What is Social Security Disability?

A. Two Different Programs

Once you qualify as disabled under the Social Security Act, the SSA makes disability payments under one of two programs:

• Social Security Disability Insurance (SSDI), for workers who have paid into the Social Security trust fund (and their dependents), or
• Supplemental Security Income (SSI), for disabled individuals with limited incomes and assets (and their dependents).

SSDI claims are also referred to as Title 2 claims because they are authorized under Title 2 of the Social Security Act. SSI claims may be referred to as Title 16 claims because they are authorized under Title 16 of the Social Security Act. A person claiming a disability is called a claimant. Some claimants apply under both Title 2 and Title 16; these are known as concurrent claims.

When the SSA receives your application, it will determine whether you are eligible for disability benefits under SSDI or SSI , even if you have not specifically requested both. This means that if you apply only for SSDI benefits, the SSA will automatically process your claim for any SSI disability benefits to which you might be entitled. If your SSDI claim is turned down, you don’t have to file another claim for possible SSI benefits.

1. Social Security Disability Insurance

SSDI provides payments to workers who have made contributions to the Social Security trust fund through the Social Security tax on their earnings. SSDI is also available to certain dependents of workers. If you are found eligible for SSDI, you might be entitled to retroactive (past) benefits if you can show that you were disabled before the date of your application. (See Chapter 10 for more details on when benefits begin.)

a. Who Qualifies?

To qualify for SSDI, you must fall into one of the following categories:

i. You are a disabled insured worker under age 65

You must have worked both long enough and recently enough to qualify. It may not be sufficient that you worked for many years and paid Social Security taxes. When you worked is also important. The law requires that you earn a certain number of work credits in a specified time before you are eligible for benefits. You can earn up to four credits per year, each credit representing three months. The amount of earnings required for a credit increases each year as general wage levels rise.

The number of work credits needed for disability benefits depends on your age when you become disabled. Most people need at least 20 credits earned over ten years, ending with the year they become disabled. Younger workers may qualify with fewer credits.

In effect, you count backwards from the year that you became disabled to see whether you have the appropriate number of credits. That means that credits from many years before you became disabled are automatically wiped out, or expire. This can lead to a dangerous situation for people who haven’t worked for many years before becoming disabled. Their credits may dip below the required amount, and they can lose eligibility for SS DI. The date on which they lose their eligibility is called the "date last insured," or DLI —often a subject of dispute in Social Security cases. If you think your DLI is too far in the past to qualify you for SSDI, talk to your local SS A Field Office to make sure—in certain rare circumstances, you may still qualify.

The rules are as follows:

• Before age 24. You’ll need at least six credits earned in the three-year period ending when your disability started.
• Age 24 to 31. Credit for having worked half the time between age 21 and the time you become disabled. For example, if you become disabled at age 27, you would need credit for three years of work (12 credits) during the six years between ages 21 and 27.
• Age 31 or older. In general, you will need the number of work credits shown in the chart below. Unless you are blind (see CD Part 2 for definitions of legal blindness), at least 20 of the credits must have been earned in the ten years immediately before you became disabled.

You can find out how many credits you have by contacting your local SSA office or, if you have access to the Internet, by filling out a form at www.ssa .gov/mystatement.

ii. You are the family member of an eligible worker

The SSA pays auxiliary benefits to people who qualify based on certain family members’ entitlement to retirement or disability benefits. Benefits are paid based on the earnings records of the insured worker who paid enough Social Security taxes. If you qualify for auxiliary benefits, you do not necessarily have to be disabled; nor do you need the work credits described above.

