disability benefits will be reduced if the total of your workers’ compensation and disability benefits exceeds 80 percent of your average wages before you became disabled.

Applying for benefits

Unlike applying for retirement benefits, the application process for disability benefits is complicated and time-consuming. Before you can collect benefits, you have to have been disabled for at least six months. However, since the application process itself can take up to six months, do not wait for the six-month period of disability to elapse before applying for benefits; do it as soon as you become disabled.

The initial application is made at your local Social Security Office. (Don’t know where your local office is? Click here for the SSA’s Social Security Locator.)  If the office determines that you have sufficient work credits to collect disability benefits, it will forward your application to a Disability Determination Services office in your state, which will make the decision about whether you meet the Social Security Administration’s criteria for disability. This decision is made by a doctor and a disability evaluation specialist. They may request additional medical records and/or request a medical evaluation or test. This exam will be paid for by the SSA.

David Wingate is an elder law attorney at the Elder Law Office of David Wingate, LLC. The elder law office services clients with powers of attorneys, living wills, Wills, Trusts, Medicaid and asset protection. The Elder Law office has locations in Frederick and Montgomery Counties, Maryland.