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Why is the SSA telling me that I can only get SSI benefits?

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Q:

Why is the SSA telling me I can only get SSI benefits?

A:

SSI vs. SSDI

Social Security disability benefits are offered to workers who have a severe disability that limits their ability to perform substantial gainful activity (SGA) for at least 12 continuous months, or that is expected to result in their death. The Social Security Administration (SSA) offers two different types of programs for disabled workers: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).

The first disability program, SSDI, is for disabled workers who have worked, paid employment taxes and earned sufficient work credits to be insured for benefits.

In 2015, workers must earn $1,220 in covered earnings to earn one Social Security disability work credit and $4,880 to get the maximum four credits for the year. The number of work credits that a disability applicant will need to earn to be insured for SSDI benefits will depend on their age at the time they become disabled.

For example, if you become disabled prior to the age 24, you may qualify for SSDI benefits if you have six work credits in the three-year period ending when your disability begins. Older workers, however, will generally need 40 work credits, and 20 of those credits must have been generated in the last 10 years ending with the year the disability began.

The second disability program, SSI, is offered to the aged, blind or disabled, who do not have sufficient work credits to be insured for SSDI benefits, have limited income and resources, and are not able to work for at least 12 continuous months.

Denied SSDI benefits

Workers can be denied SSDI benefits for a variety of reasons, but one of the most common is that the worker lacks sufficient work credits to be considered “insured” for SSDI. As mentioned above, work credits must be earned through payroll tax contributions by workers. If a worker is employed and gets paid but does not pay taxes on their earnings, they are not generating work credits.

If you have been denied SSDI benefits because the SSDI states that you have insufficient work credits, unless the SSA has made a mistake, it will be impossible to qualify for SSDI without going back to work and generating additional work credits. Work credits cannot be bought or borrowed; they must be earned by each worker.

SSI and Expected Benefits

Workers who do not qualify for SSDI benefits because they lack sufficient work credits may qualify for Supplemental Security Income, assuming they are disabled, and they have limited income and resources.

Disability requirements for SSDI and SSI are the same: workers will have to prove they have a severe health condition that does not allow them to perform SGA work for at least 12 continuous months.

To qualify for SSI, applicants also cannot earn more income than the current federal benefit rate. They must also have limited resources. In 2015, this limit is $2,000 for an individual and $3,000 for a couple. The SSA, however, does not consider all resources countable. According to the SSA, the following resources are excluded from the resource calculation:

  • A primary residence and land it occupies
  • Household goods and personal effects
  • Burial plots for the family
  • Burial funds up to $1,500
  • One vehicle
  • Life insurance policies with a combined face value of $1,500 or less
  • Certain grants, scholarships, fellowships or gifts set aside to pay educational expenses
  • A certain amount of retroactive SSI or SSA benefits

How Much Will SSI Pay Each Month?

In 2015, the monthly maximum paid to SSI recipients (referred to as the Federal Benefit Rate) is $733 for an eligible individual and $1,100 for an eligible individual with an eligible spouse (the amounts are adjusted periodically). Some states offer additional state supplemental payments.

Unlike SSDI, which is funded from employment taxes paid into the Disability Insurance Trust, the SSI program is funded from federal income taxes and other federal revenues.

Will I get Medical Care with SSI?

Although SSDI recipients will receive Medicare benefits, SSI recipients will not be given Medicare but will generally be given Medicaid. In most states, the application for SSI benefits is also the application for Medicaid. In other states, however, SSI recipients will have to apply for Medicaid and are not guaranteed to qualify. For more information about Medicaid, you can contact the Medicaid site at www.medicaid.gov.

Bottom Line

If the SSA has told you that you can only get SSI, most likely it is because you have insufficient work credits for SSDI benefits. This is called a technical denial and generally cannot be challenged. Challenges may be made, however, if you believe that the SSA made an error or did not have all of your employment information. Appeals must be filed within 60 days of the date you received the denial.

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