Iv: What Financing Issues Does Ssdi Face
SSDI costs have leveled off, but the program faces a long-run funding gap. SSDI costs have stabilized as the baby boomers move from their peak disability-prone years to their peak retirement years. But SSDIs costs will still exceed its revenues. Over the next 75 years, its shortfall is projected to be about 6 percent of the programs costs or income.
SSDI has financial challenges but doesnt face bankruptcy. The payroll taxes that workers contribute out of every paycheck fund most of SSDIs costs. In addition, SSDI has built up trust fund reserves, which Social Securitys trustees estimate will last until 2065. At that point, tax revenues will be enough to pay for 92 percent of benefits even if policymakers do nothing to strengthen Social Securitys financing .
Though the SSDI trust fund has enough funding for more than three decades, policymakers must address overall Social Security financing before then.Overall, Social Security can pay full benefits for 16 more years, the trustees annual report shows, but then faces a significant, though manageable, funding shortfall. Policymakers should address Social Securitys long-term shortfall primarily by increasing Social Securitys tax revenues. Social Security will necessarily require an increasing share of our nations resources as the population ages, and polls show a widespread willingness to pay more to strengthen the program.
Who Can Help When I’m Filing For Disability Benefits
A disability benefit from the Social Security Administration can help you with living expenses when you are no longer able to work because of your disability, but the process of applying for the benefit can seem challenging without help. Fortunately, there are many ways that someone else can help you with the application process such as help from a:
- doctor or other medical professional
- family member of a friend
- SSA representative
- the Disability Benefits Center.
Request A Reconsideration Online For A Medical Determination
If we recently denied your disability claim for medical reasons, you can request an appeal online.
A reconsideration is a complete review of your claim by someone who did not take part in the first determination. We will look at all the evidence used in the first determination, plus any new evidence that we obtain or that you submit.
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Iii: Who Receives Ssdi
Eligibility criteria are strict, and most SSDI applicants are rejected. Applicants for SSDI benefits must be
- Insured for disability benefits .
- Suffering from a severe, medically determinable physical or mental impairment that is expected to last 12 months or result in death, based on clinical findings from acceptable medical sources.
- Unable to perform substantial gainful activity anywhere in the national economy regardless of whether such work exists in the area where the applicant lives, whether a specific job vacancy exists, or whether he or she would be hired.
Lack of education and low skills are considered for older, severely impaired applicants who cant realistically change careers but not for younger applicants.
There is a five-month waiting period for SSDI, but Supplemental Security Income may be available during that period for poor beneficiaries with little or no income and assets.
SSA denies applicants who are technically disqualified and sends the rest to state disability determination services for medical evaluation. Applicants denied at that stage may ask for a reconsideration by the same state agency, and then appeal to an administrative law judge at SSA. Roughly half of people who get an initial denial pursue an appeal.
SSA monitors disability decisions at all stages of the process. SSA conducts ongoing quality reviews at all stages of the application and appeal process. Many reviews occur before any benefits are paid, thus reducing errors.
Special Rules For People Who Are Blind Or Have Low Vision
We consider you to be legally blind under Social Security rules if your vision cannot be corrected to better than 20/200 in your better eye. We will also consider you legally blind if your visual field is 20 degrees or less, even with a corrective lens. Many people who meet the legal definition of blindness still have some sight and may be able to read large print and get around without a cane or a guide dog.
If you do not meet the legal definition of blindness, you may still qualify for disability benefits. This may be the case if your vision problems alone or combined with other health problems prevent you from working.
There are several special rules for people who are blind that recognize the severe impact of blindness on a person’s ability to work. For example, the monthly earnings limit for people who are blind is generally higher than the limit that applies to non-blind workers with disabilities.
In 2022, the monthly earnings limit is $2,260.
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What Are The Most Common Disabilities For Di Recipients
Many beneficiaries have multiple conditions. Of the nearly 9 million individuals receiving disabled worker benefits at the end of 2014, 31 percent had mental impairments as the main disabling condition, or primary diagnosis. Musculoskeletal conditions such as arthritis, back injuries and other disorders of the skeleton and connective tissues were the main condition for 32 percent of the disabled workers. These conditions were more common among beneficiaries over the age of 50. About 8 percent had conditions of the circulatory system as their primary diagnosis. Another 9 percent had impairments of the nervous system and sense organs. The remaining 20 percent includes those with injuries, cancers, infectious diseases, metabolic and endocrine diseases, such as diabetes, diseases of the respiratory system, and diseases of other body systems. Moreover, many beneficiaries have life-threatening conditions: about 1 in 5 men and nearly 1 in 6 women who enter the program die within five years.
