Social Security Disability Benefits

Social Security disability benefits benefits are paid if a worker is so severely disabled (physically or mentally) that the disability is expected to last at least 12 continuous months or result in death.  

The Social Security Administration (SSA) manages two disability programs: Social Security Disability Insurance (“DIB” or “Title II”) and Supplemental Security Income (“SSI” or “Title XVI”). Although both programs apply the same substantive criteria to determine disability for adults, eligibility requirements for each program differ substantially.

Supplemental Security Income (“SSI” or “Title XVI”)

SSI is a federal program that provides monthly payments to people who have low-income and are:

  • age 65 or older
  • blind; or
  • disabled (per Social Security regulations).

Unlike Social Security Disability Insurance (DIB) benefits, eligibility for SSI is contingent on one’s household income and financial resources falling below certain thresholds.  So a person need not have worked a certain number of years (and paid Social Security taxes) to receive SSI benefits.  But, it is difficult to qualify for SSI because the resource threshold is so low.  For example, a single individual may have no more than $2,000 in disposable assets ($3,000 for a couple), including:

  • cash;
  • money in a checking or savings account;
  • cash value in life insurance policies (over $1,500);
  • stocks and bonds, household good (over $2,000);
  • motor vehicles (any value in the first car over $4,500 counts as an asset); and
  • real estate (other than the home in which the claimant resides).

Additionally, in order to be eligible for SSI, the individual must apply for other cash benefits for which he or she may be eligible, including DIB benefits.  For those claimants who receive a low DIB benefit, SSI does exactly what its name implies: supplement income. For example, if an approved disability claimant receives DIB benefits in the amount of $350, an SSI award could be used to guarantee that the claimant’s total monthly benefits equal the full SSI amount—$733/month. Thus, the DIB recipient would receive an additional $383 in SSI to bring her total monthly benefits to $733, a sum equal to the full SSI monthly benefit amount.

Social Security Disability Insurance (“DIB” or “Title II”)

Unlike SSI, if an individual is found disabled, the individual will receive DIB benefits regardless of the individual’s assets or financial resources.  But before an individual is found disabled he must (1) earn a certain number of work “credits” and (2) have a medical condition that meets the SSA’s definition of disability.

Determining Work Credit Eligibility

To qualify for DIB, you must have worked a certain number of years in a job or combination of jobs where you paid Social Security taxes. As you work and pay taxes, you earn Social Security “credits.”  Specifically, you need to earn a sufficient number of work credits based on your earnings—so the more you earn (in your lifetime), the more credits you accrue.

In 2014, you must earn $1,200 to get one Social Security work credit, or $4,600 to get the maximum four credits per year.  It does not matter which quarter you collected the earnings.  Therefore, an individual need only earn a minimal amount of money to get credit for a year of paying into Social Security.

The number of credits you need to be eligible for DIB benefits depends on (1) the age you become disabled, (2) the number of credits you earned, and (3) the number of years you worked.  The older you are, the more work credits you need to qualify for benefits.  There are two tests you must pass that involve work credits to be eligible for DIB benefits: the “recent work test” and the “duration of work test.”

Recent Work Test

If you are 31 or older you must have worked at least 5 of the last 10 years to pass the recent work test. In other words, you need to have earned 20 credits in the 10 years immediately before becoming disabled.

If you are between 24 and 31, you need to have worked at least half the time since turning 21. So, if you are 29, you must have worked at least 4 years out of the last 8 years (or have earned 16 credits in the last 8 years).

If you are under 24, you must have worked at least 1 ½ years in the 3 years immediately before becoming disabled (or have earned 6 credits in the last 3 years).

Duration of Work Test

You must have worked the following number of years or earned the following number of credits to qualify for DIB benefits.

