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SSDI (Social Security Disability Insurance) is for individuals who’ve paid into Social Security through past work. It’s based on your work credits. On the other hand, SSI (Supplemental Security Income) supports low-income individuals, regardless of their work history. It’s based on financial need.

Work credits are measurements of your work history and earned as you pay into Social Security through taxes. Typically, you can earn up to 4 credits per year. The number of credits required for SSDI varies by age.

It’s possible but rare. While SSDI is based on work history, SSI is for those with limited resources and income. If your SSDI benefits are low and you meet SSI’s financial criteria, you might qualify for both.

SSI is for individuals with limited income and resources. If your income or assets exceed the set limits, or if you don’t meet other eligibility criteria, you may not qualify.

Once you reach full retirement age, your SSDI will automatically convert to retirement benefits. As for SSI, if you start receiving retirement benefits, they might count as income, potentially reducing or ending your SSI eligibility. Every case is unique, and we’re here to help navigate your options.

The Social Security Administration (SSA) determines how much a person receives based on the amount of past earnings that an individual has paid into their FICA taxes for all the years they’ve worked. It’s important to know that the severity of a disability does not affect how much a person will receive.  

• If you’re eligible for Social Security Disability Insurance (SSDI) benefits, the amount you receive each month will be based on your average lifetime earnings before your disability begins. Unlike veterans compensation, workers’ comp, or Supplemental Security Income payments, SSDI isn’t based on how severe your disability is or how much income you have—everything depends on those lifetime earnings.
• The average SSDI payment is $1,483 in 2023, with the maximum amount reaching about $3,600. In addition, individuals with dependents (under 18) could receive an additional amount of half the monthly benefit. An easy way to estimate a monthly SSDI payment is to use a benefits calculator.

What Is the Maximum Social Security Payment?

The maximum monthly benefits for SSI, SSDI, and retirement in 2023:

• Supplemental Security Income (SSI) – The maximum payment is $914 monthly for individuals and $1,371 monthly for couples.
• Social Security Disability Insurance (SSDI) – The maximum payment is $3,627 a month.
• The maximum family benefit for SSDI is about 150% to 180% of the disabled worker’s benefit.
• The maximum payment at full retirement age is $3,627 monthly. However, if you retire at age 62, your benefit is $2,572. If you retire at age 70, your benefit increases to $4,555.
• Note: The maximum amount of earnings subject to the Social Security tax will also increase to $160,200 in 2023.

How to Calculate Social Security SSI Benefits

Supplemental Security Income (SSI) is for low or no-income individuals. It provides money for basic needs. SSI, at its core, is a welfare program for the disabled. For example:

• Individuals must have less than $2,000 in assets
• A married couple must have less than $3,000 in assets 
• Note: When calculating the assets for a married individual, SSA will count the working spouse’s income toward the $3,000 asset limit.

The monthly maximum SSI Federal Payments amounts for 2023:  

• $914 for an eligible individual
• $1,371 for an eligible individual with an eligible spouse
• $458 for an essential person
• Note: Maximum Federal Supplemental Security Income (SSI) payment amounts increase with the cost-of-living increases that apply to Social Security benefits. The latest increase was 8.7 percent, effective January 2023.

If you have earnings from a job or other sources of income, it may be deducted from the maximum SSI monthly benefit. It may also result in a reduced payment to you. However, SSI does not count all income. Examples of income that is not countable against you include the following:

• The first $20 a month of earned or unearned income
• The first $65 of earned monthly income, such as from working at a job
• One-half of the balance remaining of earned income after deducting the first $65 and, if you did not have other earned or unearned income in a month, the $20 exclusion
• Note: There may also be deductions because of your living arrangements (i.e., an adult getting free room and board.

Any condition could qualify for SSDI benefits if the person’s severity and medical evidence support the claim for benefits. To meet the SSA’s definition of disability, an individual must not be able to engage in any substantial gainful activity (SGA) due to a medically determinable physical or mental impairment that has lasted or is expected to last for a continuous period of at least 12 months or lead to death.

There are a few criteria for someone to be eligible for SSDI.  

• The applicant must have worked at least five of the last 10 years and paid payroll (FICA) taxes during that period.
• They must have had a disability before reaching full retirement age (65-67). If an applicant is younger than 21, they can still apply for SSDI under their parents’ earning records even if they haven’t worked or contributed to the program.
• The individual must be unable to work due to their physical or mental condition, and their condition is expected to last at least a year or result in death.

It’s also vital that the person applying for benefits is under the care of a health professional who can confirm their condition and has medical documentation. Working with a representative can dramatically improve an applicant’s chances of receiving SSDI benefits. A quick assessment can help determine if you are eligible for SSDI.

