Understanding Social Security Disability Programs
The United States Social Security Administration has four basic programs to assist people who have disabilities and cannot earn an income through employment. While these programs are similar, each is designed to assist a particular group and has different rules. If you are disabled and unable to work and earn enough money to support yourself, you may qualify for one of these programs. At Greeman Toomey PLLC, we want to help you understand the programs and the benefits you may be able to receive.
Social Security Disability Insurance Benefits (DIB)
This program is designed for adults who have worked and paid into the Social Security system through FICA taxes. Often referred to as SSDI or DIB, it provides benefits for workers who become disabled due to a physical or mental impairment. The disability must be severe enough to prevent you from earning a “substantial” amount of money through work, or it must be one that has prevented or will prevent you from earning for at least 12 months. By “substantial,” the Social Security Administration means that you may not earn over $1010 per month, or $1650 per month if you are blind, to receive benefits under this program. These amounts apply to 2012, and change each year, according to economic conditions.
To qualify for benefits under this program, you must have worked in the past and contributed to Social Security through FICA taxes or Self-Employment taxes. How long you must have worked, and how recently, depends on your current age. For most applicants over the age of 31, you must have worked and paid into the system for five of the past ten years.
In determining whether you qualify for benefits, the Social Security Administration will consider the severity of your disability, using a state agency to ask your physicians about your condition. It will also consider whether your disability is on the current listings of Adult Impairments and Child Impairments. In some cases, additional medical examinations will be scheduled, paid for by the SSA. It will consider whether you can continue in your current occupation or another occupation with your disability. If you are blind, there are other things they may consider. If it is determined that you are disabled, your benefits will begin six months after you became disabled, with retroactive payments made from that date.
If your application is denied by the Social Security administration, as happens in over 70% of cases, you have the right to appeal the decision. You also have the right to legal representation. Greeman Toomey PLLC practices only in the field of Social Security disability law. If your initial application has been denied, call us right away for a free consultation about your situation.
Supplemental Security Income
Commonly known as SSI, this program is different from the Disability Insurance Benefits (DIB) program and is also administered by the Social Security Administration. Unlike with DIB, you need not have worked and contributed FICA taxes to qualify. SSI is “needs-based” and is designed to provide benefits to individuals who have few or no income or assets.
The medical conditions qualifying for SSDI also apply to SSI. You must have a physical or mental disability that prevents you from earning “substantial” income, and that disability must exist or be expected to exist for at least 12 months.
There is no waiting period before receiving benefits under SSI, and payments are not made retroactively. You can only receive payments from the month you make your application or when the determination of disability is made, whichever is later. The SSI program also provides benefits for minor children with disabilities, but the restrictions on household income and assets apply in these cases as well.
As with SSDI, you have the right to appeal an unfavorable decision and the right to legal representation. Contact Greeman Toomey PLLC to discuss your situation and to arrange a free consultation if your application has been denied.
Benefits for Disabled Adult Children
This program is designed for disabled adults whose disability began before they reached the age of 22. The types of disability are the same as for SSDI and must prevent the adult from earning a “substantial” income. In addition, the adult child must have a parent who is either receiving SSDI benefits or retirement benefits or who is deceased and who qualified for SSDI benefits.
The adult child must also not have worked and earned “substantial” earnings for an extended period after reaching the age of 22. Benefit payments are based on the parent’s earning record, not that of the adult child.
In some cases, adults receiving SSI disability payments might qualify for this program, which may provide higher monthly benefits and result in entitlement to Medicare medical insurance. If your application is denied, you may appeal and have legal representation. Greeman Toomey PLLC will be happy to discuss your case in a free initial consultation.
Disabled Widow’s and Widower’s Benefits
If you are a disabled widow or widower over the age of 50 and your spouse or former spouse paid FICA taxes through employment or through the self-employment tax, you may qualify for benefits. These benefits are based on the spouse’s Social Security record, not on your own.
If you were married to your spouse when he or she died, there is no time period limitation. However, if you were divorced from a former spouse, the marriage must have lasted for at least 10 years, and your disability must have begun before you were 60 years old and within seven years of when the former spouse died. You will need proof of the marriage or a divorce decree from a former marriage.
The rules for the type of disability and inability to earn a “substantial” income are the same as with SSDI and SSI. You may apply for more than one program, but you will receive payment from only one – the one with the higher payment. If your application is not approved, you have the same rights of appeal and to legal representation. Greeman Toomey PLLC can assist in these cases. Call us to schedule a free consultation.
Medical Insurance Benefits
If you have been approved for disability benefits, you may become eligible for Medicare or Medicaid medical insurance benefits. The type of benefits you may receive depends, in part, on the program under which you receive disability benefits.
If you applied for and receive SSI benefits, you will probably qualify for your state’s Medicaid program. Requirements for eligibility Medicaid vary from state to state, but all require low incomes and few assets.
If you applied for and were approved for DIB, Disabled Adult Child benefits, or Disabled Widow’s/Widower’s benefits, you may be eligible for Medicare after you have been disabled for 25 months. The Social Security Administration will contact you two months before your Medicare coverage begins, and you may be reimbursed for some medical expenses that you incurred during that 25-month period.
Greeman Toomey PLLC – A Social Security Disability Law Firm
Obtaining disability benefits can be a difficult process. The Social Security Administration denies most initial applications. At Greeman Toomey PLLC, we focus on Social Security disability law and help our clients get the maximum benefits to which they are entitled. We have the expertise and experience that is essential to navigate the complex bureaucracy involved in the appeals process. If you have applied for any of these benefits but have had your application denied, call Greeman Toomey PLLC right away, since there is a limited time to appeal the decision. Let us schedule a free consultation with you to discuss your situation. If we handle your appeal, you will pay us nothing unless we succeed in obtaining benefits for you.
