| Social Security Disability
Insurance (SSDI)
What is SSDI?
SSDI stands for Social Security Disability Insurance. SSDI is an
insurance program for disabled people who have worked "on the books"
and paid FICA taxes for a certain number of calendar quarters. SSDI
pays a variable monthly benefit amount, which depends on your work
history. Payments begin after a 5-month waiting period from the
time of disability. SSDI is administered by the Social Security
Administration (SSA).
How long does it take to start?
It is to your advantage to file for benefits as soon as
you become disabled. However, you must be disabled for
five full months before you become entitled to
SSDI. You will receive your first benefit payment for the sixth
month of your disability. You do not receive SSDI benefits for the
waiting period.
These are terms you need to know:
Date of Onset
Your "date of onset" is considered the first day you are unable
to work because of your disability. The date of onset may or may
not be the same as the date you were diagnosed. Applicants usually
use the day they last worked as the date of onset.
Month of Entitlement
Your "month of entitlement" to SSDI will be that month which is
five full months following your last day of work (your sixth month
of disability). For example: If you last worked on January 5, 2005,
your month of entitlement to SSDI will be July 2005.
Back Payment
If your disability began (and you were unable to work) more than
six months before you applied for SSDI, you may be eligible for
"back benefits." Applications for SSDI can be retroactive only up
to 12 months.
What happens if I don't apply right away?
Sometimes people apply for benefits many months after they stop
working. This does not change the eligibility date, but it may effect
when your first benefit payment will arrive. For example, if you
become disabled and unable to work on January 1, your date of onset
is January 1. If you apply for SSDI benefits in January, your month
of entitlement to SSDI and your first benefit payment will be for
June. The check for June will arrive in July.
A person who is disabled on January 1, but waits to apply until
June or July (or even later) is already eligible to receive SSDI
benefits (because he/she has been disabled for 5 full months). However,
since the application has to be evaluated, processed and approved
(which normally takes at least 90 days), the first check may not
be received until September or later. This person, though, will
be able to receive a separate check covering the time from the month
of entitlement (June) to the date of the first check (September).
That is called "back payment."
Remember: The month of entitlement is the month following 5 full
months after your date of onset (last day you worked).
How are SSDI benefits calculated?
SSDI benefits amounts are determined by a formula which takes
into account your age and earnings record. This formula allows
for yearly
increases in the level of individual benefits in order to reflect
adjustments in the cost of living. As of January 2004 SSDI payments
will be incresased by 2.7%. The amount of your benefits will be
based upon your average earnings for all of the years you've been
working, not just your most recent salary.
There is no minimum SSDI benefit amount. Your monthly benefit will
be based on your earnings record, not on how much
money you need for food, rent and living expenses. If you receive
only a small SSDI benefit, however, and you don't have a large amount
of savings or other assets/resources, you may be eligible for some
Supplemental Security Income (SSI) benefits in addition to your
SSDI benefit. (Please see the SSI
Fact Sheet).
SSDI beneficiaries may receive additional unearned income
and have unlimited assets/resources. Unearned income you may receive
includes private disability payments from an insurance policy or
short-term and long-term disability coverage from your employer.
How do I file applications?
Social Security has a telephone number, 1-800-772-1213
(also known as TELECLAIM) for people with AIDS and HIV symptoms
who wish to apply for SSDI and SSI benefits.
Tell the TELECLAIM representative that you have an AIDS diagnosis
or HIV symptoms and you would like to file for both
SSI and SSDI.
The TELECLAIM representative will ask you some basic questions
(name, address, date of birth) as well as some questions about your
disability. Your approval will be based on a complex set of factors.
For more specific information call your local Social Security office.
I know I didn't work on the books long enough, so why file
for SSDI? Applications for both SSI and SSDI should always
be filed because people don't necessarily recall their work histories
completely or accurately. Or, if you were ever married, you may
qualify for benefits under your spouse's Social Security number.
What happens after I call Teleclaim?
TELECLAIM will refer your claim for SSDI benefits to your local
Social Security District Office. A Claims Representative will call
you back at a later date (usually within two weeks) to complete
the applications over the telephone. Be certain to record in a log
or diary the name and telephone number of the Claims Representative
with whom you speak and the date and time of any calls. You should
also ask for the address of your local Social Security District
Office for your records.
What will I be asked?
In addition to basic demographic information, the Social Security
Claims Representative will ask you questions about your disability.
The most important question is about the date you last worked because
of your disability. It is best to use the earliest date possible.
SSA can often establish an earlier date of disability onset if you
were in and out of work because of illness.
The Claims Representative will also tell you about the documentation
you will need to provide, such as a birth certificate and a letter
of diagnosis from your physician.
What happens next?
Social Security will mail the completed application to you for
review, corrections and signing. Be sure you check the forms for
accuracy before signing. You should initial next to any changes
you may make on the applications they send you.
Included with the applications is a Disability Report
(Form SSA-3368). This is an 8-page report, tinted green. You complete
the first 6 pages (pages 7 and 8 are for the use of SSA).
The application will ask for the names, addresses and telephone
numbers of all doctors, hospitals and clinics that have medical
information on your disability.
Required application documents.
Social Security will tell you which documents you will need to send
to them. You should write your Social Security number on all documents.
You must send the original documents. Photocopies are not
acceptable.
- birth certificate, passport, baptismal certificate or school
records, etc.
- social security card
- diagnosis letter form physician which should also indicate
that you are unable to continue working
- W-2 for last year or income tax return (1040) or Schedule SE
if you are self-employed
- your last pay stub for all jobs for the current year.
Where do I send my applications?