Became Disabled at Age Number of Credits Needed Number of Years Worked
21 – 24 6 1.5
24 – 31 6-18 1.5 – 4.5
31 – 42 20 5
44 22 5.5
46 24 6
48 26 6.5
50 28 7
52 30 7.5
54 32 8
56 34 8.5
58 36 9
60 38 9.5
62 or older 40 10

Those who have not earned enough to qualify for DIB benefits may still be eligible for SSI, if you are able to show financial need—e.g. have low income and assets.   It is also possible to file for DIB benefits based on the earnings record of another—e.g. one’s parent (if the disability started prior to age 22) or one’s deceased spouse (in specific circumstances).

Determining Medical Disability

To be eligible for DIB benefits, you must also have a medical condition that meets the SSA’s definition of disability. Disability is defined as “the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” (42 U.S.C. § 423(d), 20 C.F.R. §§ 404.1505(a), 416.905(a).) To assist in this determination, Social Security regulations set forth a five-step sequential evaluation process. (Id. §§ 404.1520, 416.920.)

Are you working?

The first step is to determine whether an individual has engaged in substantial gainful activity since the alleged onset date of the disability. Work is substantial if it involves “significant physical or mental activities” and gainful if it is done “for pay or profit.” (Id. § 404.1572.) For the year 2014, substantial gainful activity is defined as monthly earnings of $1,070 or more. An individual who has engaged in substantial gainful activity throughout the entire period in which disability is alleged will not be found disabled and will not proceed to the remaining steps, unless certain exceptions apply.

Is your medical condition “severe”?

The second step asks whether an individual has a severe, medically determinable impairment that is expected to result in death, or has lasted or is expected to last for a continuous period of at least 12 months. (Id. § 404.1509.) Social Security Ruling (SSR) 85-28 clarifies that an impairment is “severe” if it causes more than slight abnormality or combination of slight abnormalities having more than a minimal effect on an individual’s physical or mental ability to perform basic work activities. This is a threshold question, and again the evaluation ceases if it is not met.

Is your medical condition on the List of Impairments?

Step three is the most technical, and asks whether an individual has an impairment that meets or equals in severity a listed impairment. (20 C.F.R. §§ 404.1525, 416.925.) The Listing of Impairments is found at 20 C.F.R. part 404, subpart P, appendix 1, and contains for each body system, impairments established by specific criteria that are considered to prevent an individual from doing any gainful activity, regardless of an individual’s age, education, or work experience. If an individual is not found to meet or equal a listed impairment, his or her residual functional capacity must be assessed. (Id. §§ 404.1545, 416.945.) This is defined as the most an individual can do despite the limitations caused by his or her medically determinable impairments. Limitations may be exertional (the ability to sit, stand, walk, lift, or carry), nonexertional (postural, manipulative, communicative, or visual limitations), or mental (the ability to understand and perform tasks, sustain concentration for extended periods, interact with others, and adapt to changes in a work routine). (SSR 85-15, 1985 WL 56857 (1985).)

Can you do the work you did before?

Step four asks whether an individual can return to past relevant work, defined as work that has been performed long enough to learn the job, at substantial gainful activity level, and within 15 years of the date of adjudication. (20 C.F.R. §§ 404.1565, 416.945.)

Can you do any other type of work?

Finally, step five asks whether an individual’s impairments prevent performance of other work that exists in significant numbers in the national economy. (Id. §§ 404.1560, 416.960.) This is determined by applying medical-vocational grid rules based on an individual’s exertional capability, age, education, and vocational background. In cases where an individual does not meet a medical-vocational grid rule, vocational expert testimony may be required to compare his or her residual functional capacity against the requirements of jobs that exist in significant numbers in the national economy.  An individual who cannot perform his or her past relevant work or other work that exists in significant numbers in the national economy is found to be disabled, unless certain exceptions apply.

As we are dealing with a hypothetical individual, it is immaterial whether such work exists in the individual’s immediate area, or whether a specific job vacancy exists, or whether the individual would have been hired if he/she applied for work.

Average 2014 monthly Social Security benefits

  • Disabled Worker: $1,148
  • Disabled Worker with a Spouse and Child: $1,943

2014 monthly SSI payment rates (does not include state supplement, if any)

  • $721 for an individual
  • $1,082 for a couple

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