When I first started working as a disability lawyer, my conversations went like this:
Client: “I can’t work, and I’m wondering if I can get disability benefits?”
Me: “Maybe! Which type of disability benefits? There are many different ones.”
I learned quickly that almost nobody knows what programs are out there. This is a huge problem! Many clients (even very competent ones) miss options that could be life-changing.
This post explains (in plain English) all the different ways disabled people can get benefits — and how to figure out which ones you qualify for. Understanding this is critical. Otherwise, you’ll apply for the wrong things, and never get the benefits you need.
You’re disabled: You’re unable to work (or at least unable to work much) due to a serious medical condition, and will stay that way for at least a year.
If you’re under 50, you typically must be unable to hold any kind of job in the world. (This is a hard standard.)
If you’re over 50, you typically must be unable to hold the kinds of jobs you’ve held before. (This is easier to meet.)
Before you became disabled, you were working: You worked (and paid social security taxes) for much of your adult life, including (if you’re 31 or older) five of the last ten years.
To qualify, it’s critical that you have a doctor who knows you and is quite familiar with your medical condition. The government will ask to see medical records proving your disability, and without them it’s nearly impossible to qualify.
What benefits do you get with SSDI?
Recipients get a monthly check (the size depends on what you earned previously) and health insurance through Medicare.
Benefits last as long as you’re disabled — sometimes for decades. The average check size is around $1,300 per month, but it can be as large as $3,200 or as small as $200. (It all depends how much you’ve paid into the system in the past).
After a two-year waiting period, SSDI recipients also get health insurance through Medicare.
Why does SSDI exist?
SSDI is a very old federal (nationwide) program. The basic idea: If you have to “retire early” due to disability, you should get the same benefits others get when they reach retirement age.
When most Americans turn 66 and retire, they start getting a monthly check from social security. But what if you can’t work until retirement age, but instead have to stop work due to disability? SSDI allows you to start receiving the same social security check you’d get at age 66, but before normal retirement age.
As with retirement benefits, the size of the check is determined by how much you’ve paid into the system. SSDI isn’t welfare: what you get out is entirely determined by how much you’ve paid in.
Does SSDI conflict with other programs?
You can collect SSDI and other types of benefits without impacting your eligibility. But getting other benefits might reduce the size of your check. The most you can earn while on SSDI (from all sources) is 80% of your pre-disability income. If you’d be over that amount, the government will reduce the size of your check so that you make exactly 80%.
How do I get SSDI?
There are several different options to apply for SSDI. You can apply on your own through the Social Security Administration (which can process your application online, over the phone, or in person). Or you can hire a lawyer who will handle everything for you. I tell clients that if you’re the type of person who’s capable of filing your own taxes 100% accurately, you should apply on your own. If not, you should hire a lawyer.
Most people who appeal with a lawyer eventually win. When you win on appeal, you get paid “back benefits” — everything you should have been getting since you applied.
Lawyers all work roughly the same way: They don’t charge any up-front fee. But if you win, they typically get 25% of your first check (which includes those “back benefits”). Given the amount of work involved, it’s usually worth the cost. And it’s essential at the appeal stage (where very few people win without a lawyer). Lawyer’s will charge the same whether you bring them on at the application stage, or after the first rejection.
2. SSI: Supplemental Security Income
Are you unable to work for at least the next year, and you have little income or assets? Get monthly payments of up to $914 from the federal government, plus health insurance through Medicaid.
Who qualifies for SSI?
You can qualify for SSI if you’re unable to work due to a serious and long-lasting medical condition and have no other means to support yourself.
There are two basic requirements, the first of which is shared with SSDI:
1. You’re disabled: You’re unable to work (or at least unable to work much) due to a serious medical condition, and will stay that way for at least a year.
If you’re under 50, you typically must be unable to hold any kind of job in the world.
If you’re over 50, you typically must be unable to hold the kinds of jobs you’ve held before.
2. You have few resources: You have little or no income, and little or no money in the bank.
Your monthly income is low, from work or any other source. (The actual calculation is too complicated to go into here, but individuals rarely qualify if they get more than $1,000 per month). If you’re married, your spouse must be very low-income too.
