If you are in the process of applying for Social Security Income (SSI) or Social Security Disability Insurance (SSDI), you know first-hand that it can be a lengthy and overwhelming endeavor. With multiple hurdles to go through, it may take up to ten months or longer to be approved. An estimated three out of five applicants will need to appeal their denial, which makes the process even longer.
This blog post covers the basics of Social Security, the differences between SSI and SSDI, how to ensure a smooth application process, and maximize your chances of getting approved.
What is SSI?
Supplemental Security Income (SSI) is a program designed to provide monthly benefits to individuals with limited income and resources. SSI caters to those who are blind, aged 65 or older, or facing qualifying disabilities. Moreover, children with disabilities or those who are blind may also be eligible to receive SSI benefits. SSI pays benefits based on financial needs.
What Are the Total Resource Limits for 2024 Associated with SSI?
SSI is a needs-based program. To qualify for SSI, individuals cannot earn more than $1,971 from work each month according to SSA. However, individuals who are earning over the substantial gainful activity level of gross $1,550 monthly are ineligible for benefits regardless of the nature of their disabling condition. Child support is viewed as countable income. The maximum award for SSI in 2024 is $943. As SSI is linked to Medicaid, an individual’s total resources cannot exceed $2,000.
As a needs-based income, SSI is intended for immediate use, not saving for future expenses. The money should be spent on necessities like rent and food.
Never deposit your monthly SSI income into a savings account because SSI examines both checking and savings, potentially jeopardizing eligibility. SSI income cannot be direct deposited into ABLE accounts.
There are multiple steps you can take to prevent going above the resource limits. To ensure that total resources never surpass the $2,000 mark, it is advisable that caregivers set up a separate account for their loved one. This could be a Representative Payee account for example. This ensures no co-mingling of household expenses in the personal account with the SSI.
If additional funds, such as gifts, are received, using an ABLE account instead of a traditional savings account is a good solution because resources in an ABLE account won’t impact SSI eligibility.
A Pooled Special Needs Trust serves as a strategy for managing eligibility criteria. For instance, if an individual is designated as the beneficiary in life insurance policies, a supplementary needs trust is essential to ensure the protection of resources and the preservation of Medicaid eligibility, thus addressing potential challenges in meeting eligibility requirements.
Another thing to keep in mind is that SSI in Georgia features automatic enrollment with Medicaid, which is a significant advantage. But remember, Medicaid is always the payer of last resort, making it an excellent option for secondary insurance. It can cover expenses like medication copays or necessary hospitalizations. To preserve Medicaid eligibility, you cannot exceed the total resource limits.
When Should I Apply for SSI?
To apply for SSI, you must be 65 years old or older, be totally or partially blind, or have a medical condition that keeps you from working and is expected to last at least one year or result in death.
Children under the age of 18 can qualify for SSI if they have a medical condition or a combination of conditions that align with Social Security’s definition of disability. For a child without blindness, it’s essential that they are not engaged in work or earning more than $1,550 per month in 2024. A visually impaired child must ensure they are not working or earning more than $2,590. These income thresholds are subject to annual adjustments. Additionally, the child must have a medical condition or a combination of conditions that lead to “marked and severe functional limitations,” significantly restricting the child’s activities. The child’s conditions must have been disabling or are expected to be disabling for at least 12 months, or they must be anticipated to result in death.
One of the biggest mistakes when applying for social security is to apply too early. The rule of thumb is to submit your application the month following the individual’s 18th birthday.
Remember, if you apply before that, the parents’ income will be considered, which may affect eligibility. “Unless the household is operating at a federal poverty line, they’re going to get denied. Wait until age 18. At that point, the means testing, which is the income limit and the resource limit, SSI is not going to be looking at parents’ income,” explains Anna Maki, Director, Program Services at Bobby Dodd Institute (BDI).
What is SSDI?
SSDI is an entitlement program. It draws its funds from the Social Security and Social Security taxes. When a parent retires, becomes disabled, or passes away, their dependents, including adult children, may become beneficiaries. Adults established as an adult dependent child, or also known as childhood disability beneficiaries, are linked to the parent’s work record.
SSDI may offer more substantial income than SSI. Usually, 50% of what a parent would be receiving is going to be substantially more than the SSI income.
