Understanding SSDI and SSI

If you are disabled, you may qualify for Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), or both. The program for which you qualify depends on a number of factors and this publication will try to help you understand the basic similarities and differences.

Under both SSDI and SSI, an applicant must be considered disabled, or blind, for twelve consecutive months or longer, or likely to be so disabled if you apply before twelve months have passed. In other words, you do not need to wait and see if your disability has lasted twelve months. You may apply anytime and you and your doctor know best if your disability is likely to persist for at least twelve months.

Once you make the decision to apply, it is helpful to know more about these programs.

Under SSDI, in order to qualify, you must show that you are disabled or likely to be disabled but you must also have sufficient work credits to qualify. The older you are, the more work credits are required before you can qualify for SSDI. If you are 31 or older, you need to have earned 20 credits in the 10 years immediately prior to your disability. If you are between 24 and 31, you need 16 credits earned during the last eight years. If you are under 24, you must have earned 6 credits in the last three years. The Social Security Administration will calculate the work credits you have earned. Check with them to find out if you have earned sufficient work credits to be eligible for SSDI. It may also be possible to rely upon the work credits of your spouse or parents, depending upon your situation.

Under SSI, the work credits are not applied as a test of eligibility. Instead, you must have limited income and resources.

Under SSDI, if benefits are granted, you will also become eligible for Medicare after you have received disability benefits for two years. This consists of hospital insurance (Part A), supplementary medical insurance (Part B), Medicare Advantage (Part C), and voluntary prescription drug benefits (Part D). Under SSI, you will qualify for Medicaid, which is jointly funded between both the State and the Federal government.

The amount of your SSDI benefit is based upon what the SSA calls you “average current earnings” or ACE. There are three approaches that SSA takes. The first is called the “High-1” ACE. The second is called the “High-5” ACE. The third is called the “Average Monthly Wage”. Fortunately, you do not need to perform this calculation. Just understand that this is based upon your earnings history and let the SSA do the calculation for you. Under SSI, your benefits depend on what is called the “Federal Benefit Rate” or FBR. The amount varies from year to year but in 2015, that amount was $733 for an individual, $1,100 for a qualified couple. SSA will subtract any “countable income” from the FBR and then add your state supplement, if any. No all income is included in the deduction, only “countable income”. Typically, the FBR changes each year and with that change, so will your benefit change.

Finally, understand that for SSDI, there is no State supplemental benefit. However, for SSI recipients, many States offer a supplemental benefit. Check with SSA or DSHS to see if your state offers such a supplemental benefit.

The most important thing is to submit your application as soon as you find you cannot work due to a disability that is likely to persist for at least twelve consecutive months. If you don’t know for which program you should apply, consider the information in this blog post and ask someone at the SSA. If you are still undecided, you won’t be penalized if you apply for both programs, so I encourage you to do so. Let SSA make the determination if you do not qualify due to a lack of sufficient work credits or because you have excess income or excess resources. And remember, if your application is declined, file a Request for Reconsideration and if rejected a second time, seek the advice of an attorney experienced in Social Security claims for the disabled.