SSDI 101: An Overview (Social Security Disability Insurance)
Social Security Disability Insurance (SSDI) is a Federal government program that provides a monthly income when you can't work or when you can only do a limited amount of work because of a physical or mental condition or a combination of the two. SSDI refers to not being able to work as "disabled."
In order to be "insured" for purposes of SSDI, you must:
- Be an eligible person (which includes certain family members of a worker)
- Have worked long enough and paid Social Security taxes (generally referred to as FICA taxes)
- Have a physical and/or mental condition which qualifies you as "disabled" as defined by the law.
The following do not matter when it comes to claiming SSDI:
- The amount of your other income and/or assets
- Whether your condition is work related
The determination about whether you are eligible for SSDI is made by the Social Security Administration (Social Security.) Social Security uses State agencies known as DDS Agencies to determine whether your physical and/or mental condition qualify as a "disability" within the meaning of the law.
Educated Consumers: Before you apply for SSDI, keep in mind that almost two thirds of applications for SSDI are turned down the first time. If you want a real chance at succeeding in qualifying for SSDI, it is advisable to understand how Social Security defines "disability," the process for approval of a claim, and time-tested guidelines. Following the guidelines empowers you, speeds the process, and improves your chances of receiving SSDI.
- Before filing an SSDI claim, it is advisable to prepare.
- It is also advisable to apply for SSDI in person. During the eligibility meeting, it is advisable to try to make a friend of the person or people with whom you interact, and to follow-up on the process.
- You must apply for SSDI within a specified period of time after becoming disabled. If your disability was the cause for stopping work, or if you stopped work within the past year, you don't have to worry about a filing deadline. Otherwise, a concept known as "Date Last Insured" comes into play.
If your application ("claim" in Social Security language) is denied, it is advisable to appeal. Success rates on appeal are high.
There are special rules for people who are legally blind.
It's worth the effort: Proving that you are entitled to receive disability payments may seem like a lot of work (there is a reason applying for SSDI has been called "an exercise in patience"). However, it's not that difficult if you start with an overview. An overview helps clarify what to expect at each step and how to maximize the results of your efforts. Then take one step at a time.
When you think of the money you may receive, as well as the possibility of receiving Medicare, the amount of effort is worth it. If the process begins to seem like too much, ask a friend or family member to help, see is help is available through your health care provider or a non-profit organization concerned with your condition, or consider hiring a professional.
- Benefit amount is based on your past earnings.
- Benefit payments do not start until the end of a five month waiting period. If you don't apply for benefits as soon as you stop working, SSDI will give you a lump sum payment for the period that starts the date you stop working (less the five month waiting period) to a maximum of 12 months.
- Benefits are payable as long as your disability continues.
- If you receive SSDI benefits for twenty-four (24) months, you automatically qualify for Medicare - no matter what your age.
- There are incentives built into SSDI to encourage a return to work, including a nine month trial work period and easy re-entry to SSDI if the return to work is not successful.
While receiving SSDI benefits, you may be subjected to what is referred to a Continuing Disability Review.
- To maximize chances of a favorable result from the review, it is advisable to follow the prescribed medical protocol and keep track of how your condition affects your life. It is also advisable to get your doctor(s) on board, and to have noted in your medical record how your ongoing mental and/or physical situation impacts your life.
- During the review you may be requested to take a Consultative Examination. If so, you have the right to have the exam done by your own doctor. You also have a say about when and where to meet with an investigator.
Our information provides details about SSDI, starting with thinking about applying while still working, through the application and determination process, to returning to work - including practical information and tips. Your experience dealing with SSDI may be different from what we describe. As much as Social Security tries to standardize the process, procedures vary at different offices. In order to avoid being overwhelmed, we suggest that you only read what you need as you need it.
- Before filing a claim.
- Take the steps most likely to lead to approval of your claim when you file.
- Understand the process used when deciding whether to approve your claim, and how to follow-up.
- When you receive a Notice of Approval or a Notice of Disapproal, we suggest reading:
- Our article: Notice of Approval/Disapproval. It will give you an overview about Continuing Disability Reviews, Medicare, and the possibility of returning to work.
- If your claim is approved:
- It is important to understand what happens after approval, including guidelines to follow to help assure you continue to keep this income as long as possible. For instance, you may be subjected to a Continuing Disability Review (Our article includes what to do to prepare for a review and how to handle one.)
- It helps to understand what happens when you return to work
- If your claim is disapproved, it is advisable to appeal. For tips, see: Appeals
If you desire to see a list of all the SSDI subjects we cover, please see: SSDI Table Of Contents.