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Understanding the Similarities and Differences Between SSDI and SSI

You may have heard of disability benefits, though you may have questions regarding the regulatory maze that disabled individuals must work through to obtain them. A major area of confusion is the distinction between Social Security Disability Insurance (SSDI) and Supplementary Security Income (SSI). Both programs are administered through the Social Security Administration and have different criteria and requirements. This blog is meant to help demystify these two important federal programs and help you understand whether you or a loved one qualify.

Image Source (CC BY 2.0) by Aric Riley via flickr

Image Source (CC BY 2.0) by Aric Riley via flickr

Similar Medical Criteria for SSDI and SSI

SSDI and SSI are similar in the area of medical eligibility. For both programs, there must be some evidence of a disability. Additionally, the disability must be diagnosed by a licensed medical treatment professional, must have lasted or be expected to last at least one year, and must be defined by the Social Security Administration as being disabling.

To keep it simple, if you are considered disabled under the SSDI program, there is a very good chance you will be deemed medically eligible for SSI benefits.

Financial Eligibility

The biggest distinction between the two programs is the financial requirements to obtain SSI benefits. Generally, SSI is meant to be accessed by senior citizens 65 or older, the disabled, or the blind whose income is below the federal benefit limit. SSI is provided for the disabled when they do not qualify for SSDI, or the amount of benefits they receive through SSDI and any other income they might have is not enough to place them above the government’s financial standard.

Source of Benefits

Another key distinction is where the benefits come from. SSDI funds are taken from pooled contributions you make throughout your working life. Basically, you pay into the SSDI program through taxes. You essentially insure yourself to protect you in case of a disability. This is why the Social Security Administration requires SSDI applicants to have worked a minimum period of time prior to qualifying for benefits. Conversely, SSI benefits are funded by general tax revenues and do not require you to have worked for a specific period of time to qualify.

Can I Apply for Both SSDI and SSI Benefits?

It is possible to be eligible and apply for both SSDI and SSI. To obtain benefits through both programs, you must suffer from a medical condition listed as disabling by the Social Security Administration under both programs. That is key to ensure you qualify for SSDI benefits since those who can work generally would not qualify for SSDI.

To obtain SSI benefits, your monthly income must be below the SSI federal benefit rate. In 2015, that rate was $733 per month. In addition, to obtain SSI benefits, you must have total assets worth less than $2,000 if you are single,or $3,000 if you are married.

If you meet the criteria set forth above, there is a good chance you can get benefits through both SSDI and SSI.

Speak to an Experienced Social Security Disability Lawyer Today

As you can see, social security law is complex and requires a level of understanding to navigate the federal benefit system. At Hoffman, Larin & Agnetti, we are here to help you and your loved ones. We offer free, confidential consultations so that you can understand your rights under both federal programs. There are no fees for representation before the Social Security Administration in disability claims unless we win your case.

Supreme Court Doma Decision and Social Security Benefits

The United States Supreme Court, in United States v. Windsor, struck down Section 3 of the Defense of Marriage Act (DOMA), which defined marriage for federal purposes as the union between a man and a woman, finding that it violates equal protection and federalism principles.

There are currently an estimated 114,000 legally married same-sex couples in the U.S.  Another roughly 535,000 same-sex couples now live in shared households.

Extending Social Security benefits to same-sex couples is a major consequence of the U.S. Supreme Court decision. There are more than 1,000 benefits now enjoyed by heterosexual married couples and their children; the decision may result in these benefits becoming available to same-sex claimants. [Read more…]

Fibromyalgia & Social Security Disability

Convincing the Social Security Administration (SSA) that you are disabled because of Fibromyalgia is a challenge for you and your attorney.

Fibromyalgia is a rheumatic disease that can produce muscle and joint pain, stiffness and fatigue and a pattern of sleep disturbance. If the symptoms are sufficiently severe, it can be disabling. For a general overview of Social Security Disability, please see the main article in Legal Information under “Social Security’.

