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Social Security Disability Benefit Overview

Reviewed October 2016
Author: Paula L. Thomas , RN
Care Manager
Rehabilitation Institute of Chicago
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Author: Lynn Danford , MS, LD
Education Program Manager
Rehabilitation Institute of Chicago LIFE Center
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When people think of Social Security (SS), they usually think of retirement benefits which are collected at age 65 or 67. While this is true, social security benefits are also available to individuals who are under the age of 65 and have become disabled. The information below provides an overview of the Social Security Disability benefit (SSDI) program, including the application process and information on who is eligible to receive benefits.

Social Security Disability Benefits (SSDI)
The SSDI benefit program is considered an Entitlement program. This means that if you qualify under the definition of “Disability” and have paid into the social security system through payroll deductions, you are entitled to receive these benefits. Most individuals who work do have social security contributions automatically deducted from each paycheck. There can be exceptions, and it is always wise to check pay stubs or speak with your employer to verify participation.

Eligibility
Social Security pays benefits to people who cannot work because they have a medical condition that is expected to last at least one year. The SS Administration also requires that two different earnings tests be met: a “recent work test” based on age at the time of disability; and a “duration of work” test based on amount of time spent working under social security. You may request an estimate of your disability benefits (as well as Retirement/Survivor Benefits) by contacting your local SS office and requesting your SS statement. You may also access this information through the SS web site (address listed below). You may not qualify for benefits if you have not paid into the SS system or have had a limited work history during the last 10 years.

Certain members of your family may also qualify for benefits if you become disabled:
• Spouse, if age 62 or older;
• Spouse of any age if he/she is caring for your child who is under the age of 16 or disabled and also receiving SS benefits;
• Unmarried child, including an adopted child, or in some cases a stepchild or grandchild, if under age 18 or under age of 19 if in school full time;
• Unmarried child, age 18 or older, if he or she has a disability that started before age 22.

Application Process
You can apply for benefits online (see link below), by phone or by making an appointment at a local SS office.

The following information is needed to file an application:
• Social security number;
• Birth or baptismal certificate;
• Names, addresses and phone numbers of doctors, caseworkers, and medical facilities and dates of visits;
• Information on all medications;
• Medical records;
• Laboratory and test results;
• Summary of work history;
• Copy of most recent W–2 Form or, if self–employed, federal tax return for past year.

Medicare Benefits
Medicare coverage is available automatically after receiving disability benefits for two years.

Appeal Process
If an application for Disability Benefits is denied, you have the right to appeal the decision. The appeal request must be made in writing within 60 days from the date of receiving the letter from SS. Contact the local SS office for more information on filing an appeal.

SS Disability Benefits and Workers Compensation (WC) Benefits
You may collect both SS Disability Benefits and Workers Compensation Benefits at the same time. There may, however, be an “offset” which could reduce the amount of SS. In some states, the “offset” works in the other direction where the WC benefits are reduced and the SS benefits remain the same. Check with your local SS office to determine how it would work in your particular situation.

Termination of Disability Benefits
Many people worry that SS Disability Benefits could be terminated. This usually happens for two reasons. The first would be if an individual were able to return to work and had an income that is determined “substantial, ” usually average earnings of $900 per month or more. The actual amount allowed may fluctuate based on work expenses or changes in the SS guidelines.

The other reason that benefits could be discontinued would be that the SS Administration determined that a person's medical condition has improved and he/she is no longer disabled. If your benefits are terminated and you feel that you are still disabled and should continue to receive Disability Benefits, you have the right to appeal this decision – see above for more information on the Appeal Process.

For more information, there are many different pamphlets. Spanish versions are also available. See link below.
Location Information
 
Company: Social Security Administration
Address: Office of Public Inquiries
1100 West Highrise 6401 Security Blvd.
Baltimore, MD 21235
 
 
Email: webmaster@ssa.gov
Tollfree: 800.772.1213
TTY: 800.325.0778
Web: http://www.ssa.gov
 

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