Category: Social Security Disability Resources

Obtaining Social Security Disability (SSDI) and/or Supplemental Security Income (SSI) benefits is a complex process.  Those who successfully prove to the Social Security Administration (SSA) that they are unable to work often ask whether getting married will affect their benefits.  The answer is “no” and “maybe”.

SSDI and Marriage

For anyone receiving SSDI, because they paid into Social Security, getting married will not affect their continued receipt of SSDI benefits.

SSI and Marriage

For anyone receiving SSI benefits, getting married may have an impact.  The income of the person’s household is a factor in determining if one spouse can receive the full monthly amount of SSI, a reduced monthly amount, or none at all.  The SSA has household income guidelines which determines this.  So, as you contemplate marriage, examine your new spouse’s income from all sources and contact SSA to determine if your new spouse’s income will impact your SSI benefits.

What’s Next? 

If you need to speak with someone about SSDI or SSI and being married, please contact the Social Security Administration office at 800-772-1213 or visit their website at: https://www.ssa.gov/benefits/disability/.

Do I Automatically Qualify for SSI or SSDI Disability Benefits?   

Technically speaking, the answer to this question is no.  All persons currently receiving disability payments were required to submit an application, present detailed medical evidence of their physical or mental health conditions and meet certain non-medical requirements before ever receiving these benefits.  However, the process involved in getting there may have been less difficult for some recipients than it was for others, depending on the conditions the Social Security Administration relied on in approving their application.  

For more about the conditions which make the path to receiving disability benefits quicker and more straightforward, continue reading.

Is Your Condition in SSA’s Blue Book of Listed Conditions?

To be medically eligible for disability benefits, a person’s physical or mental health must be deemed severe and in accordance with the applicable disability standard established by the SSA. According to the SSA, an adult’s health condition is sufficiently severe for disability purposes if it prevents his or her capacity to work for one year or longer or is likely to cause death, while a child’s condition must be one that is terminal or that creates significant obstacles for his or her functional abilities.

Without more, these standards offer minimal guidance as to whether a particular individual’s health impairments are serious enough to entitle them to disability.  Social Security’s Blue Book adds substance to these standards and helps simplify disability determinations by providing an up-to-date list of health conditions which the Administration has determined are severe enough that those suffering from them should “automatically qualify” for disability benefits. 

Unfortunately, this doesn’t actually mean you will begin receiving disability payments the moment you are diagnosed with a listed condition. Individuals with such condition(s) are still required to apply for these benefits, and must include with their application their medical records, test results, and/or other reports or evaluations for SSA to review before determining whether there is enough objective and reliable medical evidence to support the diagnosis and to meet each of the criteria required for that condition, as prescribed by the condition’s Blue Book listing.

The conditions listed in the Blue Book are organized by major body system, with several qualifying diseases, disorders, and impairments listed under each.  Each listing provides an overview of the condition, the diagnosis or symptoms associated with the condition, and the types of evidence needed to qualify for disability benefits based on that condition.  Today, the types of conditions listed in the Blue Book are still primarily physical, but the list continues to grow and evolve alongside emerging research, technology, and other medical advancements.

Even if an individual’s physical or mental health impairment does not appear in the Blue Book, however, he or she may still be found disabled and eligible for benefits.  Applicants who can present reliable medical evidence which establishes their health condition or impairment is as severe or more severe than a listed condition, or which otherwise proves that their condition aligns with the above-referenced disability standard applicable to their claim may still be found disabled by the SSA.

Is My Condition Part of the Compassionate Allowance Program?

Often, the conditions listed in the Blue Book are confused with those which qualify for expedited treatment under Social Security’s Compassionate Allowance Program, or CAP.  Applicants who will receive the advantages of the CAP program are those suffering from a terminal illness or other disease or condition that typically lasts for one year or longer.  Under CAP, applications which reference or contain keywords related to a program-eligible condition are sent through an expedited review process, thereby allowing the applicant to begin receiving their benefits much sooner than they would if their application been subject to the normal review and processing timeline.

Non-Medical Eligibility Requirements

Even if an individual suffers from a condition listed in the Blue Book or under the Compassionate Allowance Program and would be considered disabled and medically eligible, he or she will not receive benefits unless they also have enough work credits to be covered by Social Security Disability Insurance, or SSDI, or fall below certain established income and asset limits applicable to the receipt of Supplemental Security Income (SSI).  

For more information on the non-medical eligibility requirements applicable to these programs, please reference our previous blog posts:

Should I Apply For SSI Or SSDI?

Am I Eligible For Disability Benefits?

What’s Next?

Determining your chances at being approved for disability benefits can be challenging, and requires an in-depth analysis of several medical and non-medical factors in most cases.  If you would like to speak with one of our attorneys about whether your health impairments may entitle you to benefits under SSDI or SSI, please contact our firm at (417) 883-7800 to schedule a consultation.

Am I eligible for Disability Benefits?

For persons dealing with severe impairments to their physical or mental health, working can be challenging, or impossible in some cases.  Many health conditions inhibit the performance of physical activities such as heavy-lifting or standing for extended periods of time, while others impact fine-motor skills or skills that require focus and concentration.

