This training on SSI and SSDI helps to demystify public benefits, particularly those resourced by individuals and families with housing barriers. This training covers eligibility, how to apply, how to maintain benefits, and how to resolve common issues with obtaining or maintaining benefits.
An uptick in applications that are connected to changing requirements from other benefits programs is expected. There are possible short-term impacts during the current government shutdown and some longer-term impacts that are connected to changes in eligibility.
Thank you to Benefits Law Center for sharing this information with us. Benefits Law Center makes direct legal representation accessible at the convenience of the client and assists in the benefits application and appeals process in a way that accommodates their disability and other barriers that they may face.
Types of Benefits
There are a couple of different types of benefits that a person can receive. A person can get benefits based on having a disability, which means they have health conditions that are so severe that they wouldn’t allow you to do any kind of full-time job.
SSI – Social Security Income
To get benefits based on disability for SSI, the only requirements are that you meet the disability, age, or blindness requirements and you meet the income and resource limits, meaning that you’re not making too much money, and you don’t have too much money or assets.
SSDI – Social Security Disability Income
SSDI has the same disability verification requirements but it has different financial requirements. You have to have worked enough hours or enough work credits at a job where you’re paying taxes into the Social Security system to qualify for this benefit.
Disabled Adult Child Benefits
Disabled adult child benefits are for people who became too disabled to work before age 22 and their parent is also receiving Social Security benefits. The child can continue to receive record benefits under their parents’ record.
SSI – “Old Age” SSI
For people who are not disabled, age is the requirement for eligibility for SSI. SSI is not based on your work history. It is only based on, in this case, being at least 65 years or older and not having too much income or resources.
Social Security Retirement
Social Security Retirement is for people who have worked and paid taxes into the system. A person can retire as early as 62 or they can retire as late as 70. For most people who are getting Social Security retirement right now, their full retirement age is 67. If you take it early, you get less benefits per month, and if you take it late, you get more benefits per month.
Auxiliary Spousal/Family Benefits
There are also benefits based on a family member’s earnings. For example, if a spouse passes away, there are survivor’s benefits. These are benefits are on another person’s record.
SSI Qualifications
A person qualifies for SSI if they are 65 years of age or older, blind, or meet Social Security’s definition of disabled.
A person can’t have more than $2,000 in resources, which includes money as well as assets, like property. If a person owns more than one property or more than one vehicle, the value of those assets will be counted as part of a person’s resources.
The resource limit for a married couple is $3,000.
A person can’t make too much money. The income limit this year is $1,620 per month, which includes income, gifts (monetary support received), and investment returns.
A person needs to be a citizen or a documented, qualified immigrant and then meet special criteria or be exempt. A person’s immigration status matters to Social Security. They look at the specific status that USCIS, the Immigration Services, has awarded to the claimant. For people who are a lawful permanent resident (LPR), meaning they have a green card, Social Security views this based on federal regulations, which connect to the Immigration and Nationality Act (INA) and the federal rules and regulations that Social Security uses are tied to those immigration policies.
To see if an immigrant is eligible, first look at a person’s immigration status. The person needs to have a valid immigration status card that’s not expired. Social Security also looks at conditions, which might be additional burdens on the non-citizen who is applying. One common example is someone who is a lawful permanent resident (LPR). A LPR needs to have 40 work credits to qualify for SSI.
While SSI for citizens has no work requirement, for non-citizens, there’s a work requirement. There’s also some time limit conditions, which have detailed rules.
There are some exemptions. They include folks that are veterans, active duty, spouse of active duty, or child of active duty. Another exemption is people who are grandfathered in based on the date of receiving their immigrant status. Another exemption is for folks who are non-citizens but are members of a First Nation band in Canada. They are exempt from all non-citizen SSI rules based off a treaty.
Make sure a person has their status card available when they’re applying. Social Security should be able to tell them whether, based on their status card, they’re eligible to apply or not.
NOTE: If you leave the country for more than 30 days, your benefit should technically stop and you’re supposed to alert Social Security about that.
Common Application Issues
Common issue that SSI applicants and case managers face are:
- Lack of client follow through
- Poor communication from SSI
- SSDI notifications in the mail
For clients that are overwhelmed by the application process, case managers can read their SSI letters or notices together. Sitting with people and supporting them this way helps reduce overwhelm. It is also helpful to remind them of deadlines or help them keep track of deadlines. Case managers should also remind their clients that they need to notify Social Security if they move.
