Frequently Asked Questions

Social Security Disability

What is the difference between Social Security Disability Insurance benefits and Supplemental Security Income benefits?

Social Security Disability Insurance benefits pays benefits to an individual who has worked enough and paid sufficient Social Security taxes to be "insured" for the benefit.

Supplemental Security Income is a needs based program for disabled adults and disabled children and individuals age 65 and older who have limited income and resources.

How do I qualify for Social Security Disability Insurance benefits?

To qualify for Social Security Disability Insurance benefits you must be under your full retirement age, be found disabled, and you must have worked and earned sufficient number of credits or quarters of coverage from work on which you paid Social Security taxes. The number of quarters of coverage needed depends on your age at the time you become disabled. In addition to earning the total number or quarters of coverage required, you must have worked and paid into the Social Security system five of the ten years immediately preceding the onset of the disability.

There are special rules for very young workers particularly persons age 24 or younger who have a limited work history.

Do I have to be disabled for a year before I can apply for Social Security Disability benefits?

No. You can file for disability benefits immediately after you become disabled. However, the medical condition must be one that is likely to prevent you from working for twelve full months or more.

What information will I need when I apply for disability benefits?

You will need to have the following information available:

• Social Security Number
• Birth Certificate or Baptismal Certificate
• Names, Addresses, and Telephone Numbers of doctors, hospitals, and clinics where your received treatment and the approximate dates of service
• Names and Dosages of medications
• Summary of your past work history including place and dates of employment and the type of work done
• A copy of your most recent W-2 form or if self-employed, a copy of your most recent tax return

What is the best method of filing for disability benefits?

The most efficient way to file for benefits is to file the application online at ssa.gov. However, if you do not have a computer or not comfortable using one, you can call the Social Security Administration at 1-800-772-1213 and schedule either a telephone or an in-office appointment to file your claim. Of course, you can go to any Social Security office without an appointment.

How does the Social Security Administration determine if I am disabled?

The Social Security Administration follows a step by step method called the Five Step Sequential Evaluation process that addresses questions about your medical impairments and ability to work. The questions or steps are as follows:

Step One: Are you working and earning substantial wages?

If you are working, the Social Security Administration reviews the work activity to determine if it is substantial. Currently, gross wages that equal or exceed $1,010.00 are considered substantial and would result in a finding of not disabled. If you are not working or working but not earning over the amount considered substantial, the claim proceeds to Step two.

Step Two: Is your medical condition severe?

If your medical condition causes more than minimal interference with your ability to perform basic work activity, it will be considered severe and you move to Step Three.

Step Three: Does your medical condition meet a listed impairment?

The Social Security Administration has created a List of Impairments for each major body system that are considered so severe that a finding of disability can be made based on medical evidence alone. If the medical evidence does not show that your condition meets or equals a Listed Impairment, then the claim proceeds to Step Four.

Step Four: Does your medical condition prevent you from performing the type of work you performed in the fifteen years before the disability began?

If the medical evidence does not support a finding of disability at Step Three, the Social Security Administration must determine if your medical condition prevents you from performing your past work. If it does not, then your claim will be denied. If you are unable to perform your past work, the claim proceeds to Step Five.

Step Five: Does your medical condition prevent you from doing other work activity?

If you are unable to perform your past work, the Social Security Administration must determine if you are able to perform other types of work that exists in significant numbers in the national economy. In making this determination your age, education, and vocational skills are taken into account in addition to your medical conditions. If you are able to perform other types of work, your claim will be denied. The key issue in this determination is your capacity to perform other work and not whether someone is willing to hire you.

If I am found to be disabled and entitled to benefits, will I be eligible for health insurance?

If you are found disabled and entitled to Social Security Disability Insurance benefits, you will be eligible for Medicare within twenty-four months of the date of your entitlement. The twenty-four month period begins the first month of entitlement to benefits and not from the first month you receive a check.

In the state of Florida if you are found eligible for Supplemental Security Income benefits, you will be eligible for Medicaid in the same month that the Supplemental Security Income benefits start.

What is the difference between Medicare and Medicaid?

Medicaid is a jointly funded Federal and State health insurance program for low income, needy people including aged, blind, and disabled. Medicare is health insurance program funded by the United Sates government for persons age 65 and over, persons under age 65 entitled to Social Security Disability insurance benefits, and persons of any stage with End Stage Renal Disease.

If I am awarded benefits, how long will I continue to be paid the benefits?

If you are receiving Social Security Disability Insurance benefits, you will continue to receive the benefits as long as you remain disabled and are not performing substantial gainful work activity. If you are receiving Supplemental Security Income benefits, you will continue to receive the benefits as long as you remain disabled and meet the income and resource requirements of the program.

Will my family be paid benefits?

Benefits are available for certain family members as follows:

• A spouse age 62 or older
• A spouse of any age with a child under the age of 16 in his/her care
• Unmarried children under the age of 18
• Unmarried children over the age of 18 who were disabled prior to the age of 22

Are my disability benefits taxable?

You will have to pay federal Income taxes on your benefits if you file a federal tax return as an individual and your total income is greater than $25,000.00 or more. If you file a joint return, you will have to pay taxes on your benefits if you and your spouse have income greater than $32,000.00.

If my claim is denied, do I have appeal rights?

Yes. You have sixty days from the date of the Notice of Denial to file an appeal and it is important that you file the appeal on time. Failing to file the appeal and starting over with a new application is a common mistake made by many applicants. By repeatedly starting over, your add delays to an already lengthy process and you risk the loss of potential benefits that may have been payable with the earlier application date.