Being new to the world of Social Security Disability Insurance Benefits (SSDI) can come with a lot of uncertainty.
You’re probably wondering: How do you know if you’ll qualify, and what happens when you do?
In this article, we’ll explain the how’s and why’s of SSDI so you can go forward with a clearer picture of what you need to do next.
First things first, we’ll cover how to tell if you’re eligible. Then we’ll move into what the application process looks like along the way. Finally, we’ll explain what you can expect once you’re approved.
How do you Know who Qualifies for Social Security Disability Insurance?
It can be tricky to navigate the nuances of SSDI eligibility. Let’s start with the broadest qualifications first, and then we’ll get into some details.
To qualify for SSDI benefits, you must:
- Be under the age of 67.
- Have a disability that will last longer than one year or potentially lead to death. You cannot get SSDI benefits if you have a partial or short-term disability.
- Meet the requirements for work credits for your age. (More on this below).
Other SSDI qualifications include:
- Not being able to perform the same work you did before you became disabled.
- Not being able to work in other jobs.
- Must be an American citizen or in a legal immigrant class.
- You are not in prison or detained in connection with a crime.
What Conditions are Covered by SSDI?
Any condition that makes it impossible for you to work for at least a year can qualify for disability. The SSA has a Listing of Impairments that will almost always qualify a person for SSDI benefits. If you have been diagnosed by a doctor with one or more of these conditions and your condition is severe, you should be eligible for benefits.
However, many people find that their disability is not on this list. That doesn’t mean you will not qualify, but you will have to ensure you have all the proper medical documentation for your case. An SSDI lawyer can help you understand if your medical condition qualifies and confirm that you have the appropriate documentation from your doctor.
An important thing to remember is that you will only get SSDI if you can’t work at all, or enough, to get by. If you can work another type of job or reduce your hours, you won’t be considered disabled.
For example, if you’re a 35-year-old construction worker and become unable to do construction anymore but can work at a computer full-time, you can still earn money and make a living. In this case, the SSA won’t consider you disabled.
There’s some leniency for applicants who are older. In particular, if you’re over 50, the SSA makes some assumptions about your ability to be “retrained” and transition to other work. You may be able to make the case that your age and education, in combination with your disability, make working in a new field impossible.
How Much Money can I Have and Still get SSDI?
The SSA doesn’t look at how much money you made before becoming disabled, how much money your spouse has, or how much money you have saved in any accounts when deciding if you qualify for SSDI. They will take your past taxable income into account to determine how much your payments will be.
What they will look at is what you’re currently earning. As a rule, you can’t earn more than $1,350 per month from employment — any amount close to or above that puts your benefits at risk or makes you ineligible.
I’ve Heard I Need “40 Work Credits” to be Eligible for SSDI. How do I Know if I Have 40 Credits for Social Security?
The credit system is a way of letting SSA track how many working years you’ve put in. For example, if you’re 45 but have only worked for five years since being 18, you’re likely to get less per month — if you qualify at all — than someone of the same age that’s consistently worked since they were 18.
For credits, a general rule of thumb is if you are over forty, you must have worked at least five of the last ten years. It gets a bit more complicated if you are younger than 31, but usually, you need to have worked most years since you were 18. Atticus can answer these questions for you and help you determine your work eligibility if there are gaps in your experience or if you’re under 31.
SSDI applications are all about the details and answering the application questions correctly. Having Atticus on your side will give you the best chance of submitting a successful application the first time.
My SSDI has been Approved — What are my Benefits?
For most people, this is the most important question.
SSDI benefits include a monthly cash payment and medical care.
What’s the Monthly Cash Payment?
The average SSDI payment right now is $1,358 per month. This probably won’t be the exact amount you get because your payment depends on how many years you’ve worked.
Overall, the maximum amount that one person would get from Social Security varies. There are conditions that need to be met to get the full monthly amount, so chances are the amount you’re approved for will be closer to the average payment.
It’s also likely that your first disability payment will also include “back pay.” Because the application process is long, the government will “pay you back” the benefits you would have received between the time you became disabled and the time you were approved.
The way your back pay is calculated is complicated. But the maximum amount of back pay you can receive is one year’s worth of payments.
What About Healthcare?
When you get approved for SSDI, you’ll automatically qualify for Medicare Part A and B. However, this eligibility isn’t active until two years after you’re first deemed disabled.
For example: If in January of 2020 you injured your back—and that injury qualifies you as disabled—your disability “onset” date is in January 2020. Regardless of when you apply and when your application is approved, the earliest you would receive Medicare is two years after your onset date, or January 2022.
Here’s what Medicare includes:
Medicare Part A will cover overnight hospital stays, some health care, stays in a nursing home, and hospice care. This coverage comes from taxes you’ve been paying while working and won’t cost you anything.
Medicare Part B isn’t free. You’ll need to make a monthly payment (a premium). It will cover medical expenses like doctor's visits, stays at the hospital where you’re not in overnight, and medical supplies. Medicare Part B is not mandatory. You can choose if you want it or not, but after two years on SSDI, you’ll be automatically eligible if you do decide you would like this type of help.
If you can’t pay for your Medicare Part B fees because you don’t have enough income, your state might help you with these costs. It’s up to your state to say what their rules are for this and that application process is separate from SSDI.
Let’s sum Up
Knowing if you’re eligible for SSDI benefits and what you can expect when you’re approved is the first step. With the info in this article, you’ll be able to move forward in your application process. Here’s a quick summary of the important things you need to remember:
- SSDI benefits are determined based on your age and work history.
- The average monthly benefits are $1,358 per month.
- After two years of being on SSDI, you’ll automatically be eligible for Medicaid.
- Atticus will answer your questions and, if you are eligible, will pair you with a vetted SSDI lawyer who will guide you through a successful application process.
With what you’ve learned in this article, you’re on your way to getting the Social Security Disability benefits that you’re eligible for. Now it’s time to contact Atticus so that you can focus on your health and treatment while we worry about the details of the application process.