Denials for Insufficient Medical Evidence (and Case Manager Support)
Another common issue is denials based on insufficient medical evidence. This can happen when the claimant didn’t have access to medical care. There’s a variety of valid reasons there might not be sufficient medical evidence.
To address this issue, case managers can assist with getting supportive materials such as updated medical records, letters of support, and evaluations. If a case manager has access to EPIC or can assist their client with accessing MyChart materials, they can get lists of medications, providers, hospitalizations, and general timeframe.
Case managers can also connect clients to care or treatment if they are willing to go. If they want treatment, it’s not too late to get access once they apply, because it’s such a long process.
Providing Proof of Immigration Status
Unfortunately, undocumented immigrants are not eligible. For documented immigrants, Social Security has a verification system. They can communicate with USCIS, the Immigration Services, to verify a status card. If the card is expired, Social Security cannot verify it.
Some clients fear ICE interaction, which is warranted. The Social Security hearing office is in the downtown Seattle federal building, and ICE have patrolled that building regularly in the past.
First Time Application, Denial, and Reapplying
Some clients have to reapply for SSI multiple times. They also get told to reapply or get denied.
In general, rather than reapplying, it is advised that people should appeal the denial. This doesn’t apply to all cases, but the agency has a tendency to tell people to reapply when they actually could be appealing. Almost every Social Security decision can be appealed.
There is an appeal deadline. If it is a decision on whether a person’s disability meets the requirements of this program, there is generally a 60-day deadline. You have an additional five days for mailing. If you miss that deadline, you can appeal late.
For an appeal, the claimant needs to have good cause for late filing. These causes could be:
- I didn’t get the notice
- I was unhoused, I didn’t get the notice
- I’ve been in the hospital
- I didn’t understand, I needed assistance
When clients appeal, they preserve their filing date. If and when they get approved, they can get back paid going all the way back to the first date they applied.
How Social Security Defines Disability
In order to get SSI or SSDI, a person has to provide “verification” of their disability. Social Security has a very specific way of looking at disability.
When Social Security evaluates whether or not someone meets their definition of disability, it is called the Sequential Eligibility Evaluation. It is a five-step process:
The first step in the evaluation process is: Does the person earn too much money? This threshold changes annually. This year, the threshold is $1,620 a month in gross earnings. If a person earns above that dollar amount, they are not disabled by Social Security’s rules.
The second step is: Are the impairments severe? Social Security looks to see if the medically defined impairment is going to or is expected to last 12 months or more.
The third step is: Does the person’s condition meet Social Security’s definition of a medical listing? Social Security has a listing for certain conditions organized by body, such as mental health impairment lists and musculoskeletal listings. There are specific listed criteria and severity levels.
The next steps are: Could a person do their past relevant work? This evaluates a person’s capacity to work with all their impairments in mind, which is called the “residual functional capacity”. Essentially, Social Security is evaluating if a person can continue doing the work they once did, or if they could do any other work in the national economy. The fact that those jobs might not exist or might not be hiring doesn’t impact Social Security’s evaluation.
If a person is working substantial gainful activity, they are denied benefits. If a person’s impairment’s not severe enough, meaning it won’t last 12 months or more, a person is denied benefits. If a person meets a medical listing, they can be approved and don’t need to go any further. If a person doesn’t meet a medical listing, Social Security will evaluate the person’s residual functional capacity (could their impairments allow them to work in any other jobs?).
SSI/SSDI Application Basics
The SSI/SSDI applications are difficult to understand and it’s difficult to know where to start. The easiest thing a case manager can do is help set an appointment for their client. Use the below handout to look up the relevant field office, which is based on a person’s address.
If a person is applying for ABD or receiving ABD, they’re required to also apply for SSI. DSHS has established SSI facilitators within their offices. There is a waiting list, which clients can join.
People can also set up a My Social Security account if they have the technical ability and their own email address that they’re comfortable using. Once they set up a My Social Security account, they can apply for SSDI or first-time SSI benefits through that account.
There’s also a third-party application process if a client doesn’t have a My Social Security account but want to try an online application.
Case managers can help their clients gather information for their appointment.
Social Security offers an Adult Disability Starter Kit, which is a checklist and a worksheet to help people gather the information they need to apply, such as:
- Who their medical providers are
- What work have they done in the past?
