Helping Your Client Technically Qualify for SSDI and SSI

If you have a client with a disability or mental illness, he or she may want to apply for Social Security disability benefits. Before your client can be approved for disability benefits, the Social Security Administration (SSA) must verify your clients meets both the medical and technical eligibility requirements for disability benefits. Medical qualification is the same for both of the SSA’s disability programs, but technical eligibility rules differ.

Social Security Disability Insurance (SSDI)

SSDI is an “insurance” program that provides coverage for disabled workers. To qualify, your client must have:

• paid into the Social Security system either through FICA or self-employment taxes
• worked within the last 10 years
• between 20 and 40 work credits available at the time of disability onset, although this will be even lower for younger applicants. The SSA does not expect a 21 year old to have worked as much as a 60 year-old applicant.

Work credits accumulate at a rate of about four per year for most workers. These credits build up as you pay employment taxes. Employment taxes may be either:

• withheld automatically from a paycheck by an employer under the FICA tax code

OR

• submitted to the IRS by self-employed persons as part of their self-employment taxes.

In either instance, employment taxes fund Social Security and Medicare. The taxes your client paid over your employment history make her a “covered person” under both of these insurance programs.

Supplemental Security Income (SSI)

SSI is a need-based program available to disabled persons of all ages and the elderly. There are no work credit requirements to qualify, but there are strict financial eligibility rules. To receive SSI, your client must meet the income and other financial resource limits.

When determining eligibility, the SSA specifically reviews your client’s:

• earned and unearned income,
• other benefits, like retirement or VA benefits,
• money from other sources, like assistance from friends or family,
• free food, housing, or other donated or gifted resources,

AND

• any financial assets or other resources you have that could be converted to cash, like life insurance policies, savings bonds, and bank accounts, among others.

Although the SSA requires your client to disclose information about all of your finances, certain income sources and other financial resources are excluded from consideration. These include:

• a percentage of earned income each month,
• benefits you get through other need-based programs, like SNAP or TANF,

AND

• one vehicle and your primary residence, if your clients owns his or her own house.

Financial resources from all countable sources cannot exceed the SSA’s established income and asset limit. This limit is reviewed and adjusted each year when cost-of-living increases go into effect. For 2016, the limit is $2,000 per month for an individual or $3,000 per month for a married couple in which both spouses receive SSI.

Applying for Benefits

If your client has worked enough to qualify for SSDI, or has income low enough for SSI, he or she can start the application process. Whether applying for SSDI, SSI, or both, your client can use the SSA’s online application portal, which allows applicants to fill out and submit all the required forms for an SSDI claim. The SSA can additionally use your client’s online application to start an SSI claim.

Some applicants choose instead to apply for SSDI at their local office. The SSA requires a personal interview to complete any SSI application, so your client may need to make a trip to the local office anyway.

When your client is applying for Social Security disability benefits, be sure to submit a letter outlining how your client’s illness keeps him or her from working. A social worker’s opinion and expertise can go a long way in helping your client win Social Security disability benefits.