Spouse’s and divorced spouse’s benefits. To qualify for auxiliary benefits as a spouse or divorced spouse, one of the following must apply (42 U.S.C. § 402(b), (c), (e), (f); 20 CFR §§ 404.330–349):

• You are the divorced spouse of a retired or disabled worker who is entitled to benefits, you are 62 years old or older, and you were married to the worker for at least ten years.
• You are the divorced spouse of a worker insured under SSDI who has not filed a claim for benefits, you are age 62 or older, your former spouse is aged 62 or older, you were married for at least ten years, and you have been divorced for at least two years.
• You are a disabled widow or widower, at least 50 years of age but less than 60 years old, and you are the surviving spouse of a worker who received Social Security disability or retirement benefits.
• You are the surviving spouse (including a surviving divorced spouse) of a deceased insured worker, and you are age 60 or older.
• You are the surviving spouse (including a surviving divorced spouse) of a deceased insured worker, and you care for a child of the deceased entitled to benefits who either is under age 16 or has been disabled since before age 22. (These benefits are known as "mother’s or father’s benefits.")

Child’s benefits. A dependent, unmarried child is entitled to child’s insurance benefits on the Social Security record of an insured parent, or deceased parent who was insured at death, if any of the following apply (42 U.S.C. § 402(d); 20 CFR §§ 404.350–369):

• The child is under age 18.
• The child is age 18 or 19 and a full-time student.
• The child is an adult and has been disabled since before age 22. (See Chapter 3 for a more detailed discussion of benefits for children.)

Parent’s benefits. You may qualify for parent’s benefits if all of the following are true (42 U.S.C. § 402(h); 20 CFR §§ 404.370–374):

• Your child was an insured worker who died.
• You are at least 62 years old.
• You are divorced, widowed, or unmarried and have not married since your child’s death.
• You were receiving at least one-half of your support from your child at the time of death.
• You can provide evidence of this support within two years of the death (you may be exempt from providing evidence if unusual circumstances, such as extended illness, mental or physical incapacity, or language barrier, show that you could not have reasonably known of the two-year rule).

Lump-sum death benefits. A lump-sum death payment of several hundred dollars may be paid to the surviving spouse of an insured worker if the survivor was living in the same household as the deceased at the time of death. You must apply for this benefit within two years of the insured worker’s death. (42 U.S.C. § 402(i); 20 CFR §§ 404.390–395.)

b. Citizenship or Residency Requirements

If you qualify based on the criteria listed above, you may receive SSDI payments if you are a U.S. citizen or permanent resident, living in the United States or abroad. If you are neither a citizen nor a permanent resident, you still may be entitled to receive SSDI if you can show that you are lawfully present in the United States and meet certain other criteria. (8 U.S.C. § 1611(b)(2).)

If you are a citizen when you apply for SSDI, you will have to show proof of your citizenship. Acceptable forms of proof include a birth certificate showing birth within the United States (including Washington, D.C.), Puerto Rico after January 14, 1941, Guam, Virgin Islands of the U.S. after 1917, American Samoa, Swain’s Island, and Northern Mariana Islands. Any of the following documents will also satisfy the proof of citizenship requirement:

• Forms N-550 and N-570 (Certificate of Naturalization issued by U.S. Citizenship and Immigration Services (US CIS) or its predecessor, the Immigration and Naturalization Service (INS))
• U.S. passport issued by the U.S. State Department
• Form I-197 (U.S. Citizen Identification Card issued by US CIS or the INS)
• Form FS-240 (Report of Birth Abroad of a Citizen of the U.S. issued by the U.S. State Department)
• Form FS-545 (Certification of Birth issued by a foreign service post)
• Forms N-560 and N-561 (Certificate of Citizenship issued by US CIS or the INS)
• Form DS-1350 (Certification of Report of Birth issued by the U.S. State Department)
• American Indian Card I-872 (DHS for Kickapoo Indian Tribe), or
• Northern Mariana Card I-873 (INS card for birth in the N. Mariana islands before 1986, obsolete but still valid).

If you are a permanent resident or resident alien, you will have to show that you are lawfully in the United States under one of the following conditions:

• lawful admission for permanent residence
• admission as a refugee or conditional entrance as a refugee
• asylum status or pending application for political asylum
• parole status
• deportation withheld or pending application for withholding of deportation
• member of a class of aliens permitted to remain in the United States for humanitarian or other public policy reasons, or
• you have been battered or subjected to cruelty by a family member while in the United States.

