Denied Social Security Disability Claim Form

With similar names but different meanings, people who are unfamiliar with these two terms can become confused. While there are circumstances where someone can collect both of these at the same time, it is important to know what the criteria is for each before investing the time to fill out claims and wait for responses.

What Is SSD?

Social Security Disability (SSD) is a federal program that opens up to people who cannot work due to a disability. Eligibility is determinate upon proof of a disability and meeting a work credit requirement through employment history. Benefits begin on the 6th full month of the person’s disability. This 6-month period starts with the 1st full month after the Social Security Administration (SSA) determines when the person’s disability began. As of data from 2017, the average monthly benefit of SSD is $1,171, with a maximum of $2,687, based on work history.

SSD recipients automatically qualify for Medicare after a 24-month waiting period from when benefits begin. An exception to this rule is for people with ALS, for which there is no waiting period. The time period to wait for a response to your application varies and can take an average of 30 – 90 days. It is not uncommon for this process to take longer (sometimes years). However, there is a fast track program called the Social Security’s Compensate Allowance (CAL) program for people who have the most severe of conditions. This process could take as little as ten (10) days to process.

How Are Work Credits Earned & How Are They Calculated for SSD?

As of 2019, every $1,360 earned through employment will equal one (1) work credit. A person is only able to earn four (4) work credits per year. The number of work credits needed to qualify for SSD is determined by age and when the person became disabled. Listed below is a breakdown of work credit calculations based upon age and years worked:

  • Before Age 24 – Six (6) work credits in a 3-year period ending when disability starts.

  • Age 24-31 – Credit working half the time between age 21 and the date of disability. An example of this would be if the person was disabled at age 27, they would need three (3) years earning the maximum amount of work credit (12 work credits) out of the past six (6) years (because there is a six (6) year difference between 21 and 27).

  • Age 31-42 – 20 work credits.

  • Age 43-61 – Add one (1) credit to 20 for every year over 42. An example of this would be 21 work credits at age 43 and 22 work credits at age 44.

  • Age 62+ – 40 work credits.
Social Security Card

How Does The SSA Determine Disabled Status?

Below is a checklist by the SSA that helps people see if they will be accepted or denied when they file for SSD:

  • Are You Working? – If a person is working and making more than $1,220 a month, the SSA does not determine them to be disabled and the claim gets denied.

  • Is The Condition “Severe”? – The SSA looks to see if the disability significantly limits the person’s ability to do basic work tasks such as lifting, sitting, standing, remember and walking – for at least 12 months.

  • Is The Condition Found On The SSA’s List of Disabilities? – Available to the public is a list of disabilities recognized by the SSA. If the person’s disability is not listed, the SSA will decide if the person’s disability is as severe as the conditions listed.

  • Can You Still Do What You Did For Work? – Typically, if you can answer “yes” to this question, the SSA will decide you do not qualify for SSD.

  • Are There Other Types of Work You Can Do? – Taken into consideration for this question would be the person’s age, education, past work experience and any transferrable skills.

What Is SSI?

Social Security Insurance (SSI) is a federal program that provides minimum basic financial assistance to individuals who reach a certain age, or have a disability, and have limited resources. Eligibility is determinate upon reaching the age requirement (65+) or proof of being blind/having a disability, which has no age requirements and have limited or no income resources.

Benefits begin the 1st full month the claim was filed or, if later, when the person became eligible for SSI. As of data from 2017, the average monthly benefit of SSI is $542, with a maximum of $735/$1,103 (single/married couple), based on income. SSDI recipients automatically qualify for Medicaid upon receipt of SSI. It can take up to 6 weeks before hearing back about your application.

What Is The Difference Between SSD & SSI?

  • Eligibility Determination – SSD determinations are based on disability and work credits accumulated. SSI looks at age/disability as well as how limited the person’s resources are.

  • When Benefits Begin – SSD goes into effect after six (6) months of the disability. SSI opens up after just one (1) month of the filing date.

  • Average Monthly Benefits – Based on figures from 2017, the average SSD monthly benefits are $1,171, while SSI is $542.

  • Maximum Monthly Benefits – Based on figures from 2017, the maximum SSD monthly benefits cap at $2,687, while SSI caps at $735/$1,103 (single/married couple).

  • Health Insurance – A person automatically qualifies for Medicare after a 24-month waiting period from the time SSD begins. A person automatically qualifies for Medicaid upon receipt of SSI.
Social Security Disability and Social Security Insurance Lawyer

Contact An Experienced SSD/SSI Lawyer Today!

We work with knowledgeable Rhode Island Social Security Disability lawyers who have years of experience handling SSD and SSI claims for individuals who have been recently denied. They charge no fee unless you prevail in your claim and receive past-due benefits. Call us today toll-free 24/7 at 1-800-992-6878 or fill out an online contact form for a free (no obligation) case evaluation.

Sources:

  1. ssa.gov/planners/disability/qualify.html
  2. disability-benefits-help.org/disabling-conditions
  3. ssa.gov/planners/credits.html
  4. ncoa.org/blog/ssi-vs-ssdi-what-are-these-benefits-how-they-differ/
Author Photo

Paul d’Oliveira

Attorney Paul d’Oliveira has been practicing personal injury and disability law for over 30 years. He started his personal injury law practice in 1989 with two offices in Fall River, MA and East Providence, RI. Today his firm has 15 offices in RI and Southeastern, MA.

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