You have few assets: Less than $2,000 (or $3,000 for a married couple) in money or property. (You can exclude your home, one vehicle, basic household goods, and a few other unusual things; everything else counts).
What does SSI offer?
The default benefit is $914 per month. Residents of some states get a bit more — up to $200 extra. People who earn money from other sources get less, since the government deducts other income from your SSI check. Recipients get Medicaid (with no waiting period) once they qualify.
Why does SSI exist?
SSI is a form of welfare, for people who are unable to support themselves through work due to a disability.
Unlike SSDI, it doesn’t require past work, and the amount you get isn’t tied to what you’ve paid in. Instead, it’s designed as a last resort for people with few other options.
Does SSI conflict with other programs?
You can collect SSI and other types of benefits — but in practice, many other benefits will cause you to exceed the income limit.
SSI recipients can’t typically earn more than $750 to $1,000 per month from any source. If you receive money from other programs, it will cause a reduction in your check size.
How do I get SSI?
You can apply for SSI on your own through the Social Security Administration — and almost everyone does.
The SSA can process your application over the phone or in person — but usually not online. You can get a lawyer to handle your application, but it’s very hard to find one who will take initial SSI applications.
Like with SSDI: Most people get denied at first. If you get denied, you can (and should!) appeal — and should do so with a lawyer.
3. State Disability Insurance (Short-Term Disability)
Are you unable to work right now, but worked in the last year, and you live in CA, HI, NJ, NY, or RI? Get a percentage of your old salary for up to 6 to 12 months, from your state government.
Who qualifies for state disability insurance?
You qualify for SDI if you live in the right state, and can no longer do your last job due to a medical problem or injury.
Requirements vary by state, but the core test is the same:
You live in one of five states that offer SDI or an equivalent: California, Hawaii, New Jersey, New York, or Rhode Island
You’ve worked some amount in the past year (requirements vary)
Your doctor is willing to certify you as disabled on a state form
You’re not also receiving Workers’ Compensation — i.e. you’re probably not disabled due to something that happened at work.
What does state disability insurance offer?
Recipients get a weekly or monthly check, usually 50% to 66% (or less) of their previous wages from work.
Each state pays a different amount. At most, you’ll get 50% to 66% of what you were earning previously at your job. And each state sets a cap on the maximum check size. California pays benefits for up to a year, but every other state pays for only six or seven months.
Why does state disability insurance exist?
State disability insurance is a public safety net designed to prevent you from totally losing your livelihood if you can’t work.
Like social security, in most states employees and employers pay a little bit into the program’s fund with every paycheck, and what you get out depends on what you paid in. If you’re injured and can’t work, the fund pays part of your salary so you don’t end up destitute.
Does state disability insurance conflict with other programs?
State disability insurance conflicts with workers’ compensation: you can’t get both. But you can apply for state disability insurance and SSDI at the same time, and many do.
If you get state disability insurance, you can’t usually get full SSDI benefits for the same month, but you can still get some amount. It’s prudent to apply for both if you’ll be out of work for more than a year, as state disability insurance is temporary.
How do I get on state disability insurance?
You can apply for state disability insurance on your own — typically through your state, doctor, or employer. Almost no one uses a lawyer.
Typically you’ll fill out a state-provided form yourself, and file it by mail or online. Use these state-specific instructions:
Your doctor (in all states) and your employer (in some) will need to sign off as well.
4. Private Disability Insurance (Short-Term or Long-Term)
Did you buy private disability insurance, or receive it through your employer? File for payments from your insurer under the policy’s terms.
Who qualifies for private disability insurance?
To qualify, you need to have bought private insurance before you became disabled.
Most people with private disability insurance get it through their employer (and a few employers provide it free).
What does private disability insurance offer?
Short-term policies usually pay 80% of your past earnings for 3 to 6 months. Long-term policies usually pay 50% to 60% of your past earnings for many years (usually until you retire).
The exact terms will depend on the policy you bought.
Why does private disability insurance exist?
Like other forms or private insurance, disability insurance is a way to mitigate risk.
Employers often offer it as part of their benefit package, because it ties directly to work.
Does my private disability conflict with other programs?
You can get SSDI on top of private insurance payments — though it may reduce the size of the check you receive. Some long-term insurance companies may even require you to apply for SSDI.
