When you have suffered an illness or injury that has left you unable to work, you may be able to collect Social Security benefits under one of two safety net programs. Social Security is generally a retirement benefit, but these programs allow you to collect payments before reaching retirement age if your disability meets strict government guidelines. Knowing which of the two programs you are eligible for is an important first step in getting the benefits you need. We explain the differences here.
Supplemental Security Income (SSI)
This program is offered to those over the age of 65 as well as disabled people who are younger. In order to qualify, however, you must demonstrate financial need. In other words, this program is for people with little or no income who are elderly, blind, or disabled and who struggle to pay for food and shelter. Your benefit payment will depend on your income—the more you make, the less you will get in SSI. If you make more than the maximum allowable income, you will not qualify for this program at all.
In most cases, if you qualify for SSI, you also qualify for Medicaid, so along with the cash payments, you will also get comprehensive medical coverage. In 2017, the maximum SSI payment an individual can receive is $735 per month, but that amount is reduced based on additional earnings, so many people get less than that.
Social Security Disability Insurance (SSDI)
Unlike SSI, SSDI is not need-based. People of any income level can qualify for SSDI if they worked and paid enough into the Social Security system and have a recognized illness or disability. An applicant is considered to be fully insured if he has paid into the system for roughly five of the previous ten years. Younger applicants for whom this is not possible must meet a different eligibility standard. After a worker turns 21, he or she must have worked three months (one-quarter) out of every subsequent year in order to be fully covered. Five years after stopping work, applicants will no longer be eligible.
While SSDI recipients do not generally qualify for Medicaid, they can begin receiving Medicare benefits two years after they begin receiving SSDI benefits, no matter how old they are. Medicare covers some routine doctor visits and hospital services, but is not as comprehensive a program as Medicaid. Many recipients find they need additional health insurance to cover all of their healthcare costs.
Those collecting SSDI may be eligible to receive up to 12 months’ worth of benefits retroactively from the date of their application. SSI recipients do not qualify for retroactive benefits. In 2017, the average SSDI payment is $1,171, but people may receive more or less than this, depending on what they paid into the system.
Of course, you will not qualify for either benefit if you cannot prove that you are truly disabled. The burden of proof falls on the claimant, who must prove through medical evidence, that he or she is unable to perform gainful employment because of a disability that meets one of the following criteria:
- The condition is expected to result in death.
- The disability has persisted for at least 12 months.
- The disability is expected to persist for no fewer than 12 months.
Establishing disability relies on four areas of evidence: objective medical facts, the diagnosis and opinion of doctors, pain experienced by the claimant and the claimant’s education, age and employment history.
How a New Mexico SSDI Attorney Can Help
An estimated 65 percent of first-time applicants are denied SSDI benefits. When you work with an experienced SSDI attorney on your claim, you can be confident that your application is complete, that you have all the necessary medical evidence, and that you are submitting the strongest possible application. Call our office today to find out how Keller & Keller can help you apply for SSDI benefits.