Disability Insurance Benefits are available to those individuals who either through their own work efforts or through the work efforts of others with whom they have a relationship have obtained insured status through the Social Security Program. These benefits are also referred to as SSDI.
SSDI benefits are usually preferable to Supplemental Security Income benefits since there are no income or resource limitations that apply to these Title II Benefit programs like SSI. In addition to cash payments these insurance benefits also carry with them Medicare entitlement and can be paid for up to a year prior to the filing of the individual’s application. SSI benefits, on the other hand, have no medical coverage or retroactive effect. The 3 SSDI programs can be summarized as follows:
DISABLED WORKERS’ INSURANCE: These benefits are available for the now disabled worker who has not yet reached the full retirement age of 65. Disabled workers become insured by working a minimum of 20 quarters during a 40 quarter period (the 20/40 rule). The disabled worker must also prove he or she became disabled while he or she had insured status.
DISABLED WIDOW, WIDOWER & SURVIVING DIVORCED SPOUSE BENEFITS: These benefits are available to the disabled surviving spouse (including a surviving divorced spouse but only if he or she was married to the insured worker for at least ten years) of a deceased insured worker if such widow(er) is between age 50-59 and became disabled within a prescribed period–that period ending seven years after the insured worker died.
DISABLED ADULT CHILD BENEFIT: Also known as a CDB. This benefit is payable to the disabled adult child of a fully insured worker who he himself or herself is now retired, disabled or who is deceased. To be qualified for this benefit the child must prove disability under Social Security’s rules all before he or she reached the age of twenty-two.
The cash benefit level for Disability Insurance Benefits is most typically higher than that for SSI benefits.
The Supplemental Security Income program provides cash benefit assistance only (i.e. no MEDICARE or other medical benefit coverage) to those individuals who are either over age 65 or who are disabled, and who also have limited income &/or resources. The basic purpose of SSI is to assure a minimum level of income or assistance to disabled and elderly people.
Supplemental Security Income is traditionally paid to those individuals who have either never worked or who have worked too little to be eligible for Disabled Worker’s Insurance Benefits. SSI is a ‘needs based’ program of last resort. As such one must file for and pursue any other income &/or disability benefits for which he or she may be eligible before seeking or receiving an SSI check.
Although entitlement to a Supplemental Security Income check does not carry with it Federal Medicare entitlement in most cases an SSI beneficiary will become eligible for state medical benefit assistance such as Medicaid (known as Soonercare in Oklahoma). In some limited situations an individual may be able to draw both an SSI and SSDI cash benefit at the same time.
Unlike Disability Insurance Benefit cases–Supplemental Security Income case filings have no retroactive effect at all and can only be paid, at the earliest, starting the first full month after the application has either been actually or protectively filed, assuming all other requirements for entitlement to an SSI check have been otherwise met at the time of filing the case. SSI applicants, however, do not have to wait the customary five month waiting period that applies to most SSDI case filings. Finally–SSI cases do not provide any ‘auxiliary’ benefits payable to family members of an individual receiving an SSI check.
The current amount of a basic individual SSI check is $721. This amount is subject to cost-of-living adjustments. SSI can, under limited circumstances, make presumptive cash payments to first time filers with certain severe medical conditions. These ‘presumptive’ payments can be made for up to six months while a given individual is awaiting a formal disability decision on his or her case.
Supplemental Security Income cash payments are available to minor children under 18 with disabilities. To be found well qualified for such benefit a child must have a mental or physical impairment (or both) that results in ‘marked and severe functional limitations’ that substantially limit such child’s activities. This can best be done by the child or such child’s Social Security Disability attorney proving that the child’s medical problem either:
MEETS OR FUNCTIONALLY EQUALS A “LISTING”: A child’s medical evidence alone can establish that he or she is entitled to a SSI cash benefit check outright if the child’s diagnostic and other medical findings meet or are equivalent in severity to an impairment described in Social Security’s CHILD listing of impairments (or an ADULT listing if a child listing does not adequately address the child’s particular problem).
CAUSES ‘MARKED’ OR ‘SEVERE’ IMPAIRMENT IN ONE OR MORE “DOMAINS”: A child’s proven inability to adequately perform on a function-by-function basis in certain described ‘domains’ established by Social Security will entitle said child to a Supplemental Security Income cash benefit check. These domains are: (1) acquiring & using information; (2) attending & completing tasks; (3) interacting & relating with others; (4) moving about & manipulating objects; and finally (5) caring for himself/herself. A child’s impairment is of listing-level severity if it causes marked limitations in two domains of functioning or an extreme limitation in just one.
In considering whether a child’s medical problems seriously limit his or her activities Social Security will compare and evaluate said child’s mental and physical functioning with that of a non-disabled child of like age.
As with all Supplemental Security Income cases–income & resource limitations apply which could reduce and even in some cases eliminate altogether eligibility for the program.
Every child SSI recipient upon turning age 18 is subject to a full reevaluation by Social Security of his or her ongoing disability using the comprehensive adult standards and definition of disability.