What Is The Disability Standard For Disability Insurance And Supplemental Security
Disability Insurance and Supplemental Security are reserved for workers with the most severe disabilities and conditions, and both use the same strict disability standard: inability to engage in substantial gainful activitydefined as being able to earn $1,040 a month in 2013due to one or more severe physical or mental impairments that are expected to last at least a year or could result in death. A workers impairment or combination of impairments must be so severe that the applicant is not only unable to do his or her previous work but also unableconsidering his or her age, education, and work experienceto engage in any other kind of substantial gainful work that exists in significant numbers in the national economy.
Medical evidence is the cornerstone for the determination of disability in both programs. To qualify, there must be medical evidence from a doctor, specialist, or certain other licensed or certified medical sources that documents a severe impairment. Evidence from other health care providerssuch as nurse practitioners or clinical social workersis not sufficient to document a severe medical impairment. And statements from the applicants themselves, their families, co-workers, friends, or neighbors are not treated as medical evidence.
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Is Epilepsy Considered A Disability
Epilepsy is considered a disability and it has a listing in the Social Security Administration Blue Book. For epilepsy to qualify for disability benefits, it must meet the criteria of the Blue Book listing.
There are different listings for epilepsy in the Blue Book. One is for convulsive seizures, which is listing 11.02.
You must show that you suffer daytime seizures that cause you to lose consciousness or convulse or have nighttime seizures that cause severe daytime complications, such as difficulty staying awake, physical movement coordination, or thinking clearly.
Listing 11.03 is for non-convulsive epilepsy, and you must experience seizures either during the night or day and that you suffer pronounced issues after each seizure, which could include difficulty thinking, unusual behaviors, fatigue, or other activities to interrupt your activities during the day.
To qualify through this listing, besides meeting the requirements you must also continue to have a seizure at least weekly despite having taken anti-seizure drugs for at least three months.
The Blue Book has difficult to understand language that is technical and medical in nature. The book was written for medical experts, so you should talk with your treating physician to determine if you meet the criteria of a listing.
You should ask your physician to complete a residual functional capacity form, which is a detailed form that tells what you can and cannot do.
If Your Application Is Denied
After we review your application and the information you provided, we may decide you do not meet the qualifications for disability benefits.
If you disagree with our decision, you have the right to ask us to look at your application again. The notice you receive from us that says you don’t qualify will explain how to appeal our decision and the time period in which you must make the request.
If we decide you don’t qualify:
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Because you are not disabled under our rules, you can appeal our decision online.
The online disability report will ask you for updated information about your medical condition and any treatment, tests, or doctor visits since we made our decision.
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Special Homes For Disabled Are Often More Expensive
Complicating matters, disabled people typically require housing that is specifically tailored to their needs. They frequently require purpose-built housing, which may include handrails in bathrooms and showers, wheelchair-accessible kitchens, and other features that cater to their limitations.
Finding housing with even basic accessibility features can be difficult, if not impossible or unaffordable, for people who use mobility devices. As a result, accessible housing for the disabled is commonly more expensive due to these accommodations and requirements.
Social Security Disability Housing Assistance
There are many obstacles to housing for people with disabilities. Many disabled people are at risk of institutionalization or destitution in the absence of affordable, accessible housing in the community.
Disabled people who rely solely on Social Security Disability Insurance benefits without additional income may have trouble affording housing or rent. SSDI recipients are frequently unable to afford the rental market in the United States due to their low income, unless they have another source of livelihood.
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How Common Is It For Beneficiaries To Return To Work
Both Disability Insurance and Supplemental Security provide incentives for beneficiaries to work. Disability Insurance beneficiaries are encouraged to work up to their full capacity and can earn an unlimited amount for up to 12 months without losing any benefits. Beneficiaries who work for more than 12 months and have earnings above the substantial gainful activity level cease to receive a monthly benefit. If at any point in the next five years their condition worsens and they are not able to continue working above the substantial gainful activity level, however, they are eligible for expedited reinstatement of their benefits. This means they do not need to repeat the entire, and typically lengthy, disability-determination process that they initially went through to qualify for benefits.
Supplemental Security beneficiaries who are able to work are encouraged to do so as well. Their benefits are reduced based on their earningsafter the first $85 of earnings each month, which is not counted against the benefitbut by only $1 for every $2 of earnings. Beneficiaries who are able to do some work will therefore always be better off with both earnings and a reduced benefit than just the benefit alone.