Gathering all the correct information before their appointment allows people to get their application submitted at their appointment.
The application is submitted with the Social Security field office that’s based on where the person is residing. The office does an initial review for basic eligibility. People can be denied at this stage. This is a technical denial, since the person doesn’t meet the program rules in general.
If a person passes this initial review, the Division of Disability Determination Services (DDS) does a medical review that considers a person’s providers, diagnoses, and treatment providers. DDS looks at the providers and timeframes that the applicant provides and requests medical records from those providers.
If a person is denied at this stage, they should appeal. This initial appeal is a request for reconsideration. If a person gets denied on their first appeal, they can appeal again and request a hearing. This is an administrative hearing in front of a Social Security administrative law judge. If a person is denied after that, there are more appeals available. A person can go on to the Appeals Council within Social Security and to then to the Federal District Court.
There are a lot of steps in the application process. From application to initial decision, it will likely take at least one year. If a person requests a hearing, it’s at least two years from their application, maybe three. There are many situations, and the process can take many, many years.
SSI Resource Rules
As a reminder, SSI benefits are not based on work record. They are based on disability or being 65 years of age or older.
SSI does not want to give SSI benefits to anybody who has access to any money from anywhere else that they could use to support themselves.
A person cannot have more than $2,000 in resources, a number that hasn’t changed in decades. Resources include money in bank accounts, cash, vehicles, and property.
If a person owns and lives on their own property, that is not counted toward the $2,000 resource limit. If a person owns one vehicle, that is not counted toward the resource limit. But if a person has additional properties or vehicles, those are counted toward the resource limit.
There are some options to help people build wealth while still receiving SSI benefits:
- Set up an Able Account for up to $100,000, which only applies to people who became disabled under Social Security’s rules before the age of 26
- Enroll in the Plan to Achieve Self Support program, which is used to set money away
Burial funds up to $1,500 are allowed and not counted as part of resources.
It’s really important to report changes in income and resources to Social Security. It is also important to record how money that people receive from SSI is spent.
SSI Income Rules
In addition to resource limits, there are income limits. A person cannot be working over the Substantial Gainful Activity (SGA) level for that year.
The first $20 a person gets, from any source, is excluded from income. The first $65 that a person earns as income is also excluded. That is a total of $85 a month of excluded income.
If a person works and earns money, Social Security only counts one dollar for every two dollars they earn. This makes it possibly beneficial for someone receiving SSI to work a part-time job. With a part-time job, SSI benefits will be reduced but only at a 2:1 rate.
Unearned income, which is money a person gets that didn’t come from a job, is also considered. Unearned income reduces SSI benefits dollar by dollar.
If a person is living doubled up, their SSI benefits will be reduced by a third plus twenty dollars. To avoid this, create some kind of lease document or business agreement that shows the person is paying, or will pay back, rent.
Loans are not considered income, but a person needs to show Social Security a plan to pay them back, which can be unrealistic or difficult for someone on SSI benefits.
Common Issues with Maintaining Benefits
A common issue with maintaining benefits is not reporting changes to Social Security. Changes in living situation, financial situation, and job situation all need to be reported.
Another common issue is interacting with the Social Security office, which is extremely understaffed. Social Security staff don’t have the support or resources they need, so interactions can be tense, with a lot of stress and fear on both sides.
Case managers can prepare their clients for this by explaining upfront that the process is going to be difficult.
The handout below includes phone numbers for field offices in King County and the DDS service number.
Do not use Social Security’s online tool for finding a phone number. This directs you to the national line, which is not as effective as calling a local field office.
It is important to persevere in communications with Social Security. Hold times on the phone can be long, and people report being hung up on while waiting. Don’t give up.
Another barrier is not understanding the notices received by Social Security. Some notices are automatic and don’t need a response, they are just informing someone about their benefits. Other notices are about problems or changes. Notices all look the same, so it’s important to read them and pay attention to them so you know when a notice requires an action.
For clients who are on both SSI and SSDI, it is helpful to identify what program the notice came from. An SSI notice will say “Supplemental Security Income” at the top. An SSDI notice will “Retirement Survivor Disability Insurance” at the top.
DDS also sends notices. These have much shorter deadlines—10 days—than Social Security notices, which have a 60-day deadline. DDS will send questionnaires, function reports—which ask about a person’s health—and notices about medical appointments that people are required to attend.
