Social Security Administration (SSA) is the agency in charge of benefits for individuals that are retired, blind, or over 65 years of age. They also handle benefits for people with disabilities. This article is a brief description of the different types of benefits. It will also help you understand what is involved in applying for these benefits.
Types of Social Security benefits
SSIis for low-income people who are disabled, blind, or 65 years of age or older, with little or no income. This would also apply to people that have no job history or not enough work credits.
SSI is known as a “means-tested” program for those who qualify. A means test is an examination of your finances to see if you are eligible for government assistance. The test shows whether you or your family need the help. Learn more about how to qualify.
Social Security Disability (SSDI/SSI)
SSDI/SSI is based on your work history and work credit earned. Work credits are based on your total yearly wages or self-employment income. You can earn up to four credits each year. The amount needed for a credit changes from year to year.
This program pays monthly benefits to you if you become disabled before you reach retirement age and are not able to work. The amount you receive each month will be based on your average lifetime earnings before your disability began. It is not based on how severe your disability is or how much income you have. Learn about how to apply online.
How to apply
Applying for SSD/SSDI or SSI is very complex. You will need to answer a few questions before you even start an application.
Are you disabled?
SSA defines disabled as a qualifying physical impairment or disabling illness that lasts at least 12 months or results in death. If you can work 40 hours a week in a job that is defined as substantial gainful activity (SGA), you are not considered disabled. SGA means any work. Not just the line of work you have always had or your normal line of work, but any work that is 40 hours a week.
You have worked as a construction worker for the last 10 years. You have an accident that causes injuries that prevent you from returning to the construction industry. If you can work in retail or an office job 40 hours per week, that is considered an SGA. It does not matter that you cannot return to the construction industry.
You need to know if you are disabled according to the SSA. So make sure you understand the definition of disabled before you request these benefits.
If you are under the age of 18, you apply for SSI. In this case, the benefits would be based on the parents’ or guardian’s income and assets. If you are approved for benefits as a child, you must reapply for adult benefits when you turn 18. SSA will send you a notice when this will happen, at which time you need to reapply under the adult criteria, as shown below.
Re-apply before the benefits end date. If you re-apply before your child SSI benefits end, and you are denied, you will receive a notice that states you have the right to appeal. You must appeal within 10 days to continue receiving benefits. If you lose the appeal, you might have to pay back some or all of these benefits.
Once you know you qualify as being disabled, you will need to go to the Social Security website to see if your disability is listed and consult their Adult Listings Blue Book here. Children have their own criteria for defining disability, found in Childhood Listings Part B here.
Follow these instructions to identify if you meet the requirements:
- Determine which category you fit into and print the entire section out.
- It is very important that you read this section multiple times very carefully, highlight the categories that apply to you and your disability.
- To qualify, you must fit into certain requirements within these guidelines. Let’s say you have anxiety, which is 12.06 in the Blue Book. You will need to read the entire 12.00 Mental Disorder listing, not just section 12.06 which is anxiety.
- The definition of each section will require you to satisfy certain items on their list. You will need to go back multiple times to check definitions from the beginning sections.
- “Marked limitation” is a term you will need to understand SSA’s definition and the definition will vary depending on what section you are using.
- If you do not fit all the criteria, that does not mean you will not get benefits; it may just be more difficult. Sometimes just one impairment will not be enough to qualify.
- Once you have determined that you fit all the criteria for SSDI/SSI, you will need medical documentation proving your disability.
- If you cannot find your disability in the listing, go to section 10.00(3)(E) of the Blue Book, this explains what to do in these instances.
- If you have a medical condition like fibromyalgia, most times this will not be enough on its own to qualify. But if you have fibromyalgia and another health issue, then SSA may find you disabled.
Be prepared before starting the application; you will need to gather a lot of information to fill it out correctly. If you have all your prior work history, medical records and they fit into a listing from the Blue Book before you apply, then your chance of receiving SSI/SSDI the first time greatly improves. Remember, just because you think you are disabled, does not mean SSA thinks the same thing. Know from the start that this process will take months. Do not be discouraged.
You will need to have the following documentation before you start the application:
- A list of all doctors you have seen (including address and contact information)
- Hospital/emergency room visits (including address and contact information)
- Dates of the doctor and hospital visit and what the stay was for
- Tests you have had and the dates
- Medications you are on and why you are taking it
- A list of all jobs you have had with job duties, names and contact information of supervisors
- SSA will get the medical records for you, but it will take longer than if you get them yourself
- Have someone who knows you and your disability write something about your daily routine/activities. Showing how the disability is hindering your life on a daily basis. Write something yourself, and if you are not able to do this, dictate to someone who can
- If possible, schedule an in-person appointment when SSA calls you, not a phone appointment. Bring all the records you have; this will take time off the process of collecting documents
The more information you give SSA, the better. The most important thing to remember is, if you went to a doctor, no matter what it was for, or what the results were, you must give the SSA this information.
When you begin an application for benefits, you will be given a re-entry number. Print this page out, write down the number. You will need this to get back into the application. Do not try to fill the application out all at once. It is very long. If you do not have this number, you will need to start over.
Now, let’s say you have a developmental disability/physical disability that has affected you your entire life. One portion of the application in the work section asks for more information. You are allowed 2,000 characters, use them. Save the application and figure out what you want them to know. Like how your disability affects you on a daily basis, and how it affects your ability to work.
Other things to include:
- If you had an IEP in school, you would need to include all of these. The purpose is to show a history of disability in these school records.
- A neuropsychological exam would be very helpful in these cases for a developmental disability.
Carefully read everything that SSA sends you. If you are denied, make sure you appeal. Look at the reason you were denied an appeal based on this. Get more records if that is what they need. Get help from someone who has experience in this area, like an attorney that has Social Security Disability experience. Do not just give up.