Elder Law

What You Need to Know About Qualifying for SSDI and SSI

If you are unable to work due to a serious health condition, there is a good chance you can qualify for free health insurance and monthly benefits from the United States government. About twenty million disabled Americans currently receive assistance from the Social Security Administration (SSA) for disability through SSI and SSDI. Although the medical eligibility requirements are the same, the two programs are different. Your medical condition must extend for a minimum of one year or result in death; however, you can also meet non-medical requirements to receive benefits. Before applying, understanding the qualification process for both SSI and SSDI will increase your initial chance of success and get you benefits quicker.

Supplemental Security Income (SSI)

The Supplemental Security Income (SSI) program pays monthly benefits to adults and children with blindness or disability whose resources and income are below a specific financial threshold. SSI also makes payments to those individuals aged 65 or more without disabilities who meet the financial qualifications. SSI disability benefits become available for the first full month after the date of filing your claim. Even if you are receiving SSDI or retirement benefits, you may still be eligible to receive SSI.

Social Security Disability Income (SSDI)

The Social Security Disability Insurance (SSDI) program pays benefits to you and specific family members if you qualify as “insured.” Insured means you have worked recently and long enough to pay Social Security taxes on your earnings. Benefits through SSDI have a five-month waiting period. Therefore your benefit payments do not begin before the sixth full month of disability. This waiting period begins on the first full month after the date the SSA decides your disability began.

Disability Attorneys

Statistical outcomes to receive SSI and SSDI benefits are greatly enhanced if you hire a disability lawyer. Your lawyer will develop a case as to why you meet eligibility criteria under the Social Security disability law.

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Physical conditions will have to meet either one or more of Social Security’s disability listings:

  • Residual Functional Capacity (RFC) precludes you from participating in jobs due to exertion levels
  • Non-Exertional limitations such as difficulty with concentration or memory prevent you from working.
  • Combinations of exertional and non-exertional limitations

Because of the complexity of disability law, rules and regulations, evidence points strongly to better outcomes with a disability attorney handling your application and claim.

Proving You Qualify for Benefits

Even if you have insufficient medical records, your attorney can help you arrange to have medical testing procedures before you apply for benefits to increase your chances of approval during your initial application. Suppose you have poor breathing due to Chronic Obstructive Pulmonary Disease (COPD) with conditions such as emphysema or chronic bronchitis. Your lawyer can arrange for an ejection fraction measurement test to gauge the heart’s blood flow. Your test data helps evaluate whether you meet Social Security’s COPD or the CHF listing criteria.

Filling out your disability application and supporting documentation must clarify to a claims examiner that your conditions meet these medical listings or that limitations preclude you from working. A properly filed application at the outset of your claim for disability benefits greatly enhances your chance of success.

A Disability Case has Minimal Upfront Costs

A disability attorney typically receives payment on contingency. Legally this means payment is due only if you win your case. Your representing disability lawyer is keen on presenting important medical records, test results, doctor evaluations, and proper paperwork to ensure they will be successful for you and thus receive payment. The federal government oversees the fee structures a disability attorney can charge. Federal law typically limits a Social Security disability attorney’s fee to twenty-five percent of your back pay or $6,000, whichever is less. SSDI back pay refers to benefits you would have received from the time of your application to when your claim receives approval, minus a five-month waiting period.

A survey of readers of lawyers.com finds the average fee Social Security lawyers collected was $2,900 for SSI and $3,750 in the case of SSDI. Overall this money is well spent because statistics show the claimant may not have received SSA approval or may have been approved but with a reduced monthly benefit.

Hiring a disability attorney to help you become qualified to receive SSI and SSDI benefits is a smart move. While it is not unheard of that self-representation can meet with success, the intricacies of the qualification process and the information required to become eligible are daunting. There are many great reasons to retain a disability lawyer to protect your disability application claim for SSI and SSDI benefits. We hope you found this article helpful. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact our Reno office by calling us at (775) 853-5700.

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