Once you have gathered the requested documentation and you have
completed and reviewed your applications, make photocopies
of everything to keep for your records.
A return envelope with the address of our local Social Security
District Office will be included with the applications sent to you.
Enclose the original application and the original documenting proof
that is requested. It is best for you to return the completed application
materials by Certified/Return Receipt or Registered mail.
When Social Security receives the application, they will photocopy
the original documents and mail them back to you. If more information
is needed, they will write you. You should call the Claims Representative
at your local office to confirm that all the necessary paperwork
has been received.
If you are unsure of your local Social Security District Office,
call 1-800-772-1213, or the GMHC Advocacy Helpline:
212/367-1125.
What is the medical determination?
SSDI claims are reviewed for a medical determination of disability
by the New York State office of Disability Determination Services
(DDS). The determination is based on medical information from your
doctors, hospitals or clinics which you have been to for treatment.
The office of Disability Determination Services (DDS) will request
the medical records from your doctors, hospitals or clinics.
How long does the processing of my claim take?
It may take three to six months for a decision to be made on your
SSDI claim. Once the medical determination of your disability has
been made, Social Security will notify you in writing as to whether
or not your claim has been approved. SSDI will also inform you of
your month of entitlement to SSDI benefits, the amount of your monthly
benefit, and when you will receive your first benefit payment.
Remember: Given the time it takes to process a claim, it is best
to apply for SSDI as soon as you have stopped working because of
a disability.
How will I be paid?
SSDI benefit payments for a particular month are made on the third
day of the following month. For example, benefits for the month
of January are due on February 3, benefits for February are due
on March 3, etc.
For safety and convenience, you can have your bank arrange with
Social Security to have your monthly SSDI benefit deposited directly
into you checking or savings account. Most banks provide direct
deposit service and will be able to supply you with Form SF-1199
to fill out.
What happens if my check doesn't arrive?
SSDI benefit checks are mailed by the Treasury Department so that
you receive them on the 3rd day of the month following the month
for which the benefit is due. If you do not receive your check in
the mail by the 6th of the month and if you believe that it is lost
or stolen, notify your local Social Security District Office or
call the SSA at 1-800-772-1213. You will need to
give SSA your name as it would appear on the check, your Social
Security number, your address with ZIP code, and the month for which
the check was issued. SSA will take the necessary information to
investigate its whereabouts and start the process of getting you
a replacement.
Can I move?
You can receive SSDI benefits in all 50 States. Your benefit amount
does not change if you move from one state to another. You must
inform the SSA as soon as you know your new address so that benefit
payments can be properly delivered. You can notify the SSA by phone
at 1-800-772-1213.
What other benefits does SSDI provide?
SSDI does not provide Medicaid. An SSDI beneficiary is automatically
eligible for Medicare after collecting SSDI benefits for 24 months.
Medicare coverage starts in the 25th month of your
SSDI entitlement. SSA will automatically send you information about
3 months before your eligibility for Medicare.
SSDI recipients may be eligible for Food Stamps but must file a
separate Food Stamp Program application. (Please see the Food Stamp
Program Fact Sheet).
SSDI recipients may be eligible for Medicaid but must submit a
separate Medicaid application. (Please see the Medicaid
Fact Sheet).
Can I return to work?
Yes. The SSA has the Trial Work Program (TWP) which permits SSDI
beneficiaries to return to work for a period of about 9 months
in
a 60-month period. The 9 months do not need to be consecutive.
The purpose of the TWP is to give SSDI beneficiaries the opportunity
to see if they are able to perform sustained work. Those months
in which you do not earn $590 or more and/or
spend more than 80 hours in self-employment, do
not count as trial work months. During the Trial Work
Period, you may earn both a salary and receive your full SSDI
benefit payment.
Your eligibility for SSDI is partly based on the expectation that
your disability will last for at least 12 months, during which time
you are unable to perform substantial gainful work.
If you return to work during the initial 5-month waiting
period or during the remaining 7 months of the first year of your
disability, your entitlement to SSDI may be denied or terminated.
Any benefits you may have received may be considered an overpayment
which will have to be returned to SSA.
It is advised that you inform your local Social District Office
before returning to work to avoid any confusion
as to when your TWP can begin. Ask for written confirmation that
you reported this information to them.
What happens when the 36-month extended period of eligibility
is up?
You will need to choose between working and collecting SSDI benefits.
You will have the choice of either returning to work permanently
and giving up the SSDI benefits, or reducing the amount of work
and giving up earnings in excess of $830 or more
per month. If you continue to earn $830 or more
per month, you will receive three more SSDI checks. After that
your
checks will stop. (See Transitioning
to Work Fact Sheet.)
In other words, you can continue working as long as you do not
earn $830 or more per month and still collect
your full SSDI benefit once you have satisfied the 9-month TWP.
If you
earn $830 or more per month, you are not eligible
to receive an SSDI benefit. If you do receive an SSDI benefit
for
any month in which you have earned $830 or more,
it is considered an overpayment and should be returned to Social
Security.
A Note of Caution
Returning to work and earning wages may jeopardize other benefits
(such as Medicaid and Public Assistance). It is crucial that you
obtain informed advice before returning to work.
Questions?
There is a Social Security Hotline to call about pending applications,
lost checks, questions and applications. The number is 1-800-772-1213.
The Client Advocacy Unit at GMHC is available to assist
you. For more information, please call our Helpline: 212/367-1125,
Wednesday 2:00 to 5:30 pm. Walk-in services are available Monday
through Thursday, 10:00 am to 1 pm.
Revised 3/05
© 2005 Gay Men's Health Crisis
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