What Are Disability Benefits?

The Social Security Administration pays disability benefits through two programs. The programs are called Social Security disability insurance (also known as SSDI), and Supplemental Security Income (also known as SSI). SSDI is available to people who are found medically disabled and who have worked and paid into the system. SSI is available to people who are found medically disabled, do not have enough quarters paid into the system, and are financially eligible for benefits.

Can I Receive Disability Benefits?

If you cannot work due to a medical condition that is expected to last at least 12 months or result in death, you may be able to obtain Social Security disability benefits. Social Security defines disability as not being able to work at any job. Social Security does not pay disability benefits for partial disability or short-term disability.

What Else Do I Have To Do To Be Eligible For Benefits?

You must have worked, had payroll taxes (FICA) taken out of your paycheck, and paid into the Social Security system. Based on your age at the time you became disabled, you would have had to pay into the system for a certain amount of time (also referred to as "quarters"). A quarter is equal to three calendar months, e.g., January 1 through March 31.

When Should I Apply and What Information Do I Need?

As soon as you become disabled you should apply for Social Security disability benefits. The Social Security Administration will take approximately 90 - 150 days to review your initial application. You will need to complete an application for Social Security disability benefits and you will complete a Disability Report. The Social Security Administration will need the following:

  • Your Social Security number;
  • Your birth certificate;
  • Names, addresses and phone number of the doctors, any other medical providers, hospitals, and clinics that have provided you care, and the approximate dates of your visits;
  • Names and dosages of all your medications;
  • Copies of any medical records from your doctors, therapists, hospitals, clinics and caseworkers that you already have (do not go out and purchase these records if you do not already have them) in your possession;
  • List of where you worked, the kind of work you did, and the dates you worked at these places; and
  • A copy of your most recent W-2 Form (Wage and Tax Statement), or if you are self-employed, your federal tax return for the past year.

You will also have to complete forms about your medical condition and its effect on your ability to work. You will have to sign medical authorizations which will give your doctors and any hospitals and clinics where you have been treated, permission to send medical information to the Social Security Administration.

What Happens After I File My Application?

The Social Security Administration reviews your application and determines whether or not you have worked enough years to obtain Social Security disability benefits. If you have worked enough years and paid into the system the Social Security Administration will send your application to the Disability Determination Service (also known as DDS).

The Disability Determination Service is a state agency which has doctors and disability specialists who review information from your doctors. DDS considers the facts of your case along with the medical reports from your doctors, hospitals and clinics. If the DDS cannot make a decision with the available information, DDS may schedule you for a consultative exam with a doctor. DDS will pay for the exam. You may have your own doctor perform the examination. However, DDS will not necessarily pay as much as your regular doctor charges.

How Does the Social Security Administration Decide Whether I Am Disabled?

The Social Security Administration has a five-step process to decide if you are disabled.

Step One - Are You Working?

If you are working and your average pay is equal to, or more than what the Social Security Administration considers wages which indicate you are engaged in substantial gainful activity, you will usually not be considered disabled. Each year the amount allowed changes. If you are not working or what you make while working is less the amount considered to indicate that you are engaged in substantial gainful activity, DDS will evaluate your medical condition.

Step Two - Is your medical condition "severe?"

DDS will decide that you are disabled if your medical condition significantly limits your ability to walk, sit, and remember for at least one year. If your medical condition is not that severe, then DDS will decide that you are not disabled. If your medical condition is considered severe, then DDS will move to the next step.

Step Three - Is your medical condition on the Disability Determination Service's List of Impairments?

DDS has a list of impairments which includes medical conditions that are considered so severe that you if you have one of them you will automatically be considered disabled. If your condition is not on the DDS list then DDS will decide if your condition is severe as, or equals the severity of the conditions on the list. If the severity of your condition equals the severity of one of the conditions on the DDS list, then DDS will decide that you are disabled. If not, DDS will move onto the next step.

Step Four - Can you do your past work?

DDS will decide if your medical condition keeps you from being able to do your past work. If DDS decides that your condition does not keep you from doing your past work, DDS will decide that you are not disabled. If DDS decides that your condition prevents you from being able to do your past work, DDS will go on to the next step.

Step Five - Are you able to do any other type of work?

At this step DDS considers your medical condition, age, education and past work experience, as well as any skills you have which could be used in other work. If DDS decides that you cannot do any other type of work, DDS will decide that you are disabled. However, if you are found to be able to do other work, DDS will decide that you are not disabled.

