Facing a disability can be challenging enough, but it becomes even more difficult when the complex Social Security system is added to the mix. At Tabak Law, we stand alongside those injured or disabled people facing some of life’s toughest challenges. Our mission is to help them move from hardship to hope by ensuring they receive the benefits and compensation they deserve.
A common question we often hear is: “Am I eligible for disability benefits?” The answer to this question depends on whether or not you meet the specific criteria for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). Knowing the difference between these two programs is the first step towards securing your financial stability in the future.
The Foundation: How the SSA Defines “Disability”
The Social Security Administration (SSA) has a specific and strict definition of disability. In order to qualify for either Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), your medical condition must significantly limit your ability to work for at least a year or result in death.
The SSA uses a five-step evaluation process to determine whether you meet this definition. This includes assessing whether you are able to perform any “substantial gainful activity” (SGA), which is defined as work that pays more than a certain amount.
The Core Medical Criteria for SSI and SSDI
The medical requirements for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are the same. To be eligible for disability benefits, you must meet certain criteria:
- Your condition must be severe. Not all medical conditions qualify for disability benefits. A severe impairment is one that significantly interferes with your ability to perform basic work-related tasks. For adults, this means that the condition prevents you from working or adjusting to another job.
- Your condition must be long-lasting. Your disabling condition must have lasted or be expected to last for at least 12 months continuously. If your medical records show that you are likely to recover within a year, your claim may be denied.
- You must not be able to work due to your condition. You must have mental or physical limitations that prevent you from returning to any of your previous jobs (typically within the last 15 years). Additionally, the Social Security Administration (SSA) must determine that you cannot adapt to any other type of work based on your age, education, and work experience.
Most initial claims are denied, often because the Social Security Administration (SSA) believes that the applicant can return to their previous job or adjust to another position. This is where skilled Milwaukee Social Security Disability Insurance (SSDI) lawyers can make a significant difference by challenging this assessment with relevant evidence.
Key Differences: Non-Medical Eligibility Requirements
While the medical criteria are the same for both SSI and SSDI, the non-medical requirements for eligibility differ significantly between the two programs.
For SSI (A Needs-Based Program)
SSI is designed for individuals with disabilities who have limited income and resources. Eligibility is determined based on financial need.
- Income limits: Your countable income must be below the federal benefit rate. These amounts change annually. You can find current SSI income and resource limits on the SSA website.
- Resource limits: Your total countable resources, including cash, bank accounts, and stocks, must not exceed $2,000 per person or $3,000 as a couple.
For SSDI (An Insurance Program)
SSDI is based on your work history and the payroll taxes (FICA) you have paid into the Social Security system.
- To qualify for SSDI benefits, you must have earned a certain number of work credits over the course of your life. Generally, five years of full-time work in the last ten years leading up to your disability are required, but the specific number depends on your age.
- The exact number of work credits needed for SSDI can be found on the SSA’s website. There are no income or asset limits for SSDI eligibility, but you must not be engaged in Substantial Gainful Activity (SGA) while receiving benefits.
The Critical Role of Your Residual Functional Capacity (RFC)
Your ability to work is assessed through a Residual Functional Capacity (RFC) evaluation. This is an in-depth assessment of what you are still able to do in a work environment despite your limitations. Your RFC rating (e.g., sedentary, light, medium) is compared to the requirements of your previous work and other jobs in the national labor market.
The evidence supporting your RFC rating is crucial. A strong recommendation from your treating doctor stating that your condition prevents you from working can greatly increase your chances of approval.
Navigating the Process with an Experienced Guide
The process of applying for SSI or SSDI benefits can be challenging, with many procedural hurdles and strict deadlines. To ensure a successful claim, it is essential to provide thorough and up-to-date medical evidence, accurately detail your work history, and understand the complex medical-vocational rules.
Contact the SSDI Lawyers at Tabak Law
If you are unsure about your eligibility or have had your initial claim denied, please do not lose hope. Our experienced Milwaukee SSDI attorneys at Tabak Law can assist you in understanding the criteria, gathering the necessary evidence, and building a strong case.
We can help you turn hardship into hope. Contact Tabak Law for a free case evaluation.