Social Security Disability Information

The Social Security Administration governs two benefit programs: retirement benefits for workers who have reached the prescribed retirement age; and disability benefits for people who are unable to work but have not yet attained the prescribed retirement age. There are two disability benefit programs: Social Security Disability Insurance, also known as SSDI; and Supplemental Security Income, also known as SSI.

What is Social Security Disability (SSDI)

• The SSDI program pays benefits to you and certain family members if you are disabled, worked long enough and paid Social Security taxes. SSDI includes Medicare insurance. Your adult child may also qualify for benefits on your earnings record if he/she became disabled prior to age 22.

What is Supplemental Security Income (SSI)

• The SSI program pays benefits to disabled adults and children who have limited income and resources. SSI includes Medicaid insurance, but it does not pay benefits to family members.

Who is disabled?

Social Security determines disability using a 5-step evaluation:

1. Are you working?

   If you are working and your earnings average more than a certain amount each month, you are not disabled. The amount changes annually. If you are not working, or your average monthly earnings do not exceed that amount, then your medical condition is reviewed. 

   NOTE: SSI has additional limitations on the claimant’s assets and unearned income.

2. Is your medical condition "severe"?

   Your medical condition must significantly limit your ability to do basic work activities (walking, sitting, concentrating) for at least one year.If your medical condition is not severe enough, you are not disabled.If your medical condition is severe enough, go on to step three.

3. Is your medical condition on the List of Impairments?

   The List of Impairments describes medical conditions that are so severe they are automatically disabling as defined by law. If your medical condition is not on the list, it is reviewed to determine if it is as severe as a condition that is on the list. If the severity of your condition meets or equals that of a listed impairment, you are disabled.

   If it does not, go on to step four.

4. Can you do the work you did before?

   Your medical condition must prevent you from being able to do the work you did before. If not, you are not disabled.

   If it does, go on to step five.

5. Can you do any other type of work?

   Your medical condition must prevent you from doing other work. Your medical condition, age, education, past work experience and skills are evaluated. If you can do other work, you are not disabled. If you cannot do other work, you are disabled.

How do I apply?

An application can be filed online at www.socialsecurity.gov or by calling 800-772-1213 to arrange an appointment at a local Social Security office or over the phone. The application takes about one hour. It can take three to four months to receive a determination.

What are the different levels of the application and appeal process?

1. Initial application

   The claimant must complete an application for disability benefits. Then, the Disability Determination Service obtains your medical evidence and goes through the 5-step evaluation to determine disability. The claimant may be scheduled for a consultative examination with a state doctor as well.

2. Hearing before an Administrative Law Judge

   If the initial application is denied, the claimant can file a request for a hearing before a judge, in which the case is presented through the claimant’s testimony and medical evidence. An impartial vocational or medical expert may also testify at the hearing. Although the claimant has a right to a hearing, he/she may waive that right, opting for a decision based only upon the medical evidence instead. Upon evaluation of all the evidence, the judge will issue a written decision.
   NOTE: A request for a hearing must be filed within 60 days of the date of denial.

3. Appeals Council

   If the claimant receives an unfavorable decision, or does not fully agree with the judge’s decision, an appeal can be filed with the Appeals Council. The Appeals Council is comprised of administrative law judges who have the authority to grant, remand or deny your appeal. The Appeals Council will consider the hearing record and any additional evidence that has been submitted subsequently.
   NOTE: An Appeals Council appeal must be filed within 60 days of the date of the unfavorable decision.

4. U.S. District Court and beyond

   If you do not agree with the action the Appeals Council has taken, the appeal moves out of the administrative courts. Subsequent appeals are filed in the federal courts: U.S. District Court, U.S. Circuit Court of Appeals and U.S. Supreme Court.