Most foreign workers in the United States are covered under the U.S. Social Security program and can potentially qualify for disability benefits. If, however, you are neither a citizen nor a permanent resident, you still may be covered under Social Security Disability. Federal law generally requires that all workers should pay Social Security taxes, and therefore be covered under SSDI for services performed in the United States. This is true even if they are nonresident aliens or employees who work here for short periods.

There are a few exceptions, however. Some non-immigrant foreign students and exchange visitors temporarily working in the United States may be exempt from paying Social Security taxes and therefore would not qualify for disability benefits under SSDI if they became disabled.

Noncitizen or permanent residents of the United States who are entitled to SSDI may be paid benefits while they reside abroad, depending upon their citizenship status and the countries in which they live. However, with some exceptions, an alien beneficiary who leaves the United States must either return to the U.S. at least every 30 days or for 30 consecutive days during each six-month period in order to continue to draw benefits. One exception is made for alien beneficiaries who are on active military duty for the United States. Another exception exists for alien beneficiaries who live in and are citizens of Germany, Greece, Ireland, Israel, Italy, or Japan. (The United States has treaty obligations with these nations to continue paying benefits regardless of how long beneficiaries are outside the United States.) Citizens of the Netherlands may receive partial benefits. (See Chapter 13 for more information about receiving benefits outside of the United States.)

Be aware of restricted countries. There are a few countries where residents cannot receive benefits even if they otherwise qualify. These include Cuba, North Korea, and Vietnam.

2. Supplemental Security Income (SSI)

The SSI program provides payments to an adult or child who is disabled and has limited income and resources. If your income and resources are too high, you will be turned down for benefits no matter how severe your medical disorders. You will be turned down even if you have not paid enough in Social Security taxes to qualify for SSDI.

The SSI limits on income and resources is one of the most complicated areas handled by the SSA. Although important points are covered here, only SSA representatives can accurately determine your income and resources for purposes of qualifying for SSI.

a. Income Limits

To qualify for SSI, your monthly income (as counted by the SSA) cannot exceed something called the federal benefit rate (FBR). The FBR for a married couple is approximately 33% more than for an individual. If only one member of a couple is eligible, both spouses’ income is still considered. If a child under age 18 is living with parents, then the parents’ income is considered. The FBR is set by law. It increases annually as dictated by cost-of-living adjustments. In 2008, a cost of living adjustment (COLA) of 2.3% raised the FBR to $637 per month for individuals and $956 for couples.

The federal benefit rate sets both the SSI income limit and the maximum federal SSI payment. The FBR payment is supplemented in every state except Arkansas, Georgia, Kansas, Mississippi, Tennessee, Texas, and West Virginia. In all other states, the allowed income level and the SSI payments are higher than the federal maximums. In California, Iowa, Massachusetts, and Nevada, the state supplements are higher for blind recipients than for others. Also, the amount of the state supplement depends on whether you are single or married and on your particular living arrangements. Although the amount of the state supplement varies widely, it can be as much as several hundred dollars.

The SSA does not count the followingincome and benefits when calculating your income level:

• $20 per month of most income, except wages
• $65 per month of wages and one-half of wages over $65
• food stamps, and
• home energy or housing assistance. (See Chapter 13 for more detailed information on income limitations.)

b. Resource Limits

To qualify for SSI , your resources must also not exceed certain limits. A "resource" is cash or another asset that can be converted to cash and used for support. If you or your spouse have the right, authority, or power to sell property and keep the proceeds, it will be considered a resource.

Resources are categorized as either liquid or nonliquid. Liquid resources include cash and other assets that could be converted to cash within 20 working days. The most common types of liquid resources are savings and checking accounts, stocks, bonds, mutual funds, promissory notes, and certain types of life insurance. Nonliquid resources cannot be converted to cash within 20 working days. They include both real property (land) and personal property. The SSA may consider some resources to be both liquid and nonliquid (such as an automobile or life insurance policy).