While fibromyalgia is often quite painful, the diagnosis of fibromyalgia alone does not necessarily mean that the SSA will find that you are disabled under Social Security definitions. The SSA or an Administrative Law Judge at a hearing must make a determination as to the severity of your symptoms and limitations. Your statements about pain or other symptoms will not alone establish disability. There must be medical evidence that reasonably would be expected to produce the pain or other symptoms that you are complaining of.

If not diagnosed through objective testing, such as X-rays or blood tests; the diagnosis of fibromyalgia is made entirely on the basis of your reports of pain and other symptoms. Physical examinations of claimants who suffer from fibromyalgia usually yield normal results, such as full range of motion, no joint swelling, and normal muscle strength and neurological reactions.

More specifically, there are 18 fixed points on the body that when pressed firmly cause the patient to flinch. The general rule is that a patient must have tenderness at 11 of these 18 locations in order to be diagnosed with fibromyalgia. The American College of Rheumatology guidelines for diagnosing fibromyalgia include primarily widespread pain in at least 11 of the 18 specified tender points on the body. This method of diagnosis has been accepted by the SSA. The lack of objective testing to prove the diagnosis of Fibromyalgia and the difficulty in objectively determining the severity of the pain and other symptoms are the reasons that winning a fibromyalgia case can be difficult. Nevertheless, if presented properly and with supporting medical records, these cases can be won and social security awarded.

Social Security law is complex; at Hoffman, Larin and Agnetti, PA we offer a free consultation so that you can learn your rights. There are no fees for representation before the Social Security Administration in disability claims, unless we win. We have offices throughout south Florida,  in Dade, Broward and Monroe Counties for your convenience.


 

Social Security, Childhood Disability and HIV

The childhood disability rules apply to children from birth to age 18, although under certain circumstances, it can apply up to age 21. In any event, the onset of a disabling impairment must precede a child’s 22nd birthday.

In order to obtain Social Security benefits for a child, you must be able to show a physical or mental impairment which results in ‘marked and severe functional limitations and which can be expected to result in death or which has lasted or is expected to last a continuous period of not less than 12 months.

For children from birth to 3 years old, a child has a ‘marked impairment’ if he/she is functioning at more than one-half but not more than two-thirds of the child’s chronological age; or, for a child age 3 to 18, a limitation which is more than moderate but less than extreme. Marked limitation may exist when several activities or functions are limited and interfere seriously with the child’s functioning

The Social Security Administration (SSA) has interpreted this standard to require that in order for a child to be eligible for SSI, the child must establish that he or she meets, or medically or functionally equals, a ‘Listing’. SSA has published a Listing of Impairments (conditions) for 14 body systems and the required medical proof to show that a listing is met.  If a child meets or functionally equals a listing, this will be considered as conclusive proof of disability.

HIV infection (AIDS) is a listed impairment for both adults and children. The HIV listings, one for children and one for adults, are part of the new Immune System Listing, section 14.00. The final regulations also contain provisions regarding the particular conditions of women with HIV infections. Important factors to be considered in evaluating the functioning of children with HIV infection include, but are not limited to, symptoms, frequency and duration of manifestations of disorder, periods of exacerbation and remission, and the functional impact of treatment, including the side effects of medication. If the child’s impairment does not meet the criteria of this HIV, consideration must be given as to whether the child has an impairment that satisfies the criteria of a listing in another body system. For example, a child with HIV infection may show signs and symptoms of a mental impairment or of another physical impairment.

A continuing disability review is required for all childhood disability recipients once every three years if their impairment is likely to improve.

For additional information regarding Social Security Disability or Medicaid, please follow this link.

Social Security law is complex; at Hoffman, Larin and Agnetti, PA we offer a free consultation so that you can learn your rights. There are no fees for representation before the Social Security Administration in disability claims, unless we win. We have offices throughout south Florida in Dade, Broward and Monroe Counties for your convenience.