Unfortunately, persons who lack these types of skills and abilities are often unable to find or maintain certain jobs, or participate in the workforce altogether.  However, when their health limitations are to blame for their inability to work and earn an income, they may be able to receive some monthly pay in the form of Social Security disability benefits.

Social Security distributes disability benefits in two forms—Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).  To be eligible for either, a person must first establish they are disabled as defined by the Social Security Act.  Once disability is established, they will qualify for disability pay if they meet the additional, non-medical requirements for SSDI or SSI eligibility.

Determining eligibility for disability benefits can be difficult, and requires an analysis of the following factors and circumstances.

Are You Unable to Work?

Just because you are disabled to some extent or are unable to engage in certain activities does not mean Social Security will find that your health prevents you from working.  Under the Social Security Act, a person is disabled only if they are unable to work or earn more than minimal income for a period of 12 months or longer due to a sufficiently severe health condition established by their medical records.

Social Security has a list of conditions called “Listed Impairments” that they have predetermined are severe enough to meet the above criteria.  If an individual’s medical records show they’ve been diagnosed with a listed impairment with designated attributes indicative of its’ severity, he or she will be considered disabled and medically eligible for disability benefits.  A person whose condition or diagnosis does not appear on the list may still be eligible, though, if their medical records show their condition shares the same severity attributes as those specified under an impairment listed.

When the requisite severity level cannot be established or confirmed based on medical records alone, Social Security must assess the impact of the applicant’s condition on their ability to work.   Applicants who are currently working and earning $1,310 or more in wages each month will not be eligible, as this demonstrates their ability to work despite any limitations caused by their condition.  In addition to assessing positions currently held, Social Security reviews the applicant’s past 15 years of work experience to determine whether their physical or mental health limitations prohibit them from performing all full-time jobs they held for 3 months or more during this period.

Depending on their age, educational level, and transferable skills, Social Security may also be required to assess the applicant’s ability to perform other types of work less physically and/or mentally demanding than that which was required for their past jobs.  An applicant over age 50 and without any past sedentary or “desk-job” experience will be found disabled from working so long as they did not acquire skills through past work that would transfer to a sit-down job. For example, a 52-year-old applicant who worked as a nurse for several years until a recent back injury would have a lesser chance of being found medically eligible for disability benefits, as he or she would have acquired skills as a nurse transferable to medical billing or hospital administration jobs.

Do You Meet the Requirements of SSDI or SSI?

If the applicant cannot perform any previous work nor other types of work, Social Security will find them disabled.  Whether they can receive disability benefits requires further analysis of additional, non-medical eligibility criteria for SSDI and/or SSI, however.  These requirements are detailed below, but generally require an applicant to have “insured” status to qualify for SSDI, and/or minimal income and assets for SSI.

Criteria & Requirements for SSDI

SSDI is available to disabled persons who are “insured” by SSDI because they’ve made sufficient contributions to the relevant Social Security fund by paying taxes on their wages or self-employment earnings over the years.  For an individual to be insured, they must have earned the requisite number of relatively recent work credits for a person becoming disabled at their age.  A work credit is granted to individuals who earn wages greater than or equal to a designated amount in one 3-month quarter of a year.  This amount fluctuates depending on the average wage rate, but is $1,470 in 2021.

Individuals who became disabled before age 24 must have earned at least 6 credits in the three-years prior to the onset of their disability, while persons who became disabled between age 24 and 31 must have earned work credits in at least half of the 3-month quarters that occurred since the age of 21.  Those who become disabled at age 31 or older must have at least 20 credits in the 10-year period proceeding the onset of their disability.

Some older applicants must have earned more credits overall to be eligible, though not all must have been earned in close proximity to the onset of the applicant’s disability.  A breakdown of the number of work credits and years worked required by applicants of varying ages is available here.

Criteria & Requirements for SSI

A disabled individual who does not meet the recent work or duration of work requirements described above may nevertheless qualify for disability benefits through SSI, depending on the income and resources they have available.

SSI is restricted to disabled persons whose income and resources fall below designated levels, which may be higher or lower based on the person’s marital status and living arrangements. In general, disabled persons are not eligible for SSI unless their household income is below the applicable Federal Benefit Rate, or FBR, which is currently $794 per month for single-persons and $1,191 per month for married couples.

The types of income that counts towards this monthly limit include wages earned by you or your spouse as well as most non-earned income and government benefits such as food stamps or housing assistance.  A portion of each income source is deducted from the month’s total household income, though, and does not count towards the SSI limit.  Also, if the SSI applicant or recipient has one or more dependents, further deductions may be taken.

In addition to their monthly income falling below the applicable limit, an applicant must have minimal available resources to qualify for SSI.  Available resources include cash as well as any asset that can be readily converted to cash and used to support the applicant and/or their family, apart from their home and one automobile used for transportation.  Persons who are single must own less than $2,000 in resources to be eligible for SSI, while a married person may jointly-own up to $3,000 in resources to be eligible.

For personalized recommendations or guidance when applying for disability benefits, call Reynolds & Gold Law at (417) 883-7800 to schedule a meeting with a Social Security Disability attorney.