Individuals will transition from Supplemental SSI to SSDI as an adult dependent child when the parent applies/receives SSA benefits, says Anna Maki. This occurs when a parent experiences a life event like retirement or disability. This transition marks the turnkey moment. Specifically, when the parent applies for retirement benefits, Social Security requires information about dependent children. Upon providing the necessary personal information, both the parent’s and dependent child’s accounts become linked.
However, it is important to note that working individuals may be eligible for SSDI based on their own work record, but exceeding the substantial gainful activity level can jeopardize their status as prospective childhood disability beneficiaries.
While SSI is associated with Medicaid, SSDI is linked to Medicare. It’s essential to remember that when an individual is drawing benefits from the parent’s work record, there is a 24-month waiting period before Medicare coverage takes effect. Depending on the individual’s income, they may qualify for a Medicaid program known as Qualified Medicare Beneficiary (QMB). The QMB program provides Medicare coverage of Part A and Part B premiums and cost sharing to low-income Medicare beneficiaries. This consideration adds an extra layer to the planning process, emphasizing the need to explore all available options for comprehensive healthcare.
Additionally, there is a Special Needs Medicare Advantage plan that may be a good option for those eligible for Medicare. If you or a family member is eligible for Medicare, it’s a good idea to explore this option. The process may involve consulting with a financial planner to gain access to this plan, but the benefits make it well worth the effort.
How to Apply for SSI?
The applications for SSI and SSDI are completed online. However, while you can submit your SSDI application visiting the SSI website, for SSI you can only request an appointment for a phone interview. During that interview, you will be screened for technical eligibility. You will be asked questions related to your income and financial assets as well as employment. The process takes about 5-10 minutes. Then, you will receive an email confirming your appointment. But be prepared. In some cases, there may be a second phone interview. Some people may be prompted to complete the report and send it to the social security administration, while others may need to visit their local office in person. The SSI application process has not been standardized so every case is different.
Once you have been determined technically eligible, the second hurdle is the medical determination of disability. Your best friend here is the Social Security Blue Book. The Blue Book is going to identify all the criteria for determination for disability. Most conditions are going to require a fair amount of documentation to show the severity and impact of the disabling conditions. With Down’s Syndrome, for example, you can just show the genetic testing that says Trisomy 21, and that’s all the documentation you need. However, if you are living with a condition like cerebral palsy or autism (because they are seen as spectrum disorders), you will have to show the impact of that condition.
One thing to remember is that when you apply for SSI, you will be screened for SSDI as well. Don’t get scared when you receive a denial for your SSDI application due to insufficient work credits as your SSI application is still being reviewed. Remember, most cases take 8-10 months for decision but when awarded, the award is retroactive to the date of application.
If You Lose at the Initial Application…
If your SSI application has been denied, this is your opportunity to provide more information for reconsideration. This is a perseverance test. Even if you did nothing else, by the time you get to the hearing, you would have a 50-50 chance of winning even without any additional information. If you lose at the first level of appeal, this is called a request for reconsideration, and you should be able to complete this part online. You will need to complete a request for reconsideration form, a function report for appeals, and a new release. And even if you are unsuccessful at reconsideration, you can ask then for a hearing. A hearing provides an opportunity for interaction with the Administrative Law Judge.
If you win…
If you receive a medical determination of disability for your SSI application, it’s probably going to have been several months since you first underwent that technical review. However, you need to go through the technical eligibility/financial review again. You will receive a letter from SSI that you need to present your bank information. This is OK. It indicates that you have successfully completed the medical determination part, and they simply want to conduct the technical review once more before initiating the benefits. Typically, an SSI award amounts to two-thirds of the total award when an individual is living at home and receiving in-kind support and maintenance.
At this stage, we can provide you with a room and board agreement, moving away from the term “rental agreement” to avoid potential tax implications for parents. This agreement demonstrates that the individual is contributing their fair share and is not being subsidized by the family.
How does BDI help?
The process of applying for SSA benefits can be lengthy and frustrating. This is why the Bobby Dodd Institute Benefits Navigation experts developed a process to assist individuals and families with their applications. Benefits acquisition team provides guidance and support through the application process. We will help with Determination of Need assessments, Adaptive Function assessments to assist with demonstrating the severity and impact of the disabling condition to meet diminished residual functional capacity criteria, as well as Medical Evidentiary Reviews. We help resolve overpayment issues and are currently rolling out a futures planning process.
If you’re interested in learning more about the support services available with BDI, fill out this application form.