If you aren’t familiar with social security disability programs, this brief summary will provide a general outline of the type of benefits and application process. It will cover some of the basic terminology used when discussing social security disability programs and the application process.
Social Security Disability Benefits
When you apply for social security disability benefits, it will be determined if you are eligible for Social Security Disability Insurance (SSDI) and/or Social Security Insurance (SSI) benefits; this includes technical eligibility and medical eligibility. For adults, the law defines if you have the ability to engage in Substantial Gainful Activity (SGA) by reason of a medical or mental impairment that can be expected to result in death or last for more than a year.
Both SSDI and SSI are sources of benefits for qualified individuals that are overseen by the Social Security Administration (SSA); but, they are different programs and often confused. General differences are how the programs are funded and to whom the money is distributed. Adult children or disabled widowers may qualify for benefits based on the records of a parent or spouse.
Social Security Disability Insurance (SSDI)
SSDI benefits come from payroll tax contributions. SSDI benefits are available to qualified individuals who have had employment covered by Social Security for a specified time. Benefits are not based on your financial need and income. The benefits are funded by multiple sources which include dedicated payroll taxes that you and/or your employer paid on your behalf that are held in the SSA trust fund.
Social Security Insurance (SSI)
SSI benefits do not come from payroll tax contributions. SSI benefits are available to qualified individuals with low-income and low resources. Benefits are based on financial need and not work history. There is no prior work requirement or insured status. The benefits are funded from the US Treasury general funds, not the SSA fund.
If you have worked enough to receive SSDI, but the benefit amount is less than the SSI amount, SSI will give you enough to equal the SSI monthly amount.
SSDI and SSI Application
A claim for social security disability benefits is processed jointly by the federal and state governments for the SSDI program and/or the SSI program. The local SSA Field Offices and state Disability Determination Services (DDS) will determine if you are technically and medically eligible for benefits. You can apply for disability benefits by phone, in person, by mail or apply online.
Local SSA Field Office
The local SSA Field Office will review your technical eligibility for social security disability benefits which are non-medical requirements; and, they will begin to develop your case by asking for information about your impairment, treatment, age, employment, marital and insurance status. After it is determined you meet technical eligibility guidelines, the local SSA field office will forward your claim to DDS for medical evaluation of your disability.
The DDS will obtain evidence from medical sources that you and/or your doctors provide. For additional evidence they may arrange for a Consultative Exam (CE) if evidence is insufficient or not available. Then, they will review your medical eligibility for social security disability. A two person team from DDS will make the initial determination if you are eligible for social security disability benefits. This consists of a medical or psychological consultant (a SSA physician or psychologist) and a Disability Examiner (DE).
When you appeal a denied claim for social security disability benefits, your application can be reconsidered by DDS and can be sent to further reviewed by an SSA Administrative Law Judge (ALS) from the Office of Disability Adjudication and Review (ODAR).
This application process can take 2-3 years, 4, 5, 6….or more! Now ain’t that some bullshit? And you thought the IRS was slow!
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