Guide to Social Security Disability Benefits

Guide to social security disability benefits

Learn about Social Security disability insurance and Supplemental Security Income

The Social Security Administration pays income to people who can’t work because of a disability. In order to receive disability benefits, applicants must apply to 1 of 2 programs. Applicants can receive workers’ compensation benefits and disability benefits at the same time.
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If you’re considering applying for Social Security disability benefits, you’re not alone. Almost 9 million people received disability benefits in 2018. This shouldn’t come as a surprise considering studies show that a 20-year-old worker has a 1 in 4 chance of becoming disabled before reaching full retirement age.

Despite the large number of people receiving social security disability benefits, misconceptions and confusion persist.

In this article, we’ll explain what Social Security disability benefits are, clear up some misconceptions, and provide advice for those looking to apply.

What are Social Security disability benefits?

The Social Security Administration (SSA) administers a program that pays disability benefits to people who can’t work because they have a medical condition that’s expected to last at least 1 year or result in death. The program is called Social Security disability insurance (SSDI) and it’s funded through payroll taxes.

In order to qualify for SSDI, you must:

  • Have a medical condition that meets the SSA’s definition of a “disability.” You can only receive SSDI if you’re totally disabled (no benefits are payable for a partial disability). The SSA considers you “totally disabled” if: (1) you can’t perform the work you performed prior to the condition at issue; (2) you can’t adjust to other work because of your medical condition (i.e., there’s no other work you can perform); and (3) your disability has lasted or is expected to last for at least 1 year or result in death.
  • Have worked long enough. As you work, you acquire “work credits” based on your total yearly wages. For example, in 2019, you earn 1 credit for each $1,360 in wages (with a maximum of 4 credits per year). In order to qualify for SSDI, you must have accumulated enough work credits. The number of work credits you must acquire depends on your age and when you became disabled.
Enjuris tip: Determining whether you’re “disabled” isn’t always clear-cut. In general, you stand a much better chance of being considered “disabled” and receiving SSDI if your medical condition is listed in the SSA’s “Blue Book” of impairments.

What medical conditions qualify for disability?

To be eligible for disability benefits, you must be “totally disabled.” The SSA considers you totally disabled if:

  • You can’t do the work you did before your injury or illness,
  • You can’t adjust to any other work because of your injury or illness, and
  • Your disability has lasted or is expected to last for at least 1 year or to result in death.

According to the Social Security Administrations, benefits were awarded to 679,449 disabled workers in 2019. Among those awarded benefits, the most common medical conditions that qualified for disability included:

  • Diseases of the musculoskeletal system and connective tissue (37.7 percent). These conditions include amputations and lumbar spinal stenosis, among others.
  • Mental disorders (13.3 percent). These disorders include schizophrenia and bipolar-related disorders, among others.
  • Neoplasms (11.6 percent). These conditions include leukemia and lymphoma, among others.
  • Diseases of the circulatory system (10.6 percent). These conditions include chronic heart failure and peripheral arterial disease, among others.
  • Diseases of the nervous system and sense organs (9.1 percent). These conditions include Huntington’s Disease and traumatic brain injury, among others.

Other common conditions that may qualify a person for Social Security disability include:

  • Systemic sclerosis
  • Inflammatory arthritis
  • Endocrine disorders
  • Respiratory illnesses
  • Blindness or vision loss
  • Lyme disease
  • Sjögren’s syndrome
  • Depression
Enjuris tip:The SSA created an online tool to help you determine whether your condition will qualify for disability benefits.

What’s the difference between SSDI and SSI?

The SSA also has a program called Supplemental Security Income (SSI). The program is very similar to SSDI. Just like SSDI, the SSA must consider you “totally disabled” before you can receive these benefits.

The principle difference between SSDI and SSI is that SSI has an additional need-based requirement. In order to receive SSI, your countable resources must not be worth more than $2,000 for an individual or $3,000 for a couple. Resources include things like cash, land, and personal property that could be sold for cash.

How workers’ compensation affects disability benefits

Workers’ compensation is a form of insurance that pays medical expenses and lost wages to employees who are injured while doing their job. It’s your employer’s responsibility to carry workers’ compensation insurance.

Workers’ compensation may be paid by federal or state workers’ compensation agencies, employers, or insurance companies, but has nothing to do with the SSA. The injuries and medical conditions covered by workers’ compensation vary by state but, in general, eligibility is very different from SSDI and SSI.

For example, it’s not necessary to be “totally disabled” in order to receive workers’ compensation insurance. On the other hand, there are certain conditions, including most mental health conditions, that aren’t covered by workers' compensation but generally covered by SSDI and SSI.

Can you receive disability benefits and workers’ compensation benefits?

Yes! You can receive workers’ compensation benefits and social security disability benefits at the same time. However, the total amount of these benefits can’t exceed 80% of your average earnings before you became disabled.

If you receive workers comp and disability, the total amount of benefits can’t exceed 80% of your average earnings before you became disabled. Tweet this

If your workers’ compensation benefits and social security disability benefits exceed the 80% threshold, the SSA (in most states) will reduce the amount of disability benefits you receive until your benefits total 80%. In some states, your workers’ compensation benefits will be reduced instead.

How to file for Social Security disability benefits

There are 2 ways to apply for SSDI or SSI:

To complete the application, you’ll need to provide some background information (place of residence, income, etc.), describe your medical condition, and provide any supporting medical records.

Enjuris tip: The Disability Starter Kit (published by the SSA) can help you prepare for your application or appointment.

Once you submit your application, it will be reviewed by state medical and vocational experts. These experts may contact your doctors. In some cases, the state might require you to undergo a medical examination.

In general, it takes 3-5 months to receive a decision.

Enjuris tip: You can check the status of your decision online at any time.

If your request is denied, you’ll have 60 days to appeal the decision. In most cases, the appeal will involve a hearing in front of an administrative law judge.

Enjuris tip: How much Social Security benefits you’ll receive if your application is accepted is based on a complicated formula. In general, the amount of your benefit is determined by your age and yearly reported earnings since you began working.

When do I need a Social Security disability attorney?

You’re not required to hire an attorney to file for disability benefits. You’re also not prohibited from hiring an attorney. Whether or not you should hire an attorney is entirely dependent on your circumstances. For many people, hiring an attorney to help gather medical records and fill out the application is well worth the cost.

If your application is denied and you choose to appeal the decision, hiring an attorney is generally a good idea. Social Security disability attorneys have experience reviewing denials and determining what information is needed to strengthen your case. Attorneys understand what administrative law judges are looking for and are able to present the information during the hearing in an effective and convincing manner.

Enjuris tip: If you can’t afford a Social Security attorney, contact your local state bar association. Your state bar association can put you in touch with attorneys who work pro bono or at a reduced cost. Similarly, many law school clinics have law students who represent SSDI and SSI applicants under the supervision of a mentoring attorney. Law students often do a terrific job, as their caseloads are much smaller than the caseloads of practicing attorneys.

Need help finding an attorney? Take a look at our free online directory.