What are the eligibility requirements to get SSD disability benefits?

The following answer is from: https://faq.ssa.gov/link/portal/34011/34019/Article/3714/What-are-the-eligibility-requirements-to-get-Social-Security-disability-benefits

To qualify for Social Security disability benefits, you must have worked long enough in jobs covered by Social Security (usually 10 years). Then, you must have a medical condition that meets Social Security's definition of disability

In general, we pay monthly benefits to people who are unable to work for a year or more, or who have a condition expected to end in death. The disability must be so severe the worker cannot work, considering age, education and experience. 

If you think you may be eligible to receive disability benefits and would like to apply , you can use our online application.  

Applying online for disability benefits offers several advantages:

  • You can start your disability claim immediately. There is no need to wait for an appointment;
  • You can apply from the convenience of your home, or on any computer; and
  • You can avoid trips to a Social Security office, saving you time and money.

The following answer is Attorney Walter Hnot’s annotated response to the previous answer. 

  • The answer is, “What are the elements to SSDI and SSI?”  SSI is a poverty program, meaning you have a bunch of income restriction requirements, such as not having more than $2,000 in your bank account, or a life insurance policy worth more than $1,500 payable to the SSI claimant.  Putting it simply, you need to be really poor, or were during the claimed closed period when you are/were requesting disability benefits.  Now keep in mind, this means you are poor in two respects.  Those two types are income, and resource poverty.  So, what does the SSA consider income:

    “Income is anything you receive during a calendar month and can use to meet your needs for food or shelter. It may be in cash or in kind. In-kind income is not cash; it is food or shelter, or something you can use to get food or shelter.”

    What types of income does the SSA consider?

Earned Income is wages, net earnings from self–employment, certain royalties, honoraria, and sheltered workshop payments.

Unearned Income is all income that is not earned, such as Social Security benefits, pensions, State disability payments, unemployment benefits, interest income, and cash from friends and relatives.

InKind Income is food or shelter that you get for free or less than its fair market value.

Deemed Income is the part of the income of your spouse with whom you live, your parent(s) with whom you live, or your sponsor (if you are an alien), which we use to compute your SSI benefit amount.

So are some things not considered income.  Yes! 

Examples of payments or services that the SSA does not count as income for the SSI program include but are not limited to:

  • the first $20 of most income received in a month;

  • the first $65 of earnings and one–half of earnings over $65 received in a month;

  • the value of Supplemental Nutrition Assistance Program (food stamps) received;

  • income tax refunds;

  • home energy assistance;

  • assistance based on need funded by a State or local government, or an Indian tribe;

  • small amounts of income received irregularly or infrequently;

  • interest or dividends earned on countable resources or resources excluded under other Federal laws;

  • grants, scholarships, fellowships or gifts used for tuition and educational expenses;

  • food or shelter based on need provided by nonprofit agencies;

  • loans to you (cash or in–kind) that you have to repay;

  • money someone else spends to pay your expenses for items other than food or shelter (for example, someone pays your telephone or medical bills);

  • income set aside under a Plan to Achieve Self–Support (PASS). See the SSI Spotlight on Plan to Achieve Self–Support; 

  • earnings up to $1,790 per month to a maximum of $7,200 per year (effective January 2017) for a student under age 22. See the SSI Spotlight on Student Earned Income Exclusion; 

  • the cost of impairment–related work expenses for items or services that a disabled person needs in order to work. See the SSI Spotlight on Impairment–Related Work Expenses; 

  • the cost of work expenses that a blind person incurs in order to work. See the SSI Spotlight on Special SSI Rule for Blind People Who Work; 

  • disaster assistance;

  • the first $2,000 of compensation received per calendar year for participating in certain clinical trials;

  • refundable Federal and advanced tax credits received on or after January 1, 2010;
  • and
 certain exclusions on Indian trust fund payments paid to American Indians who are members of a federally recognized tribe.

Ok so wait, what if I have things that aren’t considered income, and aren’t resources…  How do I know that the SSA is accounting for these things in my favor?  The SSA accounts for the income, and those things that are not considered income by creating a bottom line chart, called “Countable Income.”  Countable income is the amount left over after eliminating from consideration all items that are not income; and then applying all appropriate exclusions to the items that are income.  Countable income is determined on a calendar month basis. It is the amount actually subtracted from the maximum Federal benefit to determine your eligibility, and to compute your monthly payment amount.  There are a bunch of income exclusions that exist.  One of the most popular ones is the student earned income exclusion.  The student earned income exclusion has maximum amounts which increase with the cost of living as measured by the COLA (cost of living adjustment). This exclusion applies to a blind or disabled child who is a student regularly attending school, college, university, or a course of vocational or technical training.