Who Qualifies For Ssdi
- People who have worked for a number of years and had enough money taken out of their paychecks for Social Security
- Self-employed people who paid self-employment taxes
- You must meet Social Securitys very strict definition of disability to qualify for SSDI.
- Having a low income or financial needs do not affect whether you can get SSDI.
If you get turned down for SSDI, reapply, and appeal if necessary. Many cases end up being approved after an appeal. The amount you get from SSDI will be based on how long you worked, and how much Social Security tax was taken from your pay. Once you apply for SSDI, the disability clock starts running.
If your disability application is approved, you will usually receive your first benefit payment six months after the date the Social Security Administration finds that your disability began. You will also become eligible for Medicare after you’ve received SSDI benefits for 2 years.
If you qualify and start getting SSDI, your spouse and any eligible children can also apply for SSDI. If you find you dont qualify for SSDI, but you are disabled and have limited income and resources, look into Supplemental Security Income . This program also can pay benefits to the disabled, but is based on your income and need.
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The Basics About Disability Benefits
The SSDI program pays benefits to you and certain if you are insured. This means that you worked long enough and recently enough – and paid Social Security taxes on your earnings. The SSI program pays benefits to adults and children who meet our requirements for a qualifying disability and have limited income and resources.
While these two programs are different, the medical requirements are the same. If you meet the nonmedical requirements, monthly benefits are paid if you have a medical condition expected to last at least one year or result in death.
What To Expect When Applying
You will be asked to provide information about yourself, your work history, and your disability. You will also need to have medical records or other documentation to support your claim. Once you have submitted your application, a disability examiner will review it and make a determination about whether you qualify for benefits.
If you are approved for SSI, you will receive a monthly payment that will help you cover your living expenses. The amount of your benefit will depend on your earnings before you became disabled. If you have dependents, they may also be eligible for benefits.
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Benefits For Children With Disabilities
A child under age 18 may have a disability, but we don’t need to consider the child’s disability when deciding if he or she qualifies for benefits as a dependent. The child’s benefits normally stop at age 18 unless they are a full-time student in an elementary or high school or have a qualifying disability.
Children who were receiving benefits as a minor child on a parents Social Security record may be eligible to continue receiving benefits on that parents record upon reaching age 18 if they have a qualifying disability.
How Do I Choose A Representative Payee
You want to choose a trustworthy person, who is best qualified to manage your funds, as the representative payee. This could be your relative, friend, caregiver, or even your legal guardian or attorney. The claimant can propose his or her own representative payee or the SSA may appoint one for you.
You would want to take the individual that you recommend as your representative payee with you to the SSA office. A form will need to be completed and submitted along with copies of identification.
If you want to change your payee at any time, you will need to contact the SSA. You will go to the local field office and request a change of payee. You will be given a form to complete so you can make the request. A SSA representative can provide the guidance that you need if you need help completing the form or if you have any questions about the process of switching representative payees.
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Who Can Help When Applying For Disability Benefits
While the disability application process is long, involved, and can be confusing for some, applying for benefits is well worth the effort. If you need help applying for disability benefits, you can get help with your claim from various sources, so you dont have to go through the process alone. Attorneys, advocates, family members, doctors, and SSA representatives can help you when filing for disability.
If you are unable to work because of a medical condition and you plan to apply for disability benefits form the Social Security Administration , you may need help to get through the process. There are many conditions that qualify for disability benefits.
Many people need help during the claims process, and you can get help from someone throughout the process. You can enlist the help of a disability advocate or an attorney, or you can have a friend, relative, or caregiver get your application together and filed.
Health Resources For People With Disabilities
Federal, state, and local government agencies and programs can help with your health needs if you have a disability.
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Explore the Disability and Health section of CDC.gov for articles, programs, tips for healthy living and more.
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Learn more about benefits for people with disabilities from the Social Security Administration.
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Contact your local city or county government to find out what medical and health services are available locally for people with disabilities.
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Your state social service agency can help you locate medical and health programs.
Visit USA.govs Government Benefits page to learn more about government programs and services that can help you and your family.
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Information About Family Members
- Social Security numbers and proof of age for each family member who may qualify for benefits and
- Proof of marriage, if your spouse is applying for benefits, as well as dates of prior marriages, if applicable.
If you don’t have all the documents you need, don’t delay filing for benefits. We will help you get the information you need.