Public Benefits are Key! SSI and SSDI – January 25th, 2024

Welcome Back to Public Benefits are Key!

For those mystified by Social Security benefits and want to make sure people with disabilities get the cash benefits they need, this is the training recap for you!

In this training, our public benefits experts answer the following questions:

  • What are Social Security disability benefits?
  • Who is eligible for SSI? Who is eligible for SSDI?
  • What is the application process like?
  • What are barriers to accessing/maintaining benefits?
  • How can a provider help to avoid client pitfalls and maintain benefits?
  • How can Benefits legal Center help?

We were lucky enough to be joined by knowledgeable staff from Benefits Law Center (email them with any questions!):

What is Benefits Law Center?

The Benefits Law Center (BLC) has existed since 1997 to provide legal advice and representation to low-income individuals with disabilities in their pursuit of Social Security benefits. BLC is committed to delivering high-quality advocacy centered on a client’s needs, honoring the humanity of every client, and providing a continually inclusive, collaborative environment for all. Visit their website to learn more!

Unlike many other public benefit law firms, BLC works with people who have been awarded benefits with the intent to maintain them – some examples of advocacy include responding to overpayment notices, managing threats of termination or cessation, and ensuring a smooth process when it is time for a Continuing Disability Review.

Do you or a client need help applying for or maintaining Social Security disability benefits? Contact Benefits Law Center! Call (206) 686-7252 or email info[at]benefitslawcenter[dot]org.

What are Social Security Disability Benefits?

Supplemental Security Income (SSI) and Social Security Disability Income (SSDI) are cash benefits disbursed by the U.S. Social Security Administration (SSA), a federal governmental agency that provided benefits for over 65 million Americans in 2021, providing income to those who are unable to work due to a disability and to qualifying members of their households.

It is important to note that the SSA has been a very effective anti-poverty tool for beneficiaries of all backgrounds, however it was built with racist intentions. Check out this article to learn more.

SSI and SSDI are both disability benefits, but their programs are designed to serve different people. In short, SSI is designed for those who have low incomes who may never have worked before, while SSDI is reserved for those who have substantial work history who may have any level of income.

To be eligible for SSI, a person must:

  • Be aged 65 or older, blind, or be verified by the SSA as being disabled
  • Earn a gross (pre-tax) income under $1,470 per month in 2023
  • Have limited resources (less than $2000)
  • Be a U.S. citizen – although noncitizens may qualify if they meet special requirements

To be eligible for SSDI, a person must:

  • Be verified by the SSA as being disabled
  • Make any level of income – SSDI is accessible to everyone no matter the income
  • Have worked enough to gain sufficient “work credits” – learn more on the SSA website
    • Generally, if you are 31 or older, you must have earned 40 work credits, or about 10 years of work

If eligible, SSI beneficiaries are awarded $943 per month if single and $1,415 per month if a couple. SSDI beneficiaries are awarded a variable amount that depends on their work history. Note that this amount is based on a federal standard of living and is not adjusted for high costs of living in cities like Seattle.

Definition of ‘disabled’

The SSA uses a definition of disability that is uniquely restrictive, and some eligible applicants are not immediately approved. Note that this definition does not apply to applicants who are 65 years or older or blind.

To meet the definition of ‘disabled’, a person must:

“not be able to engage in any substantial gainful activity (SGA) because of a medically determinable physical or mental impairment(s) that is either:

  1. expected to result in death, or
  2. has lasted or is expected to last for a continuous period of at least 12 months”

“Substantial gainful activity” is a term used to describe a level of work that is:

  • Substantial if “it involves doing significant physical or mental activities or a combination of both” – including part-time work, and
  • Gainful if the work results or intends to result in pay or profit.

While such a restrictive definition can mean that many people face denials, BLC wants to highlight that many applications are approved – this means you should still apply! See the below chart for varying rates of acceptance along the process and remember that BLC can help those who are facing benefits denials and terminations!

How Do I Help My Client Apply for Social Security Disability Benefits?

The process of application can take a long time – as long as years in some cases. It can help people applying to have an idea of what to expect and what can help their application.

There are several ways a person can apply for Social Security Disability Benefits.

  1. Use the Online SSI Appt Request tool
    • Visit http://www.ssa.gov/benefits/ssi/start.html
    • Applicants are notified of appointments and next steps via mail or email within 7-14 business days
    • This is the easiest option for a client advocate to support
    • This option is only accessible to those applying for SSI, not SSDI
  2. Call your local SSA office to schedule an appointment
    • Hours, physical addresses, and hotline numbers are located at https://secure.ssa.gov/ICON
    • Local office numbers can be hard to find! As compiled by Benefits Law Center, you can call your local office at:
      • Metro Seattle (2nd Ave): 866-494-3135
      • North Seattle (Aurora): 866-931-2875
      • Kent (Ramsay Way): 866-931-7671
      • Burien (156th St): 866-964-7380
      • Bellevue (120th Ave): 866-574-2323
      • Lynnwood (33rd Ave): 877-575-5197
      • Everett (Broadway): 866-563-4595
      • Tacoma (47th St): 888-487-9229
    • It can be hard to reach a local office due to wait times, but this can be a helpful method for a client to learn more about which program they are eligible for
  3. Contact DSHS to access an SSI Facilitator – contact info on the DSHS website
  4. Submit an Online Application + Additional Follow-Up
    • SSA provides a portal for clients to access their SSI and SSDI applications
    • Access the portal at http://secure.ssa.gov/iClaim/Ent002View.action
    • This process requires a login
    • This process provides a re-entry code, allowing you or your client to pause their application