The U.S. Social Security Administration provides resources to individuals and families in need through various benefit programs.  Persons with severe physical or mental health conditions can receive monthly disability payments through Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), for example, so long as they can satisfy the designated eligibility requirements.

To be eligible for benefits under either program, applicants must first establish that they are disabled.  Under Social Security regulations, a person is not disabled unless their health significantly limits their ability to perform basic job functions for one year or longer.  Applicants who are working and earning more than a certain amount each month are engaging in “Substantial Gainful Activity” and will not be eligible, as their earnings show their ability to work despite the limitations of their physical or mental health. In 2021, a person is engaging in substantial gainful activity if their monthly wages equal $1301 or higher.

Individuals who meet the above requirements and are therefore considered disabled will not always qualify for monthly disability payments, though.  To receive benefits through SSDI, an applicant’s recent work history must be of a particular nature and duration.  If it’s not, they may be able to receive SSI benefits, but only if their monthly income and assets fall below applicable limits.

Such eligibility criteria are important, as they help the Social Security Administration identify which applicants are truly disabled and in need of assistance.  However, some income-based restrictions can have unintended consequences when current beneficiaries are interested in joining the workforce if their condition improves.  Though working would increase their income, confidence, and general life satisfaction, many beneficiaries are afraid to do so for fear that their condition will return or worsen, forcing them to quit their job and being left without income from wages or disability benefits.

Work Incentives

To address these concerns and to encourage capable persons to work, the Social Security Act makes exceptions to some SSDI and SSI eligibility requirements.  These exceptions are referred to as work incentives, as they minimize the risks involved in trying to work while on disability.

The income-based restrictions on SSDI and SSI eligibility are detailed below.  If you currently receive benefits under either program and are interested in looking for employment, review the restrictions applicable to you and consider how the applicable work incentives can help you try to work with reduced risk of losing benefits or eligibility.

Work & SSDI

As stated above, persons who earn $1,301 or more each month in wages are engaged in substantial gainful activity and are not considered disabled for purposes of receiving Social Security benefits.  While this restriction applies to the initial eligibility determination of all applicants, it is only an ongoing restriction for those determined to be disabled and entitled to disability benefits through SSDI.

• Trial Work Program (TWP): Under TWP, those receiving SSDI will continue to receive monthly payments for anywhere between 9 months to 5 years while they try to decide whether they can return to work full-time. The trial period will last until the individual’s monthly earnings reach or exceed a designated amount for a total of 9 months, whether consecutive or staggered. Currently, a month is counted if the TWP participant earns at least $940, or is self- employed and works more than 80 hours.
• Extended Period of Eligibility (EPE): This period is an extension of the TWP, and lasts 36-months from the end of an individual’s trial work period. In any month during this period where the individual earns less than the designated SGA amount, they will be paid their monthly SSDI amount.  If the individual is already earning the SGA amount when the period begins, they will still receive their SSDI payment for that month and for the two months that follow.

Work & SSI

Applicants who are determined to be disabled but who lack the requisite work history to qualify for SSDI may receive SSI if their countable income is lower than the current federal benefit rate (FBR).  In 2021, the rate for individuals is $794/month, while the rate for persons living with a spouse is $1191/month. The types of income that count towards this limit include wages and earnings, benefit payments, and free food and rent.

• Earned Income Exclusions: The first $65 of income from earnings or wages is deducted from an individual’s countable income for that month, as well as half of any earnings or wages above this amount.  Further, the first $20 of any other type of countable income they receive that month will be deducted as well.  If the recipient Recipients that live with their spouse may have to account for their income even if their spouse is ineligible, depending on how much their spouse earns in a month.  If the spouse earns more than the difference between the individual FBR and the FBR for couples, their income will be counted.  The same earned income exclusions apply, though, and their income limit will be the higher FBR that applies to couples.

In practice, these rules and exceptions allow recipients who work but have no other countable income to remain eligible for SSI even while working and earning an income more than two times greater than the applicable FBR.  However, any amount of earned income that is not excluded will be deducted from the maximum payment available from SSI-up to $794 for single recipients, and as much as $1191 for those who are married.

Additional Work Incentives (SSDI or SSI)

• Expedited Reinstatement: Individuals who lost eligibility due to an increase in earnings or income that later become unable to work because of their condition may request reinstatement of their benefits without re-filing. Once such request is submitted, an individual can receive temporary benefits for up to 6 months while the SSA approves and processes the reinstatement.  This right expires five years after the initial loss of eligibility.
• Impairment-Related Work Expenses: Individuals who require impairment-related accommodations to work may deduct any related expenses from their total earnings or wages.

For more information on SSDI and SSI eligibility when working or you need more information about the Social Security disability process, contact our attorneys at Reynolds and Gold LLC at 417-883-7800.

Paying for medical costs and living expenses when you are no longer able to work due to a disability is hard, if not impossible. If you’ve worked and paid into Social Security, you may be eligible for Social Security Disability Insurance (SSDI). Though SSDI offers needed financial support, you likely won’t receive benefits until months after you’ve applied.

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