Social Security Disability Insurance (SSDI)
Social Security Disability Insurance (SSDI) is a federal program to provide assistance to people who have disabilities that prevent them from working for a significant amount of time. SSDI is only available to injured workers who have qualifying disabilities, have worked for a certain amount of time in qualifying positions, and have limited income. In many cases, SSDI claims are denied. Our work injury experts and SSDI attorneys can help you appeal an SSDI denial of benefits.
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SSDI Eligibility
People applying for SSDI are typically eligible for SSDI benefits if they can answer two questions in the affirmative. Question 1: “Do you have enough Social Security work credits?” Question 2: “Are you disabled?” If an injured worker can answer yes to both of these questions, he or she is eligible for benefits. Of course, these questions aren’t always easy to answer.
Do I have enough Social Security work credits?
Earning work credits is straightforward. If you received a certain amount of wages or self-employment income in a given year, you have earned work credits. The amount you need to earn to receive a work credit varies from year to year, but is set at a fairly low threshold. In 2018, for example, workers earn one work credit for every $1,320 earned. There is a limit of four work credits per worker per year, so if you earned $5,280 of SSDI Income or more in 2018 you received four work credits.
The number of work credits required to be eligible for SSDI benefits will depend on the applicant’s age at the time of disability.
- Up to age 24: Requires six work credits earned in the previous three years.
- Aged 24-30: Subtract your age by 21, then double the result. That is the required amount of work credits. These credits must be earned after your 21st birthday. For example, a 28-year-old would require 14 work credits (28-21 = 7, 7×2 = 14) earned after turning 21.
- Aged 31-42: 20 work credits.
- Aged 43-61: Subtract your age by 22. That is the required amount of work credits. For example, a 55-year-old would require 33 work credits (55-33).
- Aged 62 or older: 40 work credits.
For workers aged 31 and older, at least half of the required work credits must have been earned in the years leading up to their disability.
There are other exceptions and allowances for the work requirements. It’s best to consult with a work injury attorney to accurately determine your work history as it pertains to SSDI eligibility.
Am I disabled according to Social Security?
The Social Security Administration (SSA) has strict guidelines on what it considers disability eligible for SSDI benefits. First, the SSA determines if you are working. If you have earnings that average a specific threshold ($1,310 a month in 2021), the SSA does not consider you disabled. If you are determined to be unable to work, the SSA sends your SSDI application to your local Disability Determination Services (DDS) office. The sole purpose of the DDS is to accept or reject your claims of disability.
DDS will examine your application to make a determination. Is your disability ‘severe’? The disability must interfere with your ability to perform basic work tasks for at least a year. Is your disability on the curated list of eligible medical conditions? If your disability is not on the list, the DDS will determine if your disability is as severe as one found on the list. Does your disability prevent you from doing performing previous work duties? If you can, DDS does not consider you disabled. Can you perform any other work duties? DDS will evaluate your disability and determine whether or not you can do other types of work.
There are also many special circumstances considered when determining disability. An SSDI law firm can help you determine if you are likely to be considered disabled and can help you appeal a claim denial.
SSDI Benefits
While SSDI eligibility can be a bit confusing, SSDI benefits calculation is much simpler. Though they are not the same for everyone, SSDI benefits are determined solely by a mathematical formula based on an injured workers’ average indexed monthly earnings (AIME). To determine any individual worker’s AIME is a bit more complicated and would typically be done automatically by SSA. In fact, you can see what your estimated disability benefits would be by creating an account on the Social Security website.
But how do they calculate your AIME? Well, for every year after you turned 21 until the year you suffered disability, you’ll multiply that year’s income (which can also be found on the Social Security website) by an indexing factor and average the result. That amount is your average indexed yearly earnings. Divide that amount by 12 and round down to the nearest dollar for your AIME.
How does the mathematical formula to determine benefits work?. The formula is fairly static, but certain values known as ‘bend points’ change every year. The formula consists of three parts added together.
- 1) 90 percent of AIME up to the first bend point value
- 2) 32 percent of AIME over the first bend point value up to the second bend point value
- 3) 15 percent of AIME over the second bend point value
In 2020, the first bend point value is $960 and the second bend point value is $5,785. So the full 2020 formula is:
- 1) 90 percent of AIME up to $960 plus
- 2) 32 percent of AIME over $960 up to $5,785
- 3) 15 percent of AIME over $5,785
For example, if your average AIME is $7,000, your benefit amount would be 1) $864 plus 2) $1,544 plus 3) $182.25, or $2,590.25. This amount is rounded down to the nearest $.1, so the actual benefit value would be $2,590.20. Most applicants will have an AIME that does not reach the second bend point. Using a more typical AIME value of $2,000 as an example, the benefit amount would be 1) $864 plus 2) $332.80 plus 3) $0 for a benefit amount of $1,196.80. The average SSDI benefit amount in 2019 was $1,234. The maximum SSDI benefit amount was $2,861.
Applying for SSDI
You can apply for SSDI benefits immediately after becoming disabled and unable to work. Applications are accepted online, in person, or over the phone. There is certain information and documentation that must be provided, of which the SSA provides a helpful checklist:
- Medical records already in your possession.
- Workers’ compensation information, including the settlement agreement, date of injury, claim number, and proof of other disability awarded payment amounts.
- Names and dates of birth of your minor children and your spouse.
- Dates of marriages and divorces.
- Checking or savings account number, including the bank’s 9-digit routing number, if you want Direct Deposit for your benefit checks.
- Name, address, and phone number of a person we can contact if we are unable to get in touch with you.
- If a medical release Form SSA-827 (Authorization to Disclose Information to the Social Security Administration) was included with this package, please complete (sign and date with witness signature) and return it as directed.
- If unable to file online, complete the “Medical and Job Worksheet – Adult” and bring to your interview.
SSA recommends filing your application without delay, even if you do not have all of the information and documents above.
After filing your application, you’ll have an in-person or phone interview.
Contact a Social Security Disability Appeals Attorney
Do you have questions about SSDI or the appeals process? The Law Offices of Scott Warmuth helps people whose SSDI claims have been denied appeal the decision. We understand that a denial of disability can be incredibly frustrating, so we work with our clients to ensure their best chances at approval upon appeal.