What is the difference between SSDI and SSI, and how do I qualify?
by Mike McKeon
The Social Security Administration operates two distinct disability benefit programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Many folks confuse one for the other and are often surprised to find out that their overall financial status does not impact their ability to claim SSDI benefits. When considering applying for disability benefits, it is important to be aware of the differences, and similarities, between Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).
SSDI was created to allow people who have been in the US workforce and become disabled to receive their Social Security retirement benefits early. In order to apply for SSDI, you need to have enough work credits based on taxable employment to be covered for Social Security purposes. Because SSDI is based on the Federal Insurance Contributions Act (FICA) taxes you paid throughout your working career, the benefits program – unlike the SSI program, which is only available to folks with limited income and resources — entirely disregards how much money you have or do not have. (Bill Gates could receive SSDI benefits assuming he were otherwise eligible!)
The Social Security Administration (SSA) determines if you have worked enough to qualify for SSDI by converting your earnings into work credits. For example, in the year 2016, you must earn $1,260 to get one Social Security work credit, or $5,040 to get the maximum four credits for the year. The older you are, the more work credits you need to qualify for benefits (for an up to date breakdown of the credits needed for claimants of all ages you can visit https://www.ssa.gov/planners/credits.html).
Generally, in order to receive SSDI and/or SSI benefits, you will have to be found to have sustained a “disability” as defined by the Social Security Administration(SSA). The SSA defines disability as: “The inability to engage in any substantial gainful activity by reason of any medically determinable impairment which can be expected to result in death or which has lasted or can be expected to last a continuous period of no less than 12 months.”
When compared to definitions used in other areas of law, such as the Americans with Disabilities Act (“ADA”), the SSA’s definition may seem highly restrictive. For example, “the inability to engage in any substantial gainful activity” (i.e., work) as used by the SSA, does not refer to the work you did at your particular job before you became disabled; but essentially includes any work, including the thousands of jobs listed in the Department of Labor’s Dictionary of Occupational Titles. Further, “gainful” as used in the SSA’s definition of “disability” means earning more than $1,130 per month in 2016.
Also, there are two tests – in addition to meeting the SSA’s definition of “disabled” — related to one’s work history that they must pass before they can bring a claim for SSDI benefits: the “recent work test” and the “duration of work test” (though it is important to note there is an exception to these rules for certain blind applicants).
The “recent work test” requires an applicant to have worked for a certain number of years during the period immediately prior to becoming “disabled” as defined by the SSA. Applicants under the age of 24 must have worked for at least 1.5 years after turning 21 in order to pass the recent work test, while applicants between the ages of 24 and 31 must have worked for half of the time beginning when they turned 21 (For example, if an applicant is 29, she must have worked for four years in order to pass the recent work test). Finally, applicants aged 31 and over must have worked for 5 out of the 10 years prior to becoming disabled.
The “duration of work” test measures the amount of work an SSDI applicant has performed over the course of her lifetime. In general, if a claimant under the age of 42 passes the “recent work” test, she will likely also pass the duration of work test. However, once a beneficiary turns 42, she must add one quarter of work per year in order to pass the duration of work test. For instance, a 46-year-old beneficiary must have worked for 6 years since turning 21 in order to pass the duration of work test and a 50-year-old beneficiary must have worked for 7 years. (In each case, a beneficiary must have earned at least 5 of those 10 years within becoming disabled.)
The amount of your monthly SSDI benefits will be based on your Social Security income record. Supplemental Security Income (SSI) benefits are awarded based on your demonstrated financial need. When you file an SSI disability claim, you will need to demonstrate that you have very few financial resources or assets and a low income. Also, to qualify for SSI benefits you need to present medical evidence that your disability will last for at least one year. Your total countable income should also be below listed Supplemental Security Income levels. The SSI amount differs from state to state.
As you can imagine from the above, navigating a claim for either type of social security benefit can be fraught with complex issues. Even the timing of the onset of disability can be difficult to ascertain: In instances involving spinal cord injuries from a traumatic accident, it may be clearer when you became disabled than if your disabling condition is a condition that progressed over time until it became “disabling”, such as depression or another chronic illness.
Also, in both SSDI and SSI cases, a claimant’s medical records will be checked periodically to ensure the individual is still disabled. Once you’re awarded SSI disability benefits, your financial records will be reviewed every year. When you apply for Social Security Disability benefits, you should be screened for both SSDI disability and SSI. If you are awarded SSDI benefits of an amount less than a thousand dollars per month, it would be wise to consult with a representative to check if you qualify for SSI as well.
The SSDI work tests are complicated, and the Social Security Administration does not always calculate benefits properly. If you think you qualify for SSDI, or if you want more information about the program, you can seek the help of a Social Security Disability lawyer or advocate to help make the application process for Social Security Disability benefits or appealing a decision much more manageable.