Disabled individuals in the United States may be entitled to receive financial assistance in the form of disability benefits from the Social Security Administration (SSA). There are two main programs which administer this financial support: Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). The eligibility criteria for these two programs varies substantially, so it’s important to know what is necessary in order to understand which program to apply to.
The SSDI program is intended to provide financial assistance to workers who have become injured and cannot continue to support themselves. The amount of benefits to which those who are qualified to receive SSDI benefits are entitled is directly related to their earnings before the injury. Therefore, the state you work in can play a substantial role in the amount of benefits you can receive – an individual who works in South Carolina is likely to receive less than one who worked in New York.
Qualifying for SSDI Benefits
In order to be eligible to receive SSDI benefits, an applicant must meet the following criteria:
- Have a disabling condition
- Have worked a minimum amount of time
- Have worked in a job covered under the SSDI program
If these conditions are met, the individual is generally able to receive SSDI benefits, which can play a substantial role in helping to allay some of the worst costs and consequences of developing a serious disability. Additionally, there are certain circumstances in which the individual may be able to continue to receive SSDI benefits even if they do return to work.
A disabling condition can make it impossible for an individual to work and support themselves. Fortunately, those who struggle with this type of situation are typically entitled to receive financial assistance in the form of Social Security disability benefits. However, in order to receive these benefits, it is first necessary that an applicant’s disability be recognized by the Social Security Administration (SSA).
The SSA uses a straightforward process in determining whether or not an individual should be considered disabled. The following is a brief explanation of the various steps that are taken in determining whether or not an applicant is qualified as disabled:
- The applicant’s benefit claim is filed with their local Social Security office.
- After determining whether or not the individual is eligible for benefits in non-medical respects, the application is forwarded to Disability Determination Services.
- Disability Determination Services investigates provided and available medical evidence. If the available evidence is not sufficient to make a determination, a consultative examination is arranged to provide the additional evidence necessary to make the determination.
- After a determination is made, the results are returned to the Social Security office and appropriate action is taken.
These are the basic stages of the disability determination process followed by the Social Security Administration. It is important to note, however, that this process can take a considerable length of time to be successfully completed, meaning that it can delay the benefits that a disabled individual may need for a significant period. This depends significantly on the state in which you live: states such as California, which are highly populated, often have a backlog, whereas states such as North Carolina, which are less densely populated, are less likely to have substantial backlogs.
Disabled individuals in the United States who cannot support themselves may be entitled to receive financial support in the form of disability benefits from the Social Security Administration (SSA). However, the process of filing a claim for these benefits can be complicated, and it’s not uncommon for those who file for disability benefits to be rejected on the initial attempt. Fortunately, there is an appeals process in place for those who have been wrongfully rejected.
The majority of initial applications are rejected, meaning that most of those who apply will have to navigate the appeals process to get the benefits they need. The appeals process for disability benefits can be fairly complicated, and may require legal assistance for the applicant, depending on what level their appeal reaches. An appeal can be successful at any stage of the process, meaning that the applicant may be able to receive their benefits at any stage.
How the Process Works
There are multiple stages to the appeals process, which can be understood as:
- Initial application – the first step is the presentation of the application to a local SSA office. For instance, if you live in Illinois, you would send your application to an SSA office in your jurisdiction.
- Application rejection – when an application is rejected, it sets the stage for the appeals process to begin.
- Request for appeal – a signed request for an appeal of the decision must be returned to the same local office.
- Reconsideration – another individual in the same office will review the application and make a determination about benefits.
- Hearing – if the reconsideration results in another rejection, a hearing before an administrative law judge may be requested.
- Appeals Council Review – if the administrative law judge turns down the appeal, the Appeals Council will review your case.
- District Court Case – at the final level of appeal, you may bring a case against the SSA in a district court. You must have the representation of an attorney at this level of appeal.
The Social Security Administration (SSA) administers two different programs to help disabled individuals support themselves: Social Security Disability Income (SSDI) and Supplemental Security Income (SSI). However, because they are meant to serve different populations, the eligibility requirements for both of these programs vary significantly.
