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Social Security Disability Technical Eligibility

Social Security is a government program to supply a minimal income to retired or disabled citizens of the United States. Under Social Security rules, ESRD with dialysis is considered a disabling condition that will medically qualify an individual to receive an income, but there are also technical requirements to the program that a person must pass to be eligible. This article is meant to simplify the technical eligibility requirements for Social Security Disability programs in the US.

I have never been on Social Security, but I worked for seven years for a Social Security attorney, helping disabled individuals get approved for Social Security disability benefits. For the last three years of my job with this disability firm, I worked as the trainer, explaining these programs to new employees. First off, we are not talking about retirement benefits but the two programs for Disability benefits.

Before we get started on the technical eligibility requirements, we need to define a few terms:

SSDI: Social Security Disability Insurance, this pulls from the same funds as your retirement, which is taken out of your paycheck if you have been working.

DLI: Date Last Insured, the last date that you are insured for Disability Benefits under SSDI, typically around 5 years after you stopped working depending on if you were paying into Social Security the whole time

AOD: Alleged Onset Date, the date you are claiming that your disability began

SSI: Supplement Security Income, a Disability Welfare program for people that have not paid into SSDI, have low income and resources, and meet certain citizenship criteria

In order to be eligible for either benefit, you need to be found BOTH medically eligible and also technically eligible. The diagram below shows the technical eligibility requirements.

SSDI Eligibility

We will start with SSDI because it is easier.

First, you cannot have current gross earning above the Substantial Gainful Activity (SGA) limit, which for 2018 is $1180 per month. Once again this is a gross amount, before taxes. This is not really enough for anyone to live off, but under Social Security rules, working and earning this much per month means that you are not disabled. Fair or not, these are the rules, and if you are working and earning over the SGA amount, then you will be automatically denied disability benefits.

The next part is simple: your AOD must be before your DLI. In others words, you must have become disabled before your insurance ran out. The analogy that I always use is with car insurance. If you lost your insurance yesterday, and you get into an accident today, your insurance company is not going to pay for your car. The same thing goes with Social Security Disability Insurance.

SSI Technical Eligibility

For SSI, the same rule for SGA holds true. This is the basic overruling concept of both Disability programs under Social Security, but they also look at three other types of income:

  • Earned income (SGA): money that you are earning from working
  • Unearned income: money that you receive from other sources like government assistance, stock dividends, rental income, etc.
  • Deemed income: money that is deemed to be available to you from a spouse or a parent (if you are under 18 years old)
  • In-kind Income: not cash, but free food and shelter which will result in a reduction of your monthly benefit amount

I am only going to explain how Social Security looks at each of these income types individually but know that the combination of incomes can result in ineligibility. If you have any questions, leave a comment with all of your sources of income, and I can do the complex calculations for you to tell you if you are technically eligible for SSI.

There are also rules to resources (how much in assets you own) and certain citizenship rules. I will cover citizenship in more detail in another post, but if you are a US citizen, you have nothing to worry about with the citizenship requirements, even if you are a naturalized citizen. Naturalized citizens are afforded all the rights and privileges as a natural born citizen.

Earned Income

The limit to how much earned income you can have is the SGA limit, which for 2018 is $1180 per month. However, a combination of earned income and other sources of income can make you ineligible for benefits.

Unearned Income

Unearned income will directly affect the benefit amount that you will received from SSI. After a $20 exemption, unearned income will be deducted dollar for dollar from the $750 dollar a month (for 2018) Federal Benefit Rate (FBR) for SSI benefits. This amount is only for an individual receiving SSI benefits. If BOTH the individual and the individual’s spouse are receiving SSI benefits, they don’t each received $750 a month, but a combined $1125 per month (for 2018). Once again, this may not be fair, but those are the rules. There are state supplements for some states, such a California, where the cost of living is higher, but not much. California only pays an additional $160.72 for an individual.

Deemed Income

Deemed income is calculated using another complex formula (the people at Social Security have very difficult jobs). Basically, if your spouse works and earns over around $3000 per month, you may not be eligible. They do give an allowance based on how many children are under your custody that are below the age of 18. If your spouse has unearned income, the amount is even less, around $1200 for a couple with no children under the age of 18 under their custody. If you have a question about if you qualify for SSI with deemed income, leave a comment with all of your and your spouses sources and amounts of income and how many children are under your (legal) custody, and I will do all the complex calculations for you.

In-kind Income

If you are receiving a portion or all of your food and shelter from someone for free or a reduced price, then you may be receiving In-kind Income. The way they determine if you are receiving what they call In-kind Support and Maintenance (ISM) is by looking to see if you are paying your fair share of food and shelter.

For example, if four people live in a house and the total for rent and groceries is $2000 per month, and you are paying less than $500 per month, you are getting ISM.

The result of having In-kind Income is a reduction of your monthly benefits by one third. So, $750 for an individual becomes only $500 per month.

Resources

A resource is any asset that you own such as cars, properties, money in the bank, investment jewelry, etc. There are certain exemptions to both income and resources, which I will talk about in the next section.

Currently, the resource for an individual is $2000, and the resource limit for a married couple (even if only one of them is applying for SSI) is $3000. This means if you have $5000 in your bank account, you will not be eligible until the $5000 is spent down to $2000 (or $3000 for a couple). I think that because the government looks at the SSI program as a type of social welfare, that they want you to spend your own money before they start giving you money. If you are denied Social Security the first time around, a lengthy appeals process can begin, which can last two to three years or even longer. I will talk all about the appeals process in another article.

Exemptions

The government give several exemptions that are not counted as income and resources. I have listed below the most common types of exemptions to both income and resources, but there are many more than I can list.

Income

  • Income tax refunds
  • Financial aid (if it is spent in three months)
  • Child support received to care for a child (this is technically the income of the child)

Resources

  • One home, if it is your primary residence
    • Any additional homes will be counted as a resource
  • One car
    • Any additional cars will be counted as a resource, even for a married couple
  • Household goods and personal effects such as TVs, couches, wedding rings and personal jewelry
  • Up to $500 of a burial plot

If you have any questions about any of the information above, I encourage you to leave a comment, and I will do my best to research and answer your question.

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