How Will I Know Whether I Have Been Denied Benefits?

If DDS decides that you are disabled, the Social Security Administration will send you a letter stating that you have been found medically eligible to receive disability benefits. You will also get a letter called Notice of Award. This letter will explain the amount of money you will receive and when you will receive it. If DDS does not find that you are medically eligible for benefits, you will receive a denial letter which will tell you how to appeal the decision.

What Should You Do If I Am Denied Benefits?

If you disagree with the decision made by DDS you may appeal the decision. You may also have an attorney represent you. The attorney may appeal the decision for you.

When Will I Receive Benefits If My Application Is Approved? If you are awarded benefits, the Social Security Administration will pay you sixth month after the date you were found disabled. For example, if DDS decides that your disability started on March 15, your first disability check will be for the month of September. Social Security disability benefits are paid the month after the month they are due. You would therefore receive your September check in October.

How Much Money Will I Receive?

Your Social Security disability benefits are based on what you have earned, or your wages, for your lifetime. Each year you should be receiving a statement from the Social Security Administration that lists your earnings for your life. The statement also gives you an estimate of how much money you will receive if you become disabled, as well as an estimate of the amount of retirement and survivor benefits that you or your family may receive. If you do not have the statement and want an estimate of how much money you will receive, you may contact the Social Security Administration at 1-800-772-1213, or online at www.socialsecurity.gov .

Who In My Family May Receive Benefits?

If you have worked, there are members of your family who may qualify for benefits, such as:

  • Your spouse, if she or he is 62 or older;
  • Your spouse, at any age if she or he is taking care of your child who is younger than 16, or who is disabled;
  • Your unmarried child, including an adopted child, and in some cases, a stepchild or grandchild. The child must be less than 18 or under age 19 if in elementary or secondary school full time; and
  • Your unmarried child, age 18 or older, if she or he has a disability that started before age 22.
May I Collect Social Security Disability Benefits After I Begin Collecting My Social Security Retirement Benefits?

It depends. If you are collecting your full Social Security retirement benefit, you are receiving all the money for which you are eligible and you cannot receive additional money from Social Security even if you become disabled.

You can begin receiving Social Security retirement benefits at age 62. However, you will receive a reduced (full retirement minus about 30%), amount.

If you started collecting Social Security retirement benefits prior to your full retirement age, and are therefore receiving a reduced retirement benefit, you could collect additional money (disability benefits), from Social Security. The total amount you would receive each month would be a bit more than your reduced Social Security retirement benefit check, that is, in total you would not receive more per month than your full retirement benefit amount.

You can collect your full retirement (unreduced) benefit when you reach full retirement age.

If you were born before 1937, your full retirement age is 65.

If you were born between 1943 and 1954, you must be 66 to collect full retirement.

If you were born in 1960 or later, your full retirement is 67.

If you want to know how much you could collect for either Social Security disability, or Social Security retirement benefits, call (800) 772-1213.

Can My Divorced Spouse Receive Benefits On My Account?

A divorced spouse may, in some situations, qualify for benefits based on your earnings if you two were married for at least 10 years, and your divorced spouse remains unmarried and is at least 62.

If My Divorced Spouse Receives Benefits On My Account, Will It Reduce My Benefits?

Your benefits and those paid to your current spouse or children will not be reduced if your divorced spouse is paid benefits based on your account.

Can I Receive Benefits If I Have Been Arrested?

During the months in which there is an outstanding arrest warrant for a crime that is a felony (or crime punishable by imprisonment for more than one year or by death), you cannot receive disability benefits.

Can I Receive Benefits If I Am Convicted of a Crime?

Generally benefits are not paid for any months you are incarcerated for a crime. Family members who are eligible for benefits based on your record may continue to receive benefits. This applies even if you have been found not guilty by reason of insanity or mental disease, mental defect or mental incompetence, as well as if you have been found to be incompetent to stand trial.

If I Violate Probation Can I Receive Benefits?

If in any given month you violate a condition of your probation or parole, you cannot receive disability benefits.

When Will I Receive Medicare?

Twenty four months after you have been receiving Social Security disability benefits, you will receive Medicare coverage.

What Happens If I Want To Work While I Receive Social Security Disability Benefits?

If you want to try working again you may be able to keep getting your disability benefits and Medicare and have a test period to see if you are able to work. There are, however, certain rules which must be followed.