Whether insurance payments conflict with other programs will depend on the terms of your specific policy.
How do I access my private disability insurance benefits?
To apply, contact your disability insurance company. You don’t need a lawyer, but if you’re denied coverage you can find one to fight the decision.
Often, the insurance company will ask you to visit a doctor they approve to evaluate you — but you should keep seeing your own doctor as well if possible.
5. Workers’ Compensation Claims
Were you injured at work? Get monthly payments and medical coverage from your employer until you get better (as required by state law).
Who qualifies for workers compensation?
If you were injured at work, or as a result of your work, you can usually make a claim for workers’ compensation payments.
Most (but not all) employers in the U.S. must maintain workers’ compensation insurance.
What does workers compensation offer?
Workers’ compensation pays for your medical bills, and provides a monthly payment to replace part of your lost wages.
Most plans pay up to 80% of your pre-injury wages. In many states, insurance companies send you to doctors they (not you) pick.
Why does workers compensation exist?
Workers’ compensation is the result of a government compromise: it banned employees from suing their employers over injuries, and instead required employers to carry insurance
Every state has some form of workers’ compensation, though laws vary.
Does workers compensation conflict with other programs?
Workers’ comp recipients typically can’t get private or short-term disability insurance, and can’t file suit.
You can get SSDI on top of workers’ compensation payments — though you’ll likely get a smaller check. The total amount you can receive in SSDI and workers compensation can’t equal more than 80% of your total prior compensation (anything above that will get deducted from your SSDI check).
How do I get workers compensation benefits?
To pursue a claim, contact your employer or their insurance company. You can move forward without a lawyer, but if you’re denied coverage you can find one to fight the decision. A lawyer can also get you a better payout (up to 5x the amount according to this study)
Like with private disability insurance, an insurance company will often ask you to visit a doctor they approve — but you should keep seeing your own doctor as well if possible.
5. Personal Injury Claims
Were you injured outside work, and someone else was at fault? Get a one-time payment as compensation, usually from their insurance carrier.
Who qualifies to make a personal injury claim?
A personal injury claim is worth pursuing if you were injured and someone else was at fault (like if you were hit by a car).
Personal injury law is extremely complicated, but if you suffered meaningful medical injuries in an accident caused by someone else it’s worth talking to a lawyer to see if you might qualify.
What does a personal injury claim offer?
Successful claimants get a one-time payment to cover their lost wages, medical care, and suffering. Amounts vary widely.
It’s rare that an individual defendant pays money; usually, their insurance company is the one on the hook. In serious cases, the amount you get is typically limited by how much insurance the other party carries.
Why do personal injury claims exist?
The basic idea behind personal injury claims is that if someone hurts you, they should have to bear the cost.
Personal injury claims have been part of U.S. law since 1620.
Does a personal injury claim conflict with other programs?
Personal injury claims don’t impact your eligibility for other programs.
However, if you get enough money, you might be ineligible for SSI — based on the income requirements.
How do I get paid from a personal injury claim?
To pursue a personal injury claim, you should talk to a lawyer. You can attempt to negotiate a personal injury settlement on your own, but it’s rarely a good idea.
We know: a lot of personal injury lawyers seem sketchy and untrustworthy. But there are good ones, and it’s critical to consult one. This area of law is complex and counterintuitive, and you need an expert.
There’s only one narrow set of circumstances where you should consider handling a claim yourself: when your injuries are so serious that the insurer is already offering you the “policy limit” (maximum) of the other party’s insurance.
A note on unemployment benefits
Disabled people typically do not qualify for unemployment benefits. It’s not impossible to qualify, but it’s very rare.
Why? Unemployment benefits are exclusively for people who are “physically able to work” and “actively looking for work.” If you meet those criteria, you won’t qualify for most disability benefits — which are exclusively for people who can’t work!
As a result, very few people apply for both unemployment and disability benefits. Being on one would harm your chances of qualifying for another.
Atticus ensures you get the best possible benefits
If all of this sounds confusing, that’s because it is. You don’t always need a lawyer, but you could almost always use some legal advice.
Atticus has helped thousands of people navigate the disability application process. You can use our intake questionnaire to learn what you qualify for instantly, and talk to a friendly expert today who can advise you on your next step. Get started here.
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