Common Questions About Disability

What is the difference between Social Security Disability (SSDI) and Supplemental Security Income (SSI)?

SSI is funded through general tax revenues.  This program is designed to provide income to people who are unable to work for at least 12 months due to a disability, and people may qualify for this program regardless of whether or not they have worked in the past.  However, the person must meet several other requirements which demonstrate need such as limited personal assets.

SSDI is funded through payroll taxes.  This program is designed to provide income to people who are unable to work for at least 12 months due to a disability.  To qualify for this program, people must have earned a certain amount of credits.  Generally, that person must have worked for a number of years to qualify.  The amount of the benefit varies from person to person and depends on how much money they have earned over the preceding years.  The maximum benefit for an individual in 2016 is approximately $2,663 per month.

How do I qualify for SSDI or SSI?

In addition to being unable to work for twelve months and having the required work credits, an individual’s claim must pass a five step determination process. The five steps are:

  • Are you working?
  • Do you have a “severe” condition?
  • Do you have a condition found in the Listing of Impairments?
  • Can you perform your past work?
  • Can you adjust to other work?

SSA will look to answer these questions at the application, reconsideration, and hearing levels of the application process by collecting medical evidence and other information. Depending upon the information available to SSA and the Disability Determination Services (DDS) to answer these questions, the Administration will make a determination as to whether you are eligible to receive benefits.

Do I have to be unable to do any work to qualify for SSDI or SSI?

The standard to receive benefits under either program requires an inability to engage in “substantial gainful activity.”  Simply put, “substantial gainful activity” means that you are able to work and earn more than approximately $1,000.00 per month on a consistent basis.  People may be disabled even though they are able to work on some days and not on others, maintain a part time schedule, or work with accommodations from their employers.  The person’s age, education, and work history are also considered in determining whether or not he or she qualifies for SSDI or SSI.

If the injury causes the person to be unable to work for 12 months or longer, but then the person shows significant medical improvement in his conditions, he may be qualified to collect SSDI or SSI during this period of disability.  This is known as a “closed period.”  Once the injury or other disability is gone and the individual is able to return to work, he will stop collecting SSDI or SSI.  So, being disabled for the purposes of collecting SSDI or SSI does not require you to be unable to do any work at all.

Can you receive both SSI and SSDI simultaneously?

Yes, with some limitations. In some circumstances, an individual may qualify for SSDI, but because they have only earned a  certain amount of money over the preceding years, his or her benefit may be less than $733 per month.  In circumstances such as these, provided the individual also meets the qualifications for SSI, he may receive both SSDI and SSI; however, his total benefit will be capped at $733 per eligible individual, per month.  For example, a person may qualify for $500 per month through SSDI and then receive an additional $233 per month through SSI.

What is the process for receiving SSDI or SSI?

The first step involves filing an application and collecting medical records.  SSA will then render a decision on this initial application.  If it is approved, the individual will begin to receive benefits.

If it is denied, the individual may request that his application be reconsidered and submit additional medical records.  (Except in states which skip the reconsideration level).

If the application is approved at reconsideration, the individual begins to receive benefits.

If it is denied, he may request a hearing before an administrative law judge (ALJ).  This is the portion of the process which takes the longest.  Once the hearing is scheduled the claimant may present evidence to the ALJ for consideration.  This typically involves the individual appearing at a hearing before the ALJ and answering questions.  Once the hearing is concluded the ALJ will render a decision.  If the application is approved, the individual will begin to receive benefits.

If it is denied, the individual may appeal to the Appeals Council.  If the claim is denied at this point, the individual may appeal to Federal District Court.

How long does it take to receive SSDI or SSI?

The time it takes from the initial application to receiving benefits varies widely and depends on the nature of the disability, the quality/amount of medical records, the region of the U.S. where the individual is applying, and whether appeals to the Appeals Council or Federal District Court are required.  If no appeals to the higher levels are required, a good estimate is anywhere between six (6) months and two (2) years.  Due to the length of the process, it is advisable for individuals to apply for SSDI/SSI sooner rather than later.

Do I need an attorney or representative to file for SSDI or SSI?

You may file an application and represent yourself through the entire process.  However, due to the length and complexity of the process, it may be in your best interest to hire an attorney or representative to handle your claim for SSDI or SSI.

A hearing before an ALJ is the third step of the SSDI and SSI application process, how would an attorney or representative help me before then?

While there are a number of ways to approach representing SSDI and SSI claimants, an effective representative will be consistently involved with his or her clients’ cases. During the first two steps of the process a representative will assist you in gathering medical records, scheduling interviews with representative of the Social Security Administration, scheduling consultative examinations, ensuring that SSA and DDS keep to a reasonable timeline, advocating for you with adjudicators, and filing appeals if necessary. An attorney or representative will also be able to provide you with insight into your case, explain rules such as the Listing of Impairments and Medical-Vocational Guidelines (the “Grids”), and assist in presenting evidence regarding how your conditions meet these rules.

How much does it cost to hire an attorney or representative for an SSDI or SSI claim?

Many attorneys and representatives take clients for SSDI and SSI on a contingent basis.  This means that the client only pays if the claim is successful.  If the claim is denied there is no fee.  If the claim is successful and the individual is awarded benefits, the fee is regulated by statute and subject to approval by SSA.  The statutory cap for contingent representation is 25% of the individual’s back due benefits, up to a maximum of $6,000.

We would be happy to answer any further questions via email or telephone. Contact Omega Disability today!