At the bottom of DDS notices, there is a phone number and the name of the examiner. It’s much easier to contact DDS by phone.
Changes at the Social Security Administration
There have been many recent changes to the Social Security Administration.
Filed Offices by Appointment Only
The Social Security Administration has moved to an appointment-based model. This is a change that occurred at the end of 2024 before the recent administration change.
There are two separate scheduling dockets, one for people applying for benefits and another for all other issues. Call the local field office or the 1-800 number to schedule appointments to resolve issues. These appointments are short and intended to resolve issues onsite.
Government Shutdown
Social Security offices are open on a limited basis. Social Security workers are considered essential frontline workers. They are required to work but are not getting paid. This will likely lead to callouts from staff who can’t afford to come to work and not get paid. This will increase delays and communication issues.
Some Social Security services are continued while some are discontinued.
Active Services:
- Processing applications
- Processing appeals
- SSI/SSDI payments
- New social security cards
Inactive Services:
- FOIA responses
- Benefit verification letters
- Overpayments
AI Phone Answering
The Social Security Administration’s phone system has changed to an AI Answering system. People can say what they need to the automated system and it should connect them to the appropriate place. If you say “agent,” you should be routed to a phone rep. Hold times are longer—60 to 70 minutes—but it resolves the issues of needing to call back multiple times.
Alaska Native Settlement Trust Income
There are new rules for the Alaska Native Settlement Trust Income. A law passed in July that will expire in 2030 (unless it’s renewed). The new law exempts all income received by the Alaska Native Settlement Trust. Previously, only $2,000 of that income was exempt.
New Rule for Overpayments
If people don’t appeal when they get SSDI overpayments, there’s a new automatic recovery rate of 50 percent. This means only 50 percent of an SSDI check will be administered until the overpayment is repaid. People can appeal this and they can appeal late with good cause. People can also request a waiver or a change in repayment rate to negotiate to a lower payment rate.
New Form for Continuing Disability Review
SSDI does continuing disability reviews to verify a person’s disability periodically. If Social Security decides a person is no longer disabled, that person can appeal the decision. They may want to keep their payments during that appeal, in which case there is a new form to file to achieve that.
Benefit Verification Letters
Normal operations to get a benefit verification letter is to:
- Go through a field office
- Call the 1-800 number
- Download the letter from their My Social Security account
The normal operations to get a benefit verification letter are not happening under the current government shutdown. Third-party inquiries are also not happening. To help a client get a verification letter during this shutdown, you have two options:
- Use the client’s My Social Security account
- Call the 1-800 number
Make sure the beneficiary’s address is updated with Social Security. Do that first with the field office and then call the 1-800 number.
Social Security Transitions to Electronic Payments
SSI and SSDI payments have moved to electronic payments instead of paper checks. There are some small exceptions, which are unclear, but otherwise paper checks have been phased out almost completely. Emergent payments have also moved to electronic instead of paper checks.
The best option is to get your client to set up a bank account if possible and if they are willing. Consider a credit union account or a free checking account. This way, people can get direct deposit into their bank account. If your client is underbanked due to being unhoused, the Direct Express card is the next best option.
The Direct Express card is a third-party payment that operates like a debit card. Direct Express is notoriously difficult to deal with and they are in a different time zone. There are also charges involved including charges to replace a debit card multiple times or expedite a payment.
If your client is still receiving paper checks, the best thing to do is help them set up an appointment with a field office.
If a person has a My Social Security account and is on SSDI only, they can request the change to electronic payments through their My Social Security account.
However, there is a waiver form if a person wants to keep paper checks.
How Benefits Law Center Can Help
The Benefits Law Center (BLC) is a small but mighty team. Meanwhile, the volume of Social Security cases is huge. BLC helps people as best as they can, but their ability to take full representation on cases is very limited.
If you need assistance, reach out to BLC. They can provide advice and counsel. They can help guide you and your client through the issue, such as helping review notices, giving advice on next steps, helping complete forms, and answering specific questions.
BLC can offer this assistance in person or remotely.
BLC takes on cases but that is limited. They are working on expanding what they can offer. They are starting an Overpayment Clinic, which is a recurring event to help community members fill out Social Security forms. The first Overpayment Clinic will be at the Central Seattle Public Library downtown (details to be announced). These clinics will be offered quarterly for now. BLC is currently recruiting volunteers to help with these clinics. Please reach out to BLC if you are interested in volunteering.