Some people living with a mental health condition find that there are periods of time when working becomes too difficult, and they can no longer sustain employment. Fortunately, there are two national programs run by the Social Security Administration (SSA) that provide monthly income and health insurance for people unable to work. Here is some information on both programs:
Social Security Disability Insurance Benefits (SSDI)
To qualify for SSDI, you must have an impairment that prevents you from working for at least 12 months and you must have worked and paid into the Social Security program (payroll taxes or FICA) for at least five of the last ten years.
In 2014, the average SSDI monthly benefit was $1,165. However, the amount you receive is directly related to the amount of FICA taxes you have already paid into the FICA system over your working years.
Keep in Mind:
- Your spouse and children in high school and younger can also receive the benefits of your SSDI account.
- After 24 months on SSDI, you are eligible for Medicare benefits.
- You may also be eligible to receive Supplemental Security Income (SSI) benefits.
You can apply for Social Security Disability Insurance in person at any Social Security office or file an application at www.ssa.gov.
Supplemental Security Income (SSI)
SSI has two programs, one for adults and one for children (up to age 18).
Children: To quality for SSI benefits, children must have an impairment that has lasted or is expected to last for at least 12 months and that causes “marked and severe functional limitations.” The child’s family must have very low income and resources. When the child turns 18, SSA will make a determination regarding whether or not he or she is eligible for SSI adult benefits.
Adults: To qualify for SSI benefits, you must have an impairment that prevents you from working on a regular and sustained basis. In addition, you must have very low income, resources and assets; to be exact, you cannot have more than $2,000 in assets. Spousal rules are in place as well; if you are married, your spouse must also have very low income, resources and assets. A couple may not have more than $3,000 in assets.
In 2015, the federal payment was $733/month for an individual and $1,100/month for a couple. However, the amount depends on several factors, including your living arrangements.
Keep in Mind:
- For SSI purposes, assets do not include your primary residence, one car, wedding and engagement rings, certain types of financial support, burial savings up to $1,500 and additional exceptions.
- Depending on which state you live in, you may also receive a monthly supplement from the state.
- You are eligible for Medicaid coverage.
- Any adult who has paid enough into the FICA system may be eligible to receive SSDI benefits at the same time.
You may apply for SSI benefits in person at any Social Security office. Call SSA at (800) 772-1213 to schedule an appointment.
Disability Claims Process
Most Social Security applications are processed through a local SSA office. An attorney with disability claims experience or a Social Security claims representative can help you prepare your application and file it for you. Payment for disability representation is limited by law—no more than 25% of any retroactive SSI or SSDI payments you receive when you are awarded disability, but no more than $6,000—whichever is the lesser amount. Many professionals will agree to only get paid if you win your case.
SSA has detailed information on how disabilities are evaluated, so make sure to read the SSA criteria for your condition. Go to Disability Evaluation Under Social Security. If your condition is not listed, or if you don’t meet all the criteria, try looking at the standards for qualification under other disabilities. Because SSA does not use the same diagnostic system as medical professionals, you might qualify for benefits under a condition other than that which you have been medically diagnosed with.
Typically, it will take three to five months to get a decision on your application. If approved, the SSA will begin paying benefits immediately. Both SSI and SSDI applicants may receive back pay or retroactive benefits based on when the claim was filed and the date established as the onset of your disability.
Appealing Your Denied Claim
The majority of claims are denied, and most people file an appeal. You may file an appeal and have a hearing before an administrative judge. Many people whose applications were denied are often awarded benefits by these judges. You might wish to consult a Social Security disability benefits attorney or other professional to guide you through the complex hearings and appeals process. It usually takes about 22 months from the time you apply for benefits until you get a hearing.
SSA has important information about appealing decisions on your disability claim or the amount of your payment at Understanding the SSI Appeals Process and SSA Disability Appeal.