Benefits continue as long as the individual has a disability that prevents them from working. However, Social Security conducts Continuing Disability Reviews (CDR), which means they review someone’s claim for medical improvement. Those reviews can be scheduled at intervals of six to 18 months, three years, five years, and seven years after benefits began, depending on Social Security’s assessment of whether medical improvement is likely.

Technically, no, because individuals will see their disability benefits converted to Social Security retirement benefits when they reach retirement age (65-67). Also, suppose someone decides to return to work when they reach medical stability. In that case, they may be able to leave the SSDI program and actively work full-time until they decide to retire and then seek Social Security retirement benefits.

Individuals receiving SSDI benefits automatically become eligible for Medicare coverage after a 24-month waiting period. During the waiting period, beneficiaries receiving COBRA can extend that health insurance coverage for an additional 11 months.

Yes, you can attempt a return to work while receiving SSDI benefits. The Social Security Administration administers a program called Ticket to Work (TTW) with the help of authorized Employment Networks. The Ticket program includes important benefits, including protection for a participant’s SSDI and Medicare benefits while they pursue a return to work.

The earning limit for receiving SSDI benefits is known as the substantial gainful activity (SGA) amount, and that is $1,550 per month, or $18,600 annually in 2024 (non-blind). You usually cannot make more than that, or your benefits will stop.

The best way to increase your chances of receiving the benefits you have earned is to approach the application process with an understanding of how complicated it can be. The government wants to ensure people receive benefits who are genuinely deserving of them.

Sage Disability helps people with disabilities fully understand the complexities of the SSDI process. An EDPNA representative has experience with the rules and regulations; they can help get medical records or additional information to support your claim. They can also assist with requesting a reconsideration, a hearing, or an Appeals Council review if needed. It’s important to have representation at the start of the application process since it can improve an individual’s chances of SSDI approval rather than waiting to seek help at the hearing or appeals level.

The examiners at DDS decide both Social Security Disability (SSDI) claims and SSI (Supplemental Security Income) disability claims.

Social Security disability needs timely, accurate, and sufficient medical evidence.

There are conditions for which disability is automatically approved if you fulfill the listed requirements. 

What Is the Compassionate Allowance Program?

• The Compassionate Allowances program provides benefits quickly to disability applicants whose medical conditions are so severe that it’s clear they would qualify for disability under an SSA impairment listing. The program allows Social Security to target the most obviously disabled applicants quickly and grants them benefits soon after applying.
• Claiming to have a disability or disease on the Compassionate Allowance list (CAL) is enough to put your application for benefits on the fast track for approval. Your medical records need to support your claim, but if Social Security finds you have a Compassionate Allowance condition, you will almost always automatically qualify for disability benefits.

Fast Decisions for Serious Impairments

• If you have a condition designated as a Compassionate Allowance, the SSA will approve you for disability benefits based on a relatively small amount of objective medical data, such as a diagnosis or a biopsy result. You can receive a positive award decision in as little as 10 days from when you first filed your application. The average processing time for Social Security to process a compassionate allowance case is 19 days.

The majority of Social Security Disability claims are denied initially. Understanding why your claim was denied is essential to strengthen your case on appeal.

Here’s a timeline for how long a disability appeal with the Social Security administration might take.

• Disability cases don’t have deadlines, but Social Security does publish averages for the time it takes for them to process reconsideration and hearing requests.
• First, you have 60 days after receiving a denial to request a reconsideration of the decision. Once you make the request, it takes a claims examiner three to five months to approve or deny it. If you’re one of the lucky 12-13% of people approved for benefits at the reconsideration stage, you’re done.
• But if you get denied again, you have another 60 days to request an appeal hearing. Then, depending on your location, you will wait anywhere from 10 months (Texas) to 9 months (Florida) to 11 months (California) for a hearing date. The average wait time for an in-person hearing is about one year.
• After your hearing, you’ll have to wait anywhere from a few weeks to three months for the judge’s decision.
• Please note the typical case takes about two years to get a judge’s decision. But because all cases are different, especially as far as an applicant’s impairments and medical evidence are concerned, it’s tough to estimate how long a case will take. In some cases are easy for Social Security to determine that the applicant is disabled; others take much longer. In addition, sometimes, a case is assigned to a DDS claims examiner or administrative law judge who has three hundred cases to work on, and sometimes to an examiner or judge who has ninety cases on their schedule. 
• If you have a strong case, to speed up your appeal, please contact Sage Disability.  We can request an attorney advisor’s opinion, which may get you a pre-hearing decision on your appeal.
• If you have new evidence you didn’t submit with your initial application or new test results that show your condition is worsening, Sage Disability will address the new evidence at the reconsideration stage by calling the Disability Determination Services office in your state. If we can get your denial reversed at that stage, you can shorten the appeals process to three or four months.