Belleville, Illinois — June 4, 2020 —Former workers with disabilities who are considering applying for Social Security Disability Insurance (SSDI), will benefit by learning about some little-known facts that confirm their eligibility and speed their claim, according to Allsup, the nation’s premier disability representation company. This is especially true as the Social Security Administration continues to operate with office closures and restricted operations during the ongoing COVID-19 pandemic.
SSDI is a vital insurance program for men and women unable to work due to a disability, by providing monthly income, Medicare eligibility, dependent benefits and other valuable assistance. “Even though this federally insured program has existed since the mid-’50s, it is often misunderstood by those dealing with severe medical or mental illnesses that force them to stop working,” said Dan Contreras, Allsup lead advocate.
Each year about 2 million people apply for SSDI benefits, yet the Social Security Administration (SSA) only approves about 37% of first-time applicants. As many as 700,000 are immediately declined as technically ineligible.
Many applicants will appeal the denial of their application and eventually – often years later – obtain their disability benefits. Understanding the complexity, rigor and myths surrounding the initial SSDI application process, can lead to obtaining benefits earlier for those who are eligible, Contreras explained.
SSDI provides a benefit you already paid for with FICA
One of the common misconceptions is that the SSDI program is means-tested, that only lower income individuals are eligible. However, SSDI is a payroll tax-funded, federal insurance program available to individuals who can no longer work because of a disability.
“Although the program is for workers who paid for their insurance through their FICA taxes, the program has a number of requirements that add to the difficulty in receiving these benefits,” Contreras said.
Allsup outlines little-known facts about SSDI to explain why these benefits can be hard, but not impossible to obtain.
- You must meet the recent work test, meaning you are currently insured, to receive SSDI benefits. Employees and those who are self-employed fund the SSDI program by paying FICA taxes. To qualify for SSDI, you must have on record with the SSA at least 20 quarters (credits), or in general, five years of earnings during the past 10 years. This requirement varies depending upon the age you are when you become disabled. If you become disabled before age 24, you need at least six quarters of earnings in the three years before becoming disabled. Between the ages of 24 and 30, credits are needed for half of the time between age 21 and the time of disability. In 2020, one credit can be earned for every $1,410 in wages, up to four credits per year.
- You also must meet the duration of work test, meaning you are fully insured. This requirement refers to how long you have worked, and there is a minimal requirement of work/earnings in order to be fully insured for the SSDI program. You must have at least 40 quarters of paying FICA taxes throughout the course of your entire working career. For younger workers, you may be fully insured if you have six quarters of coverage, plus one quarter of coverage for each year after the year you reach age 21.
- If your disability is determined to be long term, permanent or terminal, you can apply for SSDI. “Some disabilities are progressive, and the decision to stop working isn’t immediate. Individuals should apply for benefits the moment they can no longer work because of the disability, but especially if they and their doctors believe it is unlikely they will be able to work for 12 months or more,” Contreras said. There are risks for waiting too long to apply for SSDI, including not meeting the recent work test. Social Security also imposes a 12-month limit on retroactive benefits. “In other words, if you became disabled in the summer of 2019, but did not apply for benefits until winter 2020, your retroactive benefits will only go back 12 months,” Contreras explained.
- You must meet the SSA’s definition of disability to receive SSDI benefits. Social Security has its own definition of disability. It says: you are considered disabled if you cannot work due to a severe medical condition that has lasted, or is expected to last, at least one year or results in death. The medical condition must prevent you from doing work you did previously, and it must prevent you from adjusting to other work. Program administrators at the local, state and federal level use a five-step evaluation process to determine eligibility.
- Are you working? If so, are your monthly earnings above the allowed amount, which is substantial gainful activity (or SGA)?
- Is the medical condition severe? Has it severely limited basic work activities such as lifting, standing, walking or remembering, for a minimum of 12 months, or the impairment(s) is expected to or will result in death?
- Does your medical condition meet or medically equal Social Security’s severity of a listing? SSA maintains a listing of medical criteria that are considered to be so severe that an individual is found disabled if his or her impairment(s) matches them.
- Can you do any of your past relevant work?
- Can you do any other type of work?
- There is a five-month waiting period. If you are approved for benefits, you should know in advance and plan for your benefits to begin five months after the date you last worked. This typically applies to fast approvals for extremely severe disabilities, and these can include Compassionate Allowances.
- Disability benefits will convert to retirement benefits. The average age of SSDI beneficiaries is currently about 54. After reaching full retirement age, which ranges from 65 to 67 depending on birth date, SSDI benefits convert to retirement benefits. You may not collect SSDI and Social Security benefits concurrently, as SSDI benefits are designed to help people who are forced to stop working early, due to a chronic illness or injury.
- Confirm your eligibility before you apply. As of FY 2019, 63% of applicants are denied SSDI benefits with their initial application. Allsup has helped people navigate the complicated SSDI process resulting in a 97% success rate for customers. “Our easy-to-use online tool, empower by Allsup®, assists with determining your likelihood of eligibility while helping to simplify both the application and appeals process,” Contreras said.
- Going it alone: those with disability representatives have a higher likelihood of success at the application and appeal levels of the SSDI program. You can increase your chances of getting benefits by using an experienced representative. Most representatives do not assist with SSDI applications; however, Allsup has specialists who work with those first applying. More than 325,000 people have successfully received their benefits with Allsup as their representative.
“We have more than 35 years of experience at all levels from application to appeal,” Contreras said, adding, “We also understand the inner workings of the complex disability benefits process and guide individuals through this challenging time.”
Find more information about how to apply for disability benefits or returning to work with a disability, visit TrueHelp.com.
To get started with your SSDI eligibility assessment, go to FileSSDI.Allsup.com.