February 25, 2009
How Does the Judge Decide if You are Approved for SSI or SSDI
I regularly get questions from readers of my blog and web site about SSI, SSDI and the differences between the two. The biggest difference: you will be eligible for SSDI if you have worked and paid Social Security taxes into the system. Generally to be fully insured, you need to have worked and paid taxes for 5 out of the last 10 years.
If you have worked consistently for 10 years then stopped working, therefore, you "insurability" will follow you for approximately 5 years.
One of the pieces of information I always look for is my client's "date last insured" for SSDI. If you have not worked regularly or if there is a big gap between dates that you worked, your date last insured could be an issue. In order to recover SSDI, your onset date has to be earlier than your date last insured.
This, by the way, is why part time work and large gaps between work attempts can create issues. When you add a lot of zero dollar quarters into the calculation, the date last insured will get closer and closer to the present.
The amount you received from SSDI is a function of what you paid in. If your annual earnings were in the $75,000 range your monthly SSDI benefit will be in the $2,000 + range. If your annual earnings were in the $20,000 range you are more likely to be looking at $1,000 or $1,250 per month.
SSI, by contrast, is a welfare program that pays a statutory amount (around $670) to individuals who meet the definition of disability but who are not insured for SSDI. The problem with SSI – household income serves to reduce the benefit, sometimes dollar for dollar. So, if your spouse is working and earning $50,000 annually, your SSI benefit will be totally offset.
Here is a question I received from one of my readers:
my husband was recently given a fully favorable decision and is insured and eligible for ssdi. i would like to know what they use to decide whether you get ssdi or ssi considering ssi is so much less than ssdi.do you get ssdi automtically if you're insured or are there other factors.
My answer: your eligibility for SSDI is solely based on your insured status. There are some instances where you can get both. If your SSDI benefit is low (say $500) and you are eligible for your full SSI benefit, you would get $500 from SSDI and $270 from SSI.
Also, SSDI claims are subject to a 5 month "waiting period" whereas SSI claims are not. In some cases, you can get SSI for the 5 months, then SSDI thereafter.
Filed under Earnings requirements, Eligibility Issues, SSI issues by
Jonathan Ginsberg
Comments on How Does the Judge Decide if You are Approved for SSI or SSDI »
How long I have to wait until I receive my first SSd check after the judge decisions. I had a court date for SSD 3 weeks ago, what will happen now?
Dagmar, depending upon how busy your hearing office is, you may find yourself waiting between 4 to 12 weeks for the written decision from the judge. Once that is issued, your file is transferred to the payment office. If everything goes smoothly, it will take about 4 weeks for payments to be processed. However, I have seen situations where payment processing drags on for months. Once the payment center has received your file, your attorney should follow up if you don't see payment within 30 days.
How is SSDI calculated for prior years. I received a decision in May 2009 for full SSDI and it was made retroactive to 2003. Does that mean I will get one large separate check for the prior years and then a monthly check or is the monies calculated into the monthly check? So if a person is receiving $1600.00 per month in 2009, but the amount was only 987 in 2003 how is the total amount calculated?
My daughters disability case status has changed from "ready to schedule" to "Pre-hearing review" how long does your claim usually stay in this status. Can they make a decision without having a hearing?
I had my hearing early this month and later got the letter of unfavorable decision by the judge. It was agreed that I was in fact disabled by my chronic disease, the vocational expert confirmed that. But denied because doctor did not diagnose me till 3 months after my date of last insured had expired. My county is so far behind and this has dragged on for so long. I can't back in time to have paper work from doctors prior to 12/2005. The diagnosis came 3/06. Those three lousy 3 months are what is keeping me from being approved. There truly isn't any record during time of insured to prove I was disabled prior to 3/06. Of course the disease didn't just pop up on March. There is even plenty record that majority who suffer from my disease takes 7+ yrs to get the proper diagnosis. Do I appeal? DO I start the whole lengthy process all over again? Help! I have an attorney but can't get past the office help to talk to him.
I think you should appeal – if you don't then any new application would apply to the period of time after the unfavorable decision – I think you would "estopped" from seeking benefits for the period when you were insured. You need to insist that your lawyer pursue the appeal or refer you to another attorney (preferably an appellate specialist).
I applied 3 years ago for ssi. was denied. Got a laywer this year as well and had to go for a mental examination. I got a check. Does that mean I am set? Havent seen the big check yet for back pay, just one that of 500. Also got a letter from fia saying my insurance is changed