It’s estimated that 1 in 4 of today's 20-year-olds will become disabled before they retire. Although it’s not something anyone wants to consider, planning for a disabling condition is just as important as planning for a premature death. And while many workers may be able to purchase long-term disability benefits from their employers, a number of individuals will have to depend on long-term disability benefits offered by the federal government. With that in mind, let’s review the two main governmental disability programs.
Benefits Offered by the SSA
The Social Security Administration (SSA) administers two different disability programs: Social Security Disability Insurance and Supplemental Security Income. Although the names sound similar, each program has different requirements. Prior to applying for either program, it’s important to understand the requirements of each and what you will need to do to qualify for benefits.
What is Social Security Disability Insurance?
Social Security Disability Insurance (SSDI) is a wage replacement program that offers monthly cash benefits to disabled workers. In some cases, benefits are also paid to qualifying family members. The SSA currently provides more than 11 million workers and their qualifying families with benefits. Although the benefits paid varies by worker, the current average monthly payment is a little more than $1,100 per month.
Qualifying for SSDI Benefits
Not all disabled workers qualify for SSDI benefits. In fact, to qualify for SSDI, workers must meet very specific criteria. First, workers must have worked and paid employment taxes (FICA taxes) and earned work credits to be insured for benefits. For example, a worker who becomes disabled at 24 years of age must have worked and earned six work credits to be considered insured for SSDI benefits. Workers over the age of 31 will need to have earned 20 work credits within the past 10 years before the worker became disabled. Those over the age of 62 years of age will need 40 credits to qualify.
In 2017, workers must earn $1,300 to earn on work credit. A maximum of four work credits can be earned each year. Workers who do not have enough work credits for SSDI will not qualify for benefits. In fact, the SSA will deny their claim without reviewing the severity of their condition. Furthermore, work credits must be earned on a claimant’s own work record and cannot be bought or borrowed.
How does the SSA determine if a worker is disabled?
If a worker meets the nonmedical requirements for SSDI benefits and has sufficient work credits, their SSDI application will be forward to the Disability Determination Services office (or equivalent office in their state), and a disability examiner will review their disability claim.
Specifically, the disability examiner will determine if the claimant’s condition meets the statutory definition of disability. In other words, the applicant “must not be able to engage in any substantial gainful activity because of a medically-determinable physical or mental impairment(s) that is expected to result in death, or that has lasted or is expected to last for a continuous period of at least 12 months.”
To make this disability determination, the SSA will review whether the claimant is able to perform substantial gainful activity, which the SSA currently defines as earning $1,170 per month ($1,950 for blind individuals).
Next, the SSA will determine whether the claimant’s condition is severe. To make this determination, the SSA will review the claimant’s medical records and determine whether the condition is as severe as a condition listed on the SSA Listing of Impairments (also referred to as the “Blue Book”). This listing is a comprehensive list of conditions and symptoms that the SSA considers automatically disabling. If the claimant’s condition is listed or is as serious as a listed condition, the claimant will be considered automatically disabled.
If the claimant’s condition does not “meet or equal a listing,” the SSA will determine if they have the residual functional capacity to work their current job or retrain for work. If not, the claimant is considered disabled.
What are Supplemental Security Income benefits?
Supplemental Security Income (SSI) is the second wage replacement program administered by the SSA. It is provided to the aged (65 years or older), blind or disabled who are unable to work for at least 12 continuous months. Unlike SSDI benefits, which are only offered to insured workers, individuals may qualify for SSI benefits even if they have not worked, paid employment taxes, or earned work credits.
SSI applicants, however, must prove that they have limited income and resources to qualify for benefits. Specifically, claimants who earn too much income from work, from friends or family—or from other sources such as workers’ compensation, unemployment or the Department of Veterans Affairs—will not qualify for SSI.
In addition, individuals with too many resources (i.e., cash, land, vehicles, bank accounts, stocks, life insurance or personal property) will also not qualify for SSI. Currently the SSI resource limit is $2,000 for an individual and $3,000 per couple, but certain resources are excluded from the resource calculation.
How much is the monthly SSI limit?
SSI benefit payments are generally lower than SSDI monthly benefits. In fact, the SSI payment is based on the federal benefit rate, which is currently $735 per month for individuals and $1,103 for couples.