*NOTE that SSA Field Offices are open following a lapse during COIVD-19, but are subject to lots of turnover and therefore long wait times. It is best to visit and office or call early in the morning to avoid long delays.

If you have questions about how your client can most easily apply for benefits, check out this specialized training from BLC on YouTube.

SSA’s process of documenting disability is long and can take 3-5 months during typical times. Due to ongoing staffing constraints related to the COVID-19 pandemic, processing times can unfortunately take longer.

The following steps are taken to review eligibility:

  1. Financial Eligibility or Work Credit Review– a person must currently earn less than $1,550 per month – 2,590 if person is blind if applying for SSI, and meet the required number of work credits if applying for SSDI.
  2. Documentation of Severe Impairments – a person must prove that they have severe impairments that prevent from working for at least 1 year. Clients who have co-occurring disorders, such as substance use disorder (SUD) cannot be disqualified, but they can be denied if SUD is found to be the primary cause of disability. If approved, a beneficiary may be required to participate in treatment for SUD to maintain benefits.
  3. Listing Criteria – the SSA will determine whether a person has documented history of disabling conditions, which would create a disabled finding without considering previous ability to work (#4) and work in the national economy (#5)
  4. Ability to Work – a person must prove they are not able to perform any work they have performed in the past
  5. Ability to Work in the National Economy – a person must not be able to perform any job that exists anywhere within the national economy, even if such job is not accessible to the applicant.

Once a person is declared eligible, the application process can vary depending on whether a person’s initial decision has been approved and how the appeals process goes.

It can be stressful when a person’s SSI or SSDI application is denied, especially because the SSA can be complex to navigate and our clients often have acute need for these cash benefits. We at the Coalition know that people with disabilities are entitled to disability benefits, and there are best practices that our client advocates can know so benefits can be awarded!

During the application process, a service provider can help their clients by:

  • Assisting to schedule an appointment or complete their application
  • Gathering materials needed for the application, such as medical records
  • Establishing a reliable mailing address to receive mail from the SSA – this includes important information about appointments and necessary follow-up instructions
  • Make referrals to providers and obtain medical records that can assist in proving eligibility
  • Help gather any additional evidence to prove eligibility, as necessary – this can include letters of support
    • Letters of support can be from a client advocate, providers, or friends and family. They may include attestations of how long a person has known the applicant, personal knowledge or observations of impairments, and how they affect their daily life. NOTE that letters of support should not use language such as “disabled” or “cannot work”, as these terms are considered legal terms that the SSA will determine.
  • Do your best to keep your client engaged in the process by:
    • Meeting deadlines
    • Filing a Statement of Claimant explaining if they are late (“good cause”)

After you submit the application, you can expect a wait of several months. This is because of a number of processes, including a 60 day wait time for a case worker to review the application, additional time to review basic eligibility, and additional time for Disability Determination Services to request records that can offer proof of eligibility, and to review any additional questionnaires filled out by the applicant.

There are a number of barriers that can prevent access to Social Security disability benefits, some structural and some directly related to the application and eligibility process. Due to these challenges, about 63% of applications for SSI and SSDI are denied. However, don’t fret! In our next section, we’ll talk about steps client advocates can take to mitigate these challenges.

Structural barriers pose a real challenge to accessing disability benefits. Barriers like lack of access to mailing address, impairments that challenge ability to complete the application, and access to technology can make it challenging to complete the application process and maintain benefit eligibility

To prevent changes to benefits, BLC recommends:

  • Reporting income to the SSA every month to ensure a beneficiary does not exceed the income limit of $1,550
    • Note that earned income (wages from work) are counted at 50%, while unearned income (unemployment insurance, child support, etc.) is counted dollar per dollar. Learn more at the SSA website.
  • Responding to SSA in a timely manner regarding:
    • Continuing Disability Reviews (every 2-7 years)
    • Claims of Overpayment
    • Changes in Benefits notices

If appealing a denial, termination, or cessation, it’s important to:

  • Respond within 10 days (plus 5 days for mailing) if benefits are already awarded, for a client to maintain receiving benefits
  • Appeal an unfavorable decision within 60 days – if appeals are made past this deadline, you may need to claim good cause for filing late, sharing information such as a client’s housing insecurity or homelessness or time in an inpatient setting.

Do you or a client need help applying for or maintaining Social Security disability benefits? Contact Benefits Law Center! Call (206) 686-7252 or email info@benefitslawcenter.org