FAQ + Resources

Social Security disability benefits include: Social Security Disability Insurance (SSDI) benefits and Supplemental Security Income (SSI) benefits.

Social Security Disability Insurance (SSDI) Benefits: These benefits may be available to disabled workers and certain disabled family members if the worker has a recent work history of sufficient duration and has paid Social Security taxes. To qualify, the worker must have earned a specified number of work credits. The number of work credits needed to qualify depends on the worker’s age when he or she became disabled. However, younger workers may qualify with fewer credits.

Disabled Adult Child Benefits: These benefits may be available to adults who have a disability that began before they became 22 years old. They may also be available to adults who received dependent benefits on a parent’s Social Security earnings record prior to age 18, if he or she is disabled at age 18. These benefits are paid on a parent’s Social Security earnings record.

Disabled Widow and Widower Benefits: These benefits may be available to a worker’s disabled widow or widower as early as age 50 if his or her disability started before or within seven years of the deceased worker’s death.

Supplemental Security Income (SSI) Disability Benefits: These benefits may be available to disabled individuals who have little or no income. Generally, SSI is awarded to disabled individuals who have not worked for a sufficient period of time to qualify for other programs, such as SSDI.

Supplemental Security Income for Children: These benefits may be available for children from birth up to age 18 who have disabilities if their income and resources fall within certain eligibility limits. Social Security considers the child’s income and resources as well as the income and resources of family members living in the child’s household.

Supplemental Security Income for Premature Children: These benefits may be available to certain infants born with a low birth weight whether or not they are premature. Social Security has pre-established gestational ages at birth and corresponding birth weights to qualify for these benefits. However, even if a child who was born prematurely does not fall into one of the low birth weight categories, he or she may still qualify for benefits if the evidence in his or her record shows that he or she meets the definition of disability for children for another reason.

The definition of disability for adults means that the individual must have a medical condition that can be expected to result in death or which has lasted or can be expected to last for at least one year that prevents the individual from performing work he or she did in the past, as well as other types of work that exist in the national economy. This definition applies to adult workers, widows/widowers, and “adult” children seeking disability benefits.

For children younger than age 18, the definition of disability is different. The child must have a medical condition that causes “marked and severe functional limitations” and that can be expected to cause death or that has lasted or can be expected to last at least one year.

To decide whether an adult is disabled, Social Security uses a five-step evaluation process. They are:

Step 1: Social Security will consider whether you are working and, if so, how much you have earned. If your earnings exceed a pre-established amount, you will not be found disabled. If your earnings are below the pre-established amount, Social Security will proceed to step 2.

Step 2: Social Security will consider whether your condition is “severe,” meaning that it interferes with your ability to perform basic work-related activities. If your condition is not “severe,” you will not be found disabled. If your condition is “severe,” Social Security will proceed to step 3.

Step 3: Social Security will consider whether your medical condition meets the criteria of/or is of equal severity to any of the conditions identified by the agency as so severe that it is presumed disabling. If your condition is found in the list of disabling conditions, you will be found disabled. If not, Social Security will proceed to step 4.

Step 4: Social Security will consider whether your condition interferes with your ability to perform work you held in the past. If you can still perform your past work, you will not be found disabled. If you cannot perform your past work, Social Security will proceed to step 5.

Step 5: Social Security will consider your age, education, past work experience, and any transferable skills you may have to determine whether you can perform other work in the national economy. If you cannot perform other work, you will be found disabled.

For children younger than age 18, Social Security uses a different evaluation process. In addition to meeting the Social Security’s definition of disability for children, the child must not be working and earning more than a specified amount monthly (currently $1,070 a month in 2013, and $1,070 a month in 2014).

For adults, Social Security considers medical records from your doctors as well as any consulting doctors who may have examined you at the agency’s request. Social Security also considers other evidence such as: your complaints about symptoms and medication side-effects and how they affect your ability to function; your daily activities; third party reports about your condition and how it affects your ability to function; your age, education, and work experience; and vocational evidence about jobs that may be available in the national economy.

For children, Social Security looks at medical and other information (such as information from schools and from you) about the child’s condition, and considers how the condition affects his or her daily activities. Social Security considers questions such as:

What activities is your child not able to do, or is limited in doing?

What kind of and how much extra help does your child need to perform age-appropriate activities – for example, special classes at school, medical equipment?

Do the effects of treatment interfere with your child’s day-to-day activities?

You have the right to appeal Social Security’s decision to deny you benefits. Generally, there are four levels of appeal (Colorado is one of ten test/prototype states that skips the reconsideration level of appeal). They are: reconsideration; hearing before an administrative law judge; review by the Appeals Council; and federal court review. At each level, Social Security will send you a letter explaining its decision and the timeframe for filing an appeal.

For Social Security Disability Insurance (SSDI) benefits, the amount awarded depends on how much the wage earner worked and earned in the past.

For Supplemental Security Income (SSI) disability benefits, the amount awarded is pre-established, but may be reduced if you have other sources of income.

For Social Security Disability Insurance (SSDI) benefits, workers and widows will begin receiving benefits on the sixth full month after the date the disability began. The five-month waiting period does not apply to individuals filing as children of workers.

For Supplemental Security Income (SSI) disability benefits, benefits may begin as early as the first full month after you apply or became eligible for benefits.

There is no minimum age to qualify for Social Security Disability Insurance (SSDI) benefits. However, you must meet Social Security’s definition of disability and have earned the required number of work credits. The number of work credits you need for disability benefits depends on your age when you become disabled.

Social Security will automatically enroll you in Medicare after you get Social Security Disability Insurance (SSDI) benefits for two years. Medicare has two parts – hospital insurance and medical insurance. Hospital insurance helps pay hospital bills and some follow-up care. The taxes you paid while you were working financed this coverage, so it is premium free. The other part of Medicare, medical insurance, helps pay doctors’ bills and other services. This coverage requires a monthly premium.

If you get Supplemental Security Income (SSI) disability benefits, you may be able to get help from your state or county, such as Medicaid, food or other social services.

Some people who get Social Security disability benefits will have to pay taxes on their benefits. You will have to pay federal taxes on your benefits if you file a federal tax return as an “individual” and your total income is more than $25,000. If you file a joint return, you will have to pay taxes if you and your spouse have a total income that is more than $32,000.

Social Security rules make it possible to test your ability to work without losing your right to benefits. Additionally, if you cannot continue working because of your medical condition, your benefits can start again – you may not have to file a new application. There are different rules depending on whether you are receiving Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). You can contact a Work Incentives Planning and Assistance (WIPA) coordinator to obtain more information about the decision to work. More information on Social Security’s WIPA project is available at: http://www.socialsecurity.gov/pubs/10095.html#a0=1

No. Your Social Security disability benefits will continue as long as your medical condition has not improved and you cannot work. Your case will be reviewed at regular intervals to make sure you are still disabled.

If you are still receiving disability benefits when you reach full retirement age, they will automatically be converted to retirement benefits.

Social Security Act

Social Security Administration Regulations

Social Security Administration Rulings

Social Security Administration Program Operations Manual System (“POMS”)

Social Security Handbook

Social Security Administration Official Website

National Organization of Social Security Claimants’ Representatives

U.S Department of Health and Human Services Health Center Locator

Colorado Programs for the Needy Disabled

Colorado Cares Rx – A Discount Drug Program for Coloradans

Colorado Programs For Low-Income Families, the Elderly, and Persons with Disabilities

NeedyMeds – List of Free/Low Cost/Sliding Scale Clinics for Colorado