Each year, there are over 10 million Social Security Disability Insurance (“SSDI”) beneficiaries. Disabled workers make up the large majority of SSDI recipients, but eligible disabled widow(er)s or disabled adult children may also receive SSDI. It’s estimated that half of all American workers pay Social Security taxes. This means tens of millions of workers may be technically eligible to apply for benefits. As a public entity, the Social Security Administration only has the resources to support claimants totally disabled from all meaningful work due to a qualifying medical condition. This means the eligibility requirements to receive SSDI are stringent. If you or a loved one is disabled from work due to a long-term injury or illness, you may have questions about your right to claim SSDI benefits. A trusted OC social security disability lawyer can help. Below are some of the most common questions we’re asked about SSDI eligibility.
What are the Basic Eligibility Requirements for SSDI?
There are two major requirements for SSDI eligibility: qualifying work history and a disabling medical condition. You must first have enough “work credits” to qualify for SSDI. These are calculated based on how much, how recently, and how long you paid social security taxes. If you have not filed proper tax returns and/or paid sufficient SSDI taxes, you are seldom eligible for SSDI.
Your medical condition must be expected to last more than a year or qualify under a special compassion allowance. The condition must also leave you unable to engage in any meaningful work. This means not just your current job but also all work for which you are qualified or can reasonably become qualified. Further, claimants over a certain monthly income threshold, whether from a part-time job, hobby, investments/dividends, or rental income, may not be eligible for SSDI.
What Medical Conditions Typically Qualify Claimants for SSDI?
SSDI is considered “long-term disability” insurance. Disability short-term conditions, such as pregnancy or surgical recovery, do not qualify claimants for SSDI benefits. Your condition must have lasted for over a year, be expected to last over a year, or otherwise qualify under a compassion allowance. Common qualifying conditions include:
- Cancer: Most qualifying workers with cancer qualify for SSDI, but the cancer must leave you disabled. Easily removed skin cancer or surgically treatable cancers may not qualify claimants for SSDI. Certain cancers, however, qualify claimants for immediate benefits under the compassion allowance system because they are known to last more than a year or are considered terminal. These include the following inoperable, metastasized, or otherwise unresectable cancers:
- Adrenal cancer,
- Breast cancer,
- Neuroblastomas (brain tumors),
- Kidney cancer,
- Lung cancer,
- Pancreatic cancer, and
- Prostate cancer.
- Amyotrophic Lateral Sclerosis (“ALS”): Also known as Lou Gehrig’s Disease, this incurable disorder slowly destroys your motor neurons, inhibiting your brain’s ability to control voluntary muscle function. As soon as you’re diagnosed with ALS, you’re generally eligible for SSDI benefits.
- Severe Traumatic Brain Injuries: An injury to your brain that leaves you in a coma, vegetative state, or otherwise lacking in certain physical, emotional, or cognitive function may result in SSDI eligibility.
Under the right circumstances, almost any verifiable medical or mental health condition that leaves you unable to engage in meaningful long-term employment may qualify you for SSDI benefits.
What Does It Mean to be Totally Disabled?
To qualify for SSDI, your disability must be “total.” This means all of the following:
- You cannot work in your normal occupation or any job you did before your disability,
- You cannot adjust to new work because of your condition, i.e., work remotely or return to school, AND
- Your condition must be terminal or long-term.
You are permitted to engage in certain part-time work provided you take home less than $1,220 per month. This income may affect your monthly benefits, but the allowance is designed to benefit claimants wish to keep their mind fresh, volunteer, or engage in a paid hobby.
How Do I Calculate My Work Credits?
One of the most complicated aspects of SSDI eligibility is calculating whether you have enough “work credits” to qualify. For example, what if you only started working two years ago and were permanently disabled in a car accident? The amount of work credits you need depends on the age at which you became disabled. You generally need between 20 and 40 work credits (at least half of which were earned recently) to qualify for benefits, and you’ll earn one work credit for every $1,360 in taxable, reported SSDI wages. However, you can only earn a maximum of 4 work credits per year.
In simple terms, if you paid taxes on more than $5,440 last year, you earned the maximum four credits. If you made this much over the past ten years, you’ve earned 40 credits. Younger workers need fewer credits to qualify as specified by the SSDI work credit scale. For example, if you were disabled between the ages of 24 and 31, you only need 12 credits over the past six years to qualify. That’s three years of work with at least $5,440 in taxable income over the past six years.
Are Non-Citizens Eligible for SSDI?
Yes. Certain non-citizens are eligible for SSDI if they are (1) United States’ nationals; (2) lawful permanent residents (green card holders) or (3) “qualified aliens” and otherwise meet the above requirements. This includes working lawfully and paying SSDI taxes. Certain qualified aliens include those granted asylum or humanitarian parole and those who served or had a spouse serve in the United States military.
How Much of a Monthly SSDI Benefit Am I Eligible For?
Your SSDI benefit will not be equal to your salary. While certain private employer-sponsored disability plans may cover additional lost wages, you are only eligible for about 50% of your average monthly take-home income in SSDI benefits. The average SSDI recipient takes home about $1,200 per month in benefits, while the maximum monthly benefit is about $2,800. These numbers will be offset by additional monthly income, such as the $500 a tenant pays in rent. Claimants in need may qualify for additional assistance through a state-based program or SSI, but there are limitations to your take-home income while disabled.