By Abbie Cornett

Over the years, I have discovered many patients and their families don’t understand the difference between Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), nor which benefits they are entitled to and when they should apply. While both federal programs are for people who are disabled, they have little else in common.

From a historical perspective, SSDI is an insurance program implemented in 1956 under Title 2 of the Social Security Act. SSI is an income supplement program implemented in 1974 under Title 16 of the Social Security Act.
SSDI pays a benefit to disabled individuals as long as they qualify by having worked long enough and paid enough Social Security tax. To be eligible, individuals must have worked at least five of the last 10 years, or 20 out of the 40 quarters before they became disabled. For individuals under 30 years old, the requirements are somewhat different since they have not been in the workforce as long. The SSDI benefit is funded by general tax revenues.

Individuals qualify for SSDI and SSI based on different income requirements. SSDI is based on work history, has no asset restrictions and allows recipients to return to minimal work. SSI payments are made to the blind, elderly and completely disabled who have a demonstrated financial need. For individuals to qualify for SSI, there are strict asset limitations (less than $2,000), and working reduces the benefit. Since SSI is a need-based program, assets must be taken into account, whereas SSDI is a benefit workers pay and qualify for through contributions paid into Social Security. Both programs require that applicants be disabled. The law defines disability as an inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment that can be expected to result in death or that has lasted or can be expected to last for a continuous period of not less than 12 months.

Before individuals are approved for SSDI or SSI, the Social Security Administration (SSA) will evaluate their claim. During this process, SSA will look at all factors affecting individuals’ ability to work such as the severity of the condition(s), age, education, past work experience, transferable skills and whether any other substantial gainful activity can be accomplished.

Applying successfully for SSDI or SSI is dependent on establishing a paper trail. A number of preliminary steps are required to be successful in obtaining benefits:

• Speak to a doctor first. Make sure the doctor and patient are in agreement that the patient is no longer able to work.
• Gather all clinical data and test results. To obtain benefits, an individual must have a severe impairment that is supported by medically acceptable clinical and laboratory findings.
• Document all work restrictions and accommodations. It is important for the patient to demonstrate he or she is unable to continue working.

In fact, a majority of people who apply for SSDI or SSI are denied the first time. This doesn’t mean patients should give up. When an application is denied, a letter will be sent to the applicant explaining why and how to appeal the decision. An appeal must be filed within 60 days of the date the disapproval letter was received. Because many applications are denied for technical reasons, patients may want to seek legal help. Disability attorneys are familiar with the application process and can help patients with the necessary documentation.

It’s important for patients to start the application process early, and not wait until they can no longer work. Many patients postpone filing for disability as long as they can, often to their own detriment. Many times, this is because they are embarrassed about being ill or feel a sense of guilt about being unable to work. But, it is important to remember these programs were established to help the chronically ill and their families.

If you have any questions about qualifying for SSDI or SSI, please contact me.

Abbie Cornett is the patient advocate for IG Living magazine. She can be reached at [email protected] or (800) 843-7477 x1366.