OK, so what about resources.  Think of resources as income that you kept for over a month, and poof, income turned into a resource the next month.  Resources are:

  • cash;

  • bank accounts, stocks, U.S. savings bonds;

  • land;

  • life insurance;

  • personal property;

  • vehicles;

  • anything else you own which could be changed to cash and used for food or shelter; and

  • deemed resources.

Ok cool, so then what are not considered resources, or rather, not counted as a resource?

  • the home you live in and the land it is on;

  • household goods and personal effects (e.g., your wedding and engagement rings);

  • burial spaces for you or your immediate family;

  • burial funds for you and your spouse, each valued at $1,500 or less (see the SSI Spotlight on Burial Funds);

  • life insurance policies with a combined face value of $1,500 or less;

  • one vehicle, regardless of value, if it is used for transportation for you or a member of your household;

  • retroactive SSI or Social Security benefits for up to nine months after you receive them (including payments received in installments);

  • grants, scholarships, fellowships, or gifts set aside to pay educational expenses for 9 months after receipt;

  • up to $100,000 of funds in an Achieving a Better Life Experience (ABLE) account established through a State ABLE program;
  • property essential to self–support (see the SSI Spotlight on Property You Need for Self–Support); 

  • resources that a blind or disabled person needs for an approved plan for achieving self–support (PASS) (see the SSI Spotlight on Plans to Achieve Self–Support ); 

  • money saved in an Individual Development Account (IDA) (See the SSI Spotlight on Individual Development Accounts);

  • support and maintenance assistance and home energy assistance that we do not count as income;

  • cash received for medical or social services that we do not count as income is not a resource for 1 month;

    • EXCEPTION: Cash reimbursements of expenses already paid for by the person are evaluated under the regular income and resources rules. 

  • health flexible spending arrangements (FSAs);

  • State or local relocation assistance payments are not counted for 12 months;

  • crime victim's assistance is not counted for 9 months;

  • earned income tax credit payments are not counted for 9 months;

  • dedicated accounts for disabled or blind children; 

  • disaster relief assistance which we do not count as income;

  • cash received for the purpose of replacing an excluded resource (for example, a house) that is lost, damaged, or stolen is not counter for 9 months;

  • All Federal tax refunds and advanced tax credits received on or after January 1, 2010 are not counted for 12 months;

  • The first $2,000 of compensation received per calendar year for participating in certain clinical trials;
  • Some trusts (See the SSI Spotlight on Trusts).

So, they add up your income and resources, and if they are too much for the statute, then you are financially ineligible for the SSI program.  The next elements to meet are the 5 step sequential elements.  I will summarize those after we complete what the eligibility requirements are for SSDI.

Social security disability insurance benefits, or SSDI, are all about people who work over the table, pay taxes, and have worked recently enough to still be insured when they become severely disabled.  Ok so first thing, the earned quarters of coverage layout, then the, were they disabled while still insured analysis.  First, know what a quarter of coverage (QC) is, being a Title II Federal coin.  Like a quarter to a gumball machine that bestows a benefit upon you.  Candy.

So, as you work, you earn quarters of coverage, which become more expensive as time goes on…so for example, in 2017, a quarter of coverage is worth $1,300 of earned income that you pay taxes on.  So, if you shovel, mop, answer phones, take temperatures, whatever, and pay taxes on it, every $1,300 that you earn equates to 1 quarter of coverage.  You can earn up to 4 per year.  So, 4 QCs at $1,300 each equates to: $5,200 of earned and paid taxes on income.  Now, as you get older, you need more quarters of coverage.  A cute, yet limited chart will show you how many QCs you need as you age.

So, yes, if you are younger than thirty, they have a special 10 QC rule and such, but what you really need to get from this chart, is that as you age, the amount of QCs go up.

Ok so why the heck do I need these QC’s anyways.  So long as you have enough of them for your age, you are INSURED.  Well, why do I care about being insured?  If you are insured, it means, if you are found disabled during whenever you were insured, then you can go onto the higher paying disability program, known as SSDI.  So SSDI requires these QCs, and if you have enough during a certain age, like you had 24 quarters of coverage when you were 46, then you are officially insured.  This means you get to go on SSDI, which pays on average around $1,200, as opposed to SSI, which pays around $735 (2017).  Ok now we know the differences between the eligibility requirements for SSI and SSDI.  Cool, now we need to know their shared elements, aka their medical eligibility requirements.

So, what are the medical eligibility requirements, or put as we all call it, the 5-step sequential process elements, for

SSI and SSDI?  I’m glad you have no choice in asking:

  1. You must be earning under substantial gainful activity (SGA) per month (2017 $1,170).
  2. You must have a disability that has lasted 12 months, will last 12 months, or will be terminal.
  3. You must have medical equivalency to a pre-defined list of disabilities, or go through a residual functional capacity analysis.
  4. You must not be able to do the work you did within the past 15 years.
  5. You must not be able to do relevant transferrable skilled work, or unskilled work.

These are the major eligibility requirements for the social security disability programs, being SSI and SSDI.