The resource limits are set by law. They are not subject to regular cost-of-living adjustments, but they have increased slowly over the years. For 2008, you will not be eligible for SSI disability payments if your assets exceed:

• $2,000 for a single person, or
• $3,000 for a married couple (even if only one member is eligible for SSI).

When counting up your assets, the SSA must exclude certain assets, including the following:

• your home (including adjacent land and related buildings), regardless of value. The home must be owned by you or your spouse and used as your principal residence.
• restricted allotted Indian lands
• household goods and personal effects up to $2,000 in value
• one wedding ring and one engagement ring of any value
• necessary health aids, such as a wheelchair or prosthetic device
• one automobile, regardless of value, if used to provide necessary transportation; if not used for that purpose, then one automobile up to $4,500 in value
• grants, scholarships, fellowships, or gifts used to pay tuition, fees, or other necessary educational expenses at an educational institution (including vocational or technical institution) for nine months beginning the month after the month the educational assistance was received
• nonbusiness property needed for support, up to a reasonable value
• resources of a blind or disabled person needed to fulfill an approved plan for achieving self- support (called a PASS plan). (See Chapter 13 for more information.)
• life insurance with a face value of $1,500 or less
• burial plots and certain burial funds up to $1,500
• disaster relief, and
• housing assistance paid under the U.S. Housing Act, the National Housing Act, or the Housing and Urban Development Act.

Exceptions to the residence requirements often involve complex legal issues, and you are probably best off consulting an attorney if you think an exception might apply to you.

c. Citizenship and Residency Requirements

SSI disability payments are usually available only to U.S. citizens. There are several exceptions, however, under which noncitizens might be eligible, including the following:

• During the first seven years after you were admitted, you are either legally residing in the United States as a refugee, have been granted asylum, satisfy certain conditions of withheld deportation, have been granted status as a Cuban or Haitian entrant or, under some conditions, entered as an Amerasian immigrant. (8 U.S.C. § 1612(a)(2)(A)(i)(I-V).)
• You legally entered the United States for permanent residence and have worked 40 qualifying quarters under the Social Security Act (see Section A1a, above). In some situations, you may be able to count the qualifying quarters of a parent (for the time you were under age 18) or a current spouse or deceased spouse. (8 U.S.C. § 1612(a)(2)(B).)
• You were honorably discharged from the U.S. military, you are on active duty in the U.S. military, or you are the spouse of a veteran or person on active duty, the unmarried dependent child of a veteran or person on active duty, or the surviving spouse of a deceased veteran or person on active duty and you have not remarried. (8 U.S.C. § 1612(a)(2)(C)(i-iii).)
• You were lawfully residing in the United States and receiving SSI benefits on August 22, 1996. (8 U.S.C. § 1612(a)(2)(E).)
• You were lawfully residing in the United States on August 22, 1996, and you are blind or otherwise became disabled at any time. (8 U.S.C. § 1612(a)(2)(F).)
• You are lawfully residing in the United States and are an American Indian born in Canada. (8 U.S.C. § 1612(a)(2)(G).)
• You have been battered or subjected to cruelty in the United States by a family member. (See Public Law 104-193, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, as amended by P.L.104- 208, the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, and P.L. 105-33, the Balanced Budget Act of 1997.)

d. Receiving Benefits When Outside of the U.S.

SSI payments are generally only available to people residing in the 50 states, District of Columbia, or Northern Mariana Islands. If you receive SSI disability benefits and move, for example, to Mexico or Puerto Rico, you will lose those benefits. There are a few exceptions for some U.S. citizen children and students:

• A blind or disabled child may be eligible for SSI benefits while outside the United States if the child is a U.S. citizen, lives with a parent who is a member of the U.S. Armed Forces assigned to permanent duty outside the United States, and was eligible to receive SSI benefits in the month before the parent reported for duty abroad.
• A student of any age may be eligible for SSI benefits while temporarily outside the United States for the purpose of engaging in studies not available in the United States, sponsored by an educational institution in the United States, and designed to enhance the student’s ability to engage in gainful employment. The student must have been eligible to receive SSI benefits in the month preceding the first full month abroad.

Next: B. Defining Disabled

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