Does Social Security Provide Disability Benefits? What You Need to Know

Does Social Security Provide Disability Benefits? What You Need to Know

If an illness or injury has made it impossible to work, you may be wondering how you will pay your bills. The short answer to "does Social Security provide disability benefits?" is yes. The Social Security Administration (SSA) runs two disability programs that pay monthly benefits to people who cannot work because of a serious medical condition. Knowing how they work is the first step toward getting the support you have earned.

The Two Social Security Disability Programs

The SSA offers two separate programs, and they are easy to confuse.

Social Security Disability Insurance (SSDI) is for people who have worked and paid Social Security taxes through payroll deductions. Think of it as insurance you paid into over your working life. Your monthly benefit is based on your lifetime earnings, and it is not limited by your savings or your spouse's income.

Supplemental Security Income (SSI) is a needs-based program for people with limited income and resources, whether or not they have a work history. SSI payments are a flat federal amount that varies slightly by state. Some people qualify for both programs at the same time.

This article focuses on SSDI, the program most working adults rely on after a disabling illness or injury.

Who Qualifies for SSDI Benefits?

To qualify, you must meet two sets of requirements: work credits and a medical definition of disability.

Work credits. You earn credits by working and paying Social Security taxes. In most cases you need 40 credits, and 20 of them must have been earned in the 10 years before your disability began. Younger workers can qualify with fewer credits.

The SSA's definition of disability. Social Security's rules are strict. To be considered disabled, you must:

• Have a physical or mental condition that prevents you from doing substantial work
• Be unable to do the work you did before, and unable to adjust to other work given your age, education, and skills
• Have a condition that has lasted, or is expected to last, at least 12 months, or is expected to result in death

There is also an earnings limit. If you earn more than the "substantial gainful activity" amount each month (about $1,600 for most people, adjusted yearly), the SSA will generally find that you are not disabled. Conditions that commonly qualify include heart disease, cancer, back and joint disorders, chronic pain, neurological conditions, severe depression, anxiety, PTSD, and many others. The SSA publishes a list of impairments, but you can still qualify if your condition is not listed, as long as your limitations keep you from working.

How Much Does SSDI Pay, and When Does It Start?

The average SSDI payment is roughly $1,500 to $1,600 per month, though your amount depends on your past earnings. You can find an estimate by creating a free "my Social Security" account at ssa.gov.

There are two timing rules to know:

• Five-month waiting period. SSDI benefits begin after you have been disabled for five full months, so you will not be paid for those first months.
• Medicare after 24 months. Once you have received SSDI for 24 months, you become eligible for Medicare health coverage. Some conditions, such as ALS, qualify sooner.

If your claim is approved after a long wait, you may also receive back pay covering the months between your application and your approval, which can be a substantial lump sum.

How to Apply for Social Security Disability

You can apply online at ssa.gov, by phone at 1-800-772-1213, or in person at your local Social Security office. Preparation matters, because the strength of your application often decides the outcome. Gather the following before you start:

• Your Social Security number and basic work history for the last 15 years
• Names, addresses, and phone numbers of every doctor, clinic, and hospital that has treated you
• Medical records, test results, and a list of your medications
• Your most recent W-2 or tax return

The most important evidence is your medical record. Keep seeing your doctors regularly and follow your treatment plan. Ask your doctors to describe in writing exactly what you can and cannot do, such as how long you can sit, stand, lift, or concentrate. Gaps in treatment give the SSA a reason to doubt how serious your condition is.

Apply as soon as you stop working, or as soon as you know you will be unable to work for a year or more. Waiting does not help you, and in some cases it can cost you benefits.

What to Do If Your Claim Is Denied

A denial is discouraging, but it is not the end. A majority of initial SSDI applications are denied, often because of missing medical evidence or paperwork errors, not because the person is truly able to work.

You have 60 days from the date you receive the denial letter to appeal. The appeals process has four levels:

1. Reconsideration: A new SSA reviewer looks at your file.
2. Hearing before an administrative law judge: This is often where claims are won, because you can explain your limitations in person and present additional evidence.
3. Appeals Council review: The council can reverse a decision or send it back for a new hearing.
4. Federal court: A final option if the earlier levels fail.

Missing the 60-day deadline can force you to start over, so file your appeal right away. Do not give up and reapply from scratch unless you have been advised to. Appealing keeps your original filing date, which protects your back pay.

How an SSDI Attorney Can Help

You are allowed to apply on your own, but you do not have to go through this alone. An experienced disability attorney can collect and organize your medical evidence, work with your doctors, prepare you for a hearing, and argue your case to the judge. Social Security disability attorneys are paid only if you win, and their fees are capped by federal law and taken from your back pay, so there is no upfront cost to you.

At Louis Law Group, we understand how stressful it is to face medical problems and money worries at the same time. We help clients across the country build strong SSDI claims and appeal denials, so you can focus on your health instead of paperwork.

If you believe you qualify for SSDI benefits, Louis Law Group can help. Contact us today for a free consultation.