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Social Security Disability

Am I eligible for Social Security Disability Insurance benefits (SSDI)?

Answer: Eligibility for SSDI benefits is based upon a formula of earned credits and your age at the time of onset of disability. You earn social security credits when you work in a job in which you pay social security taxes. Credits are based on your earnings in each quarter of a calendar year. For example, in 2016, for each $1260.00 of earnings, you receive one (1) credit, up to a maximum of four (4) credits.

How many credits do I need for SSDI benefits?

Answer: This depends on your age at the time you become disabled.

If you become disabled before age twenty-four (24), you generally need six (6) credits by the quarter when your disability begins.

If you are twenty-four (24) through thirty (30), you generally need credits for half of the period between age twenty-one (21) and the time you become disabled.

If you are disabled at age thirty-one (31) or older, you need at least twenty (20) credits in the ten (10) years immediately before you became disabled.

What is my Last Date of Insured Eligibility (LDIE)?

Answer: This date is the last date you would have twenty (20) credits in the ten (10) years before that date. If that date is before the date you file for benefits, then the medical evidence must show you were eligible for benefits on that date.

If I am not eligible for SSDI benefits, are there other benefits for which I may be eligible?

Answer: If you meet disability requirements for SSDI benefits, but you do not meet the credit requirements, you may be eligible for Supplemental Security Income (SSI) benefits. These benefits are available for individuals who meet the same disability requirements as SSDI beneficiaries plus meet minimal household income requirements and have limited resources. These requirements are too complex to be detailed here. We recommend you contact your nearest Social Security Administration (SSA) office and inquire if you qualify.

In general, what does the SSA consider when determining if my disability qualifies me for SSDI benefits and/or SSI benefits?

Answer: You will be considered disabled if you cannot do work you did before the onset of your disabling condition(s) and based upon SSA criteria, they determine you cannot adjust to other work because of your medical condition(s). Your disability also must last or be expected to last for at least a year or to result in death. However, the condition cannot be caused by or substantially aggravated by street or prescription drug use or alcohol abuse.

Does the SSA have a procedure for evaluating if one’s disability qualifies them for SSDI benefits or SSI benefits?

Answer: Yes. It is a five step sequential procedure:

1. Are you working?

If you are and your earnings average more than $830.00 a month, you generally cannot be considered disabled. If you are not working, they go to the next step.

2. Is your condition “severe?”

Your condition must interfere with basic work-related activities for your claim to be considered. If it does not, they will find that you are not disabled. If it does, they will go to the next step.

3. Is your condition found in the list of disabling impairments?

The SSA maintains a list of impairments for each of the major body systems that are so severe they automatically mean you are disabled. If your condition is not on the list, SSA has to decide if it is of equal severity as an impairment on the list. If it is, they will find that you are disabled. If it is not, they go to the next step.

4. Can you do the work you did previously?

If your condition is severe, but not at the same or equal severity as an impairment on the list, then SSA determines if it interferes with your ability to do the work you did previously. If it does not, your claim will be denied. If it does, they go to the next step.

5. Can you do any other type of work?

If you cannot do the work you did in the past, SSA evaluates if you are able to adjust to other work. They consider your medical conditions and your age, education, past work experience and any transferable skills you may have. If they decide you cannot adjust to other work, your claim will be approved. If they decide you can, your claim will be denied.

How does the SSA go about evaluating a claim?

Answer: The SSA contracts with the State of Michigan Disability Determination Service (DDS) to evaluate initial claims using SSA guidelines.

This agency also processes claims for the Family Independence Agency (FIA). They contract with doctors to evaluate medical records submitted. Also, they have the authority to have a claimant evaluated by a doctor if the case manager feels the medical records are not adequate.

How does the SSA calculate my SSDI benefits?

Answer: Your SSDI benefit is the “old age” insurance benefit you would be eligible to receive if you were sixty-five (65) years old at the date of your onset of disability.

If I am awarded SSDI benefits or SSI benefits, do I also get Medicare or Medicaid benefits?

Answer: At the time you are awarded disability benefits, the SSA makes a determination of your “disability onset date” (see “What are my accrued benefits” below for explanation). You become eligible for monthly benefits 5 full months from this date. You become eligible for Medicare benefits 24 month after the firs month you are eligible for monthly benefits (or 29 months after your “disability onset date”). Alternatively, recipients of SSI benefits are eligible for Medicaid benefits as of the date of onset.

What are my accrued benefits?

Answer: SSDI benefits are considered long term benefits, not short term benefits. When awarding benefits, the SSA determines your “disability onset date.” This is the date which medical evidence establishes that you qualify for SSDI benefits. Benefits are not paid for the first five (5) months from that date and begin the first of the next month. However, the SSA can only calculate your accrued benefits back one (1) year from the date you file for SSDI benefits with the SSA. Thus, if you file for SSDI benefits more than seventeen (17) months from the “onset date,” you will not receive all possible accrued benefits

If I am awarded SSDI benefits, would my spouse and/or children receive a separate benefit?

Answer: Only dependent children are eligible for a separate benefit until they are sixteen (16) or until they graduate from high school, whichever is later.

If I have dependents receiving benefits under my SSDI, are they eligible for Medicare medical benefits?

Answer: No. There are no medical benefit programs for dependents of SSDI recipients.

Can I apply for SSDI benefits if I am receiving Early Old Age Insurance Benefits?

Answer: Yes. If for financial reasons, you need to collect your “old age” insurance benefits after your 62nd birthday, while your application for SSDI benefits is pending, you are not penalized. When your SSDI benefits are approved, you will receive the accrued difference between the two benefits, which is the difference between your befits at age sixty-two (62), and the amount you would have received had you waited to the age of sixty-five (65+). (Note, you may also apply after you are receiving early benefits if you subsequently become disabled).

Can it cost me money out of my pocket to retain an attorney to assist me in obtaining SSDI or SSI benefits?

Answer: No. Attorney fees are regulated by statute and the SSA. An attorney cannot charge a fee for his services without it first being approved by the SSA. The SSA allows an attorney to charge a fee of twenty-five (25%) percent of accrued benefits, up to a maximum of $5,300.00. An attorney may also charge for out of pocket expenses in obtaining medical records from the required medical care providers. There is no attorney fee charge on future benefits.

If I am awarded SSDI benefits or SSI benefits, do I also get Medicare or Medicaid benefits?

Answer: Two years (24 months) after your date of onset of disability for SSDI benefits, you become eligible for Medicare benefits. Alternatively, recipients of SSI benefits are eligible for Medicaid benefits as of the date of onset

If I have been self-employed, can I get Social Security Disability Insurance if I become disabled?

Answer: Self-employed people who become disabled can get Social Security Disability Insurance if they have paid the government enough self-employment tax and/or FICA tax to qualify for Social Security Disability Insurance coverage. However, many self-employed people neglect to pay the tax and do not qualify. Get two free booklets from SSA: "Social Security: How You Earn Credits," SSA Publication No. 05-10072; and "If You're Self-Employed," SSA Publication No. 05-10022.

Will my spouse's income affect my Social Security Disability Insurance?

Answer: Your spouse's income will not affect your Social Security Disability Insurance benefits. SSA considers your work capacity -- not the income or resources of your spouse. Your savings and investments also will not disqualify you.

However, a spouse's income could disqualify you from SSI or reduce your SSI benefits. SSI is not insurance like Social Security Disability Insurance; it is a welfare type program limited to people with very little income and resources. The government may reduce SSI benefits or end them if the beneficiary, the spouse, or anyone contributing to their support has significant income or resources. See the free booklet "Supplemental Security Income," SSA Publication No. 05-11000

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