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Social Security Disability Explained

Social Security Disability Insurance (SSDI) covers disabled workers and their dependents. Beneficiaries typically qualify for Medicare after 2 years.

How to Qualify For SSDI Benefits

In order to be eligible for SSDI benefits, an individual must have a medical problem that prevents them from working and the condition must be one that has lasted or is likely to last 12 consecutive months. They will need to provide a proof to SSA that it is their disability that is preventing them from working. During this time, the disabled individual can apply for cash assistance from the state or unemployment benefits.

After receiving SSDI benefits, the disabled may return to work force without losing their SSDI benefits by taking advantage of the Trial Work Period. This does not apply to SSI. During the trial work period (5 years or 60 months), if the individual makes more than $1,110 per month in 2024 and it continues for 9 accumulative months, he or she will enter phase 2 called Extended Period Eligibility.

After the trial work period is over (60 months or 9 cumulative months if the disabled has earned more than the allowed amount), the disabled individual will have additional 36 months during which they can work and still receive benefits for any month their earnings do not exceed the SGA (Substantial Gainful Activity) limit which is $2,590 for the blind individuals and $1,550 for the non-blind in 2024. This period is called Extended Period Eligibility.

Beginning in the 37th month the EPE ends which means the eligibility for SSDI benefits will end the month the disabled worker’s countable gross income exceeds the SGA limit. However, if the individual becomes disabled again after EPE, they will have a period time called “expedited reinstatement” in which they won’t need to reapply for SSDI.

Important Notes on Social Security Disability:

If a disabled breadwinner has earned Social Security coverage and qualifies for disability, benefits may go to the following dependents;

  • A Spouse who is at least 62 years old.
  • A Spouse at any age who is caring for the disabled worker’s child who is younger than 16 or disabled.
  • A disabled widow or a widower who is at least 50 years old.
  • A biological child, adopted child or a stepchild who is unmarried and not yet 18 (or 19 if not graduated from high school) or unmarried adult child who is 18 or older and became disabled before the age of 22.

You may receive a benefit that is 100 percent of your PIA. SSDI benefits are not reduced for age and are switched to Retirement benefits when you reach your FRA. The benefit amount stays the same.

FAQs

I haven’t worked in years, can I get disability?​

Probably not. You are required to have worked in the last 5 years.

I haven’t worked much my whole life, can I get disability?​

Maybe, depending on your disabling condition—but you may not qualify to get much money. Social Security is based on how much you paid in, so if you didn’t earn much or work very long you may not get very much. You can go to www.ssa.gov right now and set up a free account and see how much the government estimates you would get if you got on disability.

I’m 61 and thinking about applying for disability. Should I just wait and apply for retirement at 62 instead?​

If you qualify for SSDI you will get about 30% more per month than if you take your retirement benefit. As long as you qualify, you can apply for retirement, but even if you think you’ll qualify for disability it is really hard to get it. Over 70% of applicants are denied the first time they apply. Many have to appeal several times before they get SSDI. It is hard. We don’t want to talk you out of applying, but do your research. Many people think it’s as simple as applying and in reality it is a very long process to get SSDI.

I finally got approved for disability, why does it take TWO YEARS to get Medicare?​

This is what Congress negotiated when they approved adding a disability benefit to Social Security. They did it to save money. (See our video below that explains SSDI & Medicare in greater details). Some several illnesses do qualify for Medicare coverage immediately (ALS and organ transplant and some terminal cancers) but most people do have to wait 2 years. In the meantime, you need health insurance and we can help you get ACA also known as Obamacare, or you may be able to stay on your or your spouses’ work plan.

My friend applied without an attorney and got disability the first time she applied!​

Yes, this can and does happen, but not frequently. People who get approved quickly tend to have a very serious disability or terminal illness. How long it takes you depends on how long it takes to get your medical records and other evidence for the judge to make a decision.

Why am I being charged for Medicare, I thought it was free since I’m disabled?​

You must pay for Medicare Part B unless your income and assets are low enough to qualify for state assistance with Medicare. Most people—mistakenly—think it will be free, but it isn’t. Once you have been on SSDI for 2 years, they automatically enroll you into Medicare Part B and start taking the monthly cost out of your SSDI payments!

So I don’t have to sign up for Medicare at age 65?​

Correct. As long as you have been on SSDI for at least 4 months, you will automatically be signed up and receive your Medicare Card in the mail. You DO have to contact us about choosing supplemental Medicare insurance. If you forget to call us, you may lose your rights to get a plan—the rules vary a lot from state to state. Please plan to call us 3 months before your Medicare Part B will begin.

Since I’ve been on Medicare for many years, do I have to do anything when I turn age 65?​

Yes! Please call us 3 months before you turn 65. We explain why this can be urgent based on the state you live in. Most states don’t allow you to purchase a Medicare Supplement plan when you first get approved for Medicare Part B if you are under age 65 and on disability. But at age 65, you have the same rights as anyone who is just turning age 65—and you don’t want to neglect this opportunity to see if you can get better benefits!

I didn’t understand and never signed up for Part B, or I cancelled my Part B and now I see that I need it, what can I do?​

You might have triggered a late Part B (and Part D) penalty. The good news is that those penalties will go away when you turn age 65, the bad news is you may have to pay more each month until you do turn age 65. Call us and we will help you sort this out.

Summary

Social Security Disability is difficult to get, but extremely helpful for those who get accepted. Its extremely important to track when your Medicare Part B benefits will start when you’re on SSDI. Contact us or schedule an appointment to compare the plans in your area.

Sylvia Gordon, aka Medicare Mama®, is an expert on all things Medicare and Social Security. She is the 2nd Generation here at The Medicare Family and has served on the advisory boards of major insurance companies like UnitedHealthcare®, Cigna, and Anthem. In her free time, she can be found taking care of her animals (dogs, goats, peacocks, chickens), and reading a good book. Learn More.
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