So, you have applied for help and got approved for SSI but not SSDI! Should you accept the award already offered to you or appeal your award and continue trying to get SSDI? If you accept just SSI, you can move on with your life and stop worrying about the SSDI process.
For most people, it is more beneficial to go ahead and do the appeal if you believe you qualify for SSDI. In 2020, more than 9.5 million people received SSDI disability benefits. About 89% of those awards went to disabled workers, for a total of about $11.6 billion. About one out of seven of those receiving disability benefits also received supplemental SSI benefits.
Here is some information explaining the differences between the programs and why SSDI might benefit you and your family. If you have any questions, please feel free to call us to speak about your case. We handle cases like this on a routine basis and can assist you if you have problems or want someone to go with you and help fight for your case.
SSI and SSDI Are Different Programs
Even though you may apply in the same process, SSI and SSDI are completely different programs with different benefits. Unlike SSI, your employment history determines your SSDI benefits. More importantly, you may be able to collect under both programs simultaneously. Collecting from both programs will increase your potential income while you are going through a hard time.
SSI
Supplemental Security Income, or SSI, is a means-based program. Qualified applicants are generally adults or children with low income and resources. Blind, disabled, and older people often use SSI to help meet their basic needs. SSI comes from general tax revenues and provides a monthly cash supplement so that qualified individuals can pay for food, clothing, and shelter. Anyone could potentially qualify to receive SSI regardless of disability or employment history, as long as they meet certain conditions.
SSDI
Social Security Disability Insurance, or SSDI, pays benefits to certain insured individuals and family members. To become insured, you must work long enough, and recently enough, while paying social security taxes on what you make. After approval, there is a 5-month waiting period before you start receiving benefits. How much you can earn depends on your work record. Someone who worked for 20 years at a high-paying job should be eligible for significantly more than someone who only worked for a few years at a low-paying job.
If You’re Eligible for Both Programs
Sometimes people are eligible for SSI and SSDI at the same time. If you can collect under both programs, you have concurrent benefits. Your benefit under one could affect your benefit under the other program, but overall it could help you more to have that additional source of income. If you normally receive a larger amount of money from your job, you may have bills that you need to pay that depend on your ability to get more income.
If you are using concurrent benefits, you need to be careful when you go back to work about how your employment affects how much money you can keep collecting to supplement your income. Even after your supplemental income stops, you may still be eligible to purchase Medicare or Medicaid coverage, depending on where you are.
The Application and Claims Process
Thanks to modern technology, you can now apply for benefits online, by phone, or in person.
Applying for SSDI Benefits
The application process is deceptively simple. You will need to collect the information on the checklist, and if you have not already done so, you will need to create a social security number. The application will ask for bank account information, so your assets will be visible, and you should provide any documentation about any medical conditions you are claiming, including the names and phone numbers of any medical professionals who treated you. Representatives from the Disability Determination Services office in your state will review the information and make a decision.
Appealing a Decision
If the decision is not in your favor, you may appeal. Unfortunately, a lot of claims are initially denied. The average acceptance rate is only 22% for initial applications, and the overall denial rate of SSDI applications is 63%. For that reason alone, you may find it beneficial to have an experienced attorney help you with your initial application so that your first application attempt complies with what the office expects. One of the reasons applications may be at a disadvantage is the rejection of the original claim.
Reasons for Rejection
There are several common reasons claims are routinely denied:
- You make too much money or have too many assets. Especially if you are still trying to work, your income will be closely looked at.
- You fail to provide medical evidence to back up your claims. Providing medical evidence is one of the most important parts of a disability claim, and many applicants fail to provide enough documentation to prove their disability.
- If you fail to follow treatment advice or have gaps where you did not receive medical care, your examiner will have difficulty awarding you benefits for a disability. Even if the original accident was not your fault, it is your responsibility to follow your doctor’s directions and follow through with care.
- If your original application failed, you should appeal the decision rather than simply filing a new application. An application for the same claim will likely also fail, but an appeal will give you the chance to fill in the gaps from the original application.
- Once you apply, you need to continue to cooperate throughout the process. You may get requests for additional information and/or documentation, and failing to respond will likely result in the rejection of your claim.
What an Appeal Is Like
There are four levels of appeal, any of which you have to ask for in writing within 60 days of your original denial:
- Reconsideration. You can simply ask that someone who didn’t take part in the original determination look at your claim again, possibly with more medical documentation.
- Hearing Before an Administrative Law Judge. You can ask that an ALJ listen to the reasons he or she should accept your application. The hearing may be in person or by video, although it may be in another city within 75 miles of your home.
- Appeals Council Review. If the ALJ fails to find in your favor, you can ask for a review by the Appeals Council. The Council will consider whether the ruling complied with the rules and regulations.
- Federal Court Review. The federal level is the final possible stage of appeal. If you do not prevail with any other options, you may file a civil suit in a federal court asking for the acceptance of your application.
Key Points to Keep in Mind When Applying for SSI and SSDI
Even though there are several ways to appeal an adverse decision, it is still better to prevail with your case the first time. Especially considering that there is already a wait time, you could feel as though your life is in limbo while you are waiting. Make sure that you fill out the application properly and provide enough documentation to make your case. Keep in mind that there may be deadlines so you do not lose your case by failing to follow through. Apply for both programs so that you can get as much help as you deserve.
Lastly, remember, that attorneys that specialize in Social Security claims can only get paid if you win. It’s worth reaching out to an attorney to see what your options are. Fill out our contact form and we’ll connect you with a disability attorney near you.
English