Social Security Disability – a Basic Q & A

Q: Which agencies administer DI and SSI?

A: Both programs are administered by the Social Security Administration (SSA), which assesses the severity of a disability, determines eligibility, and issues monthly checks. Initial determinations are made by state agencies under contract with SSA. The cost of administering DI is financed from Social Security payroll tax revenues; the cost of administering SSI is financed by general revenues.

Q: How long do you have to be disabled before you can apply for Social Security disability benefits?

A: If you believe your disability will last a year or longer, apply for disability benefits as soon as you become disabled. It can take three to four months to process an application. If your application is approved, the Social Security Administration will pay your first Social Security disability benefits for the sixth full month after the date your disability began.

Q: What is the Social Security disability insurance (DI) program?

A: Social Security disability insurance (DI) pays monthly benefits to workers who are no longer able to work due to a severe illness or impairment that has lasted or is expected to result in death or to last at least 12 months. It is part of the Social Security program that pays benefits to the vast majority of elderly Americans. Benefits are based on the disabled worker’s past earnings and are paid to the disabled worker and his or her dependent family members. In order to qualify, a disabled worker must have worked in jobs covered by Social Security.

Q: What is Supplemental Security Income (SSI)?

A: Supplemental Security Income (SSI) is a means-tested federal program that pays monthly benefits to low-income aged, blind and disabled individuals. This means that to get SSI benefits, you can have only limited assets and income. For adults, it uses the same test of disability as the DI program. (For children, the standard is based on the ability to perform age-appropriate functions.)

Q: What are the rules for getting Supplemental Security Income (SSI)?

A: To be eligible to receive SSI benefits, you must be disabled, blind, or age 65 or older. You also must have limited income and resources. Income is defined as wages, Social Security benefits, and pensions. Income also includes food and shelter you receive from others. Social Security does not count all of your income when deciding whether you qualify for SSI. Resources include bank accounts, cash, stocks and bonds.

Q: What is the test of disability used for these programs?

A: The same test of disability for adults is used for DI and SSI. The law states:

The term “disability” means —
Inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months…

Q: Do disability beneficiaries receive health insurance?

A: DI beneficiaries receive Medicare benefits after a 25-month waiting period from the onset of their disability. It is the same Medicare benefit package as that of retirees age 65 and older. It pays for hospital care and doctor visits but does not cover out-patient prescription drugs or long-term care. Family members are not eligible for Medicare. Some beneficiaries may have employer-sponsored health insurance from their prior employment or through their spouse, or may purchase it privately. In most states, SSI disability recipients are automatically eligible for Medicaid benefits. Medicaid covers more health care services than Medicare, including prescription drugs and long-term care.

Hoffman, Larin & Agnetti PA accepts social security disability claims (SSDI and SSI). We offer a free consultation in person or over the phone. Fees are contingent, that is, we get paid only if we obtain benefits for you.

WARNING: You have only 60 days to appeal a denial of benefits; for information, call us without delay. We have offices in Broward County- Fort Lauderdale; Miami-Dade County- North Miami Beach; Monroe County- Key West and Islamorada. Call 305-653-5555.