The Supplemental Security Income program is designed to assist disabled individuals who have live on limited resources. Unlike SSDI, it is unattached to any prior work requirements; simply being disabled and living on a low income is typically enough to become eligible for SSI. However, as simple as this may sound, it is important to understand the various criteria which must be met to receive this benefit in order to ensure that you have the financial assistance you need.
SSI Eligibility Criteria
According to the SSA’s criteria, eligibility for SSI benefits depends on several different factors, including:
- Disability – the individual has to have a medical condition which is recognized as a disability by the SSA.
- Limited income – the total earnings that an individual can have must be below a certain threshold.
- Limited resources – the total value of assets owned by the individual cannot be above a certain threshold.
- Citizenship or resident alien status – the individual applying for benefits must be either a current citizen or have legal status.
It is important to remember, as well, that because the cost of living is relatively higher in some states than others, with states such as New York representing a high-end of costs and states such as Tennessee representing a low-end, that the amount of benefits for which you may be eligible can be affected by where you reside.
Retirement from work is an inevitable course in the life of an employee; at other times, though, work is cut short by an illness or an injury, which may either have a short or long debilitating effect. It is during these times when many employees experience the greatest financial sufferings due to their inability to work and earn the salary needed to sustain their families and themselves.
The Social Security Act, which was signed into law in 1935, was particularly aimed at this specific circumstance; and though it first served as a social insurance to address principally the problem of poverty among senior citizens during the 1930 Great Depression, changes and improvements in the act have caused its positive effects to ripple down to the present times so that it continues to greatly lessen the financial difficulties experienced during old age, injury / illness or unemployment.
To make sure, though, that Social Security benefits, in the right amount, are awarded to the right persons, application for claims have been made much stricter, resulting to rejections of majority of the claims even at their initial phases of filing. Having someone to help you, called a representative, in filing a claim, or hiring legal help for the same purpose, is oftentimes beneficial as this will ensure correctness in the process of your application. In the event that you get rejected or if you find that the amount of your benefit is below what you expect, Social Security allows appeals to be made, even via its official website, within 60 days after your receipt of the decision. The Social Security office will even tell you how to make the appeal correctly.
An appeal usually undergoes four levels:
- Reconsideration – is a comprehensive review of your claim; this is to be accomplished by people who did not take part in the first decision;
- Hearing by an Administrative law judge – a hearing is conducted if the claimant still disagrees with the decision reached after reconsideration. You can present new proofs or introduce witness who will help confirm your rights for your claim.
- Review by the Appeals Council – you can ask for this council to review the decision arrived at during the hearing if you are still not satisfied. The appeals council has the right, however, to reject your appeal if it finds the administrative law judge’s decision to be sound and correct. If it decides to consider your appeal, the council may either issue its own decision or return your case to the administrative law judge who will conduct a further review on your claim.
- Federal court review – not agreeing with the decision of the Appeals Council, especially if the council’s decision is to reject your appeal, a fourth option is available – a request for a federal court review. The Social Security office will inform you of whatever decision it arrives at, as well as instructions on how to raise your concern to the federal court.
For individuals with a medically-diagnosed disabling condition, finding means to support themselves on their own can be extraordinarily difficult. Many of these conditions simply make work impossible, and even in cases where the individual may be qualified for some types of work, other barriers, such as lack of available positions or educational barriers, can make it a similar challenge to find support. Fortunately, the Social Security Administration (SSA) provides disability benefits to qualified individuals to help provide a decent standard of living to those living with disabilities.
Every individual’s case is viewed holistically by the SSA office at which an application for disability benefits is received. So, for instance, if you live in Florida, you would apply to your closest local branch office, and they would process the application under their standards. However, there are some conditions that are typically severe enough that they almost automatically render one eligible for disability benefits. These include the following:
- Cystic fibrosis
- Chronic pulmonary insufficiency
- Ischemic heart disease
- Chronic heart failure
- Inflammatory bowel disease
- Chronic liver disease
- Sickle cell disease
These and many other conditions can make it difficult or impossible for those who suffer from their effects to find gainful employment or to support themselves independently. For this reason, it is important that those who have a serious disability be able to receive the financial support to which they are entitled under the law, whether it be from the Social Security Disability Insurance program or the Supplemental Security Income program.