Understanding Social Security Disability Benefits

SSDI is an earned benefit for those who have worked, paid Social Security taxes, and accumulated work credits before becoming disabled. An individual’s average lifetime earnings before the onset of their disability determines their monthly benefit amount.

SSI offers financial assistance to elderly, blind, or disabled individuals with limited income and resources. Eligibility for SSI isn’t contingent upon prior work history – current financial needs determine the benefit amount. A maximum federal benefit rate is set each year.

Determining your eligibility involves several factors, such as work history, the severity of the medical condition, and your ability to engage in substantial gainful activity.

Determining your eligibility involves several factors, such as work history, the severity of the medical condition, and your ability to engage in substantial gainful activity.

Work History and SSDI Eligibility

To qualify for Social Security Disability Insurance (SSDI), you must have worked and paid Social Security taxes for an outlined period. Work requirements vary depending on your age at the time you become disabled.

Generally, you need 40 work credits to qualify for SSDI, with 20 earned in the last ten years before your disability arose. Younger workers may qualify with fewer credits – for example, if you become disabled before age 24, you may be eligible with just six credits earned in the three years prior to your disability onset.

Medical Eligibility for SSDI and SSI

You must also have a medical condition that meets the Social Security Administration’s definition of disability to qualify:

1. You have a medically confirmed physical or mental impairment that has lasted or is expected to last for at least 12 consecutive months or result in death.
2. Your impairment is severe enough to prevent you from engaging in substantial gainful activity (SGA), defined as earning above a monthly threshold.

The SSA maintains a list of conditions severe enough to automatically qualify for benefits, known as the Blue Book. If yours isn’t listed, you may still qualify for disability advocacy if it’s deemed medically equivalent to a listed condition or if it significantly limits your ability to perform work-related activities.

Supplemental Security Income (SSI) Eligibility

If you have a limited work history and don’t qualify for SSDI, you may still be eligible for Supplemental Security Income (SSI) if you have limited income and are disabled, blind, or over age 65. SSI eligibility looks at financial need rather than work history. Your monthly income and total assets must fall below the thresholds set by the SSA to qualify.

The Importance of Medical Evidence and Professional Guidance

Proving eligibility requires thorough medical evidence and a compelling case. An attorney can help you gather, organize, and submit your medical records, treatment history, and other relevant documentation to support your claim. 

They can also guide you through the complex application and appeals process, ensuring you meet every deadline and requirement. Legal counsel can significantly increase your chances of approval, especially if your initial application was denied and you must navigate the appeals process.

If you believe you may be eligible for Social Security disability benefits, consult with an attorney at First Ally Law in Ballwin, Missouri. We can evaluate your case and provide personalized support.

Determining the amount of SSDI monthly benefit leverages a complex formula that takes into account your average indexed monthly earnings (AIME) during your working years. In 2024, the average SSDI payment is $1,537.33 per month. However, the maximum monthly SSDI benefit for an individual who has paid the highest amount into the Social Security system over their working lifetime is $3,822.

It’s possible to be eligible for and receive benefits from both SSI and SSDI, a situation known as “concurrent benefits.” It occurs when an individual qualifies for SSDI but whose monthly benefit is low enough that they’re also eligible for SSI. The individual receives their full SSDI benefit, and their SSI payment is reduced by their SSDI benefit amount, less a $20 general income exclusion.

SSDI benefits don’t technically “stop” at a specific age but rather transition to regular Social Security retirement benefits when recipients reach their full retirement age (FRA). The FRA varies depending on the year you were born, ranging from 66 to 67 for those born in 1943 or later.

Once you reach your FRA, your SSDI benefits will automatically convert to retirement benefits, with the amount remaining the same. You won’t need to take any action for the transition to occur.

In most cases, SSDI pays more than SSI due to the fact that benefits reflect the individual’s past earnings and contributions to the Social Security system. As of 2024, the average monthly SSDI benefit is $1,537.33, while the maximum federal SSI payment for an individual is $943 per month. It’s important to note that SSDI recipients may be eligible for Medicare after a 24-month waiting period, while SSI recipients are typically eligible for Medicaid immediately.

The 5-year rule, also known as the “recent work test,” is an eligibility requirement for SSDI. It states that you must have worked and paid Social Security taxes for at least 5 of the ten years immediately before the onset of your disability.

The rule ensures that disabled individuals have made suitable contributions to the Social Security system to qualify for SSDI benefits. The exact number of work credits needed varies depending on one’s age at the time of disability, with younger individuals generally requiring fewer credits.

The SSA doesn’t publicly rank disabilities by approval rates. However, certain conditions receive regular approval for SSDI and SSI based on their prevalence and the likelihood that they meet the definition of disability.

Musculoskeletal disorders, such as back injuries, spinal disorders, and arthritis, are among the most frequently approved conditions. Mental health conditions like depression, anxiety disorders, and intellectual disabilities also have relatively high approval rates. Other commonly approved disabilities include respiratory disorders, cardiovascular conditions, neurological disorders, and cancer.

The concept of a $16,728 Social Security “bonus” is a misleading claim often used by advertisers or scammers to entice individuals to purchase products or services. In reality, the bonus doesn’t exist. Be cautious of any promises of large bonuses or secret strategies for maximizing your Social Security benefits.

The 12-month rule is a critical component of the SSA’s definition of disability for SSDI and SSI. Your medically confirmed physical or mental impairment must have lasted or be expected to last for a continuous period of at least 12 months or expected to result in death or long-term disability to qualify for benefits.

As a result, short-term or partial disabilities don’t qualify for SSDI or SSI. The 12-month duration requirement ensures that those with long-term, severe impairments that significantly limit their ability to engage in work-related functions receive benefits.

Missouri residents can expect the following:

• Medicaid eligibility: In most states, including Missouri, individuals who qualify for SSI are automatically eligible for Medicaid. However, Missouri has specific eligibility criteria for its Medicaid program, known as MO HealthNet. Some SSI recipients may need to meet additional requirements to qualify.
• SSDI and SSI approval rates: Approval rates may vary slightly by state due to differences in applicant demographics and medical and vocational resource availability.
• Local resources: Missouri residents may have access to state-specific resources, such as disability advocacy organizations or legal aid services, that can offer additional support and guidance throughout the application and appeals process.