Am I Eligible for Social Security Disability Insurance (SSDI) Benefits


Get Help with Your Denied SSDI Claim in Virginia


You are likely reading this article because you’re thinking of filing for disability benefits, have applied for disability benefits, or recently received a denial letter from the Social Security Administration (SSA) and are considering an appeal.


This article provides an overview of Social Security Disability Insurance (SSDI) benefits, also called Disability Insurance Benefits (DIB), and what to expect with your claim. After reading this article you will know the answers to the following questions:


  • What are SSDI benefits?
  • When are you entitled to SSDI benefits?
  • How are SSDI benefits calculated?
  • How difficult is it to get approved for SSDI?


Keep reading to learn more about SSDI benefits. Then call Richmond disability attorney and Newport News Social Security lawyer Corey Pollard for a free consultation. We have helped thousands of adults across Virginia and Maryland qualify for SSDI benefits – and we want to help you and your family throughout the process.


What is Social Security Disability Insurance?


SSDI provides monthly cash payments to disabled workers who have paid into the Social Security trust fund through taxes on their earnings. SSDI benefits are also available to certain dependents of disabled workers, including spouses and children under the age of 18. SSDI claims are also called Title 2 claims because payment of SSDI benefits is authorized under Title 2 of the Social Security Act.


If you qualify for SSDI benefits, you will receive monthly cash payments and become eligible for Medicare 29 months after the date you are found disabled. You may also be entitled to retroactive (past due) benefits if you can show that you were disabled before the date of your disability hearing or the date your claim was awarded.


When are You Entitled to SSDI Benefits?


If you are a disabled worker, you may receive monthly cash benefits through the SSDI program if you meet the following conditions:


  • You meet the Social Security Administration’s definition of disability.


  • You have filed an application for disabled worker’s benefits (SSDI benefits are also referred to as disabled worker’s benefits, which is different from workers’ compensation).


  • You have disability insured status. This means you have earned enough work credits by working both long enough and recently enough to qualify. As a general rule, you must be found medically disabled within 5 years of the last date you worked to receive SSDI benefits.


  • You have completed the five-month waiting period for SSDI benefits.


  • You have not reached full retirement age.


Your monthly case benefits under SSDI begin with the first month you satisfy all of the conditions above.


How Much Will You Receive in Social Security Disability Insurance (SSDI) Benefits?


If you are awarded SSDI benefits, the amount of your monthly payment will be based on your average lifetime earnings. This figure is called the Primary Insurance Amount (PIA), and it is used to determine all your cash benefit amounts. Most of you will receive from $1,000 to $2,600 per month in SSDI benefits if you’re awarded.


Your SSDI payment is not based on the severity of your medical condition or the type of injury or condition you are suffering from. This is a major difference between Social Security and workers’ compensation benefits.


Your SSDI benefits are not taxable unless you are an individual with more than $25,000 in combined income per year, or you and your spouse have combined income of more than $32,000 per year.


You can use your monthly SSDI payment to pay for food, shelter, clothing, entertainment, and any other living expenses. It is your money.


This monthly disability payment can provide you and your family with financial security and serve as the backbone of your future plans.


Each year the SSA will make a cost of living adjustment to your monthly income benefit. This increase protects your benefits against inflation. The amount of the adjustment will change from year to year based on other economic factors, but it is usually from 0 percent to 4 percent.


By the time you get approved for SSDI benefits, you may have gone months or even years without income. Depending on the date you’re found disabled (also called your established onset date) and at which stage of the process you get approved for benefits, you may be entitled to a substantial amount of back pay. The amount of back pay is based, in part, on your average lifetime earnings.


An experienced Social Security disability attorney can help you calculate your monthly benefits after you’re approved for SSDI and ensure that the SSA’s calculation is correct.


How Difficult is it to Receive SSDI Benefits?


Contrary to popular belief, winning SSDI benefits is difficult.


According to the SSA, 2,263,563 applications for disability benefits were filed in 2014. Only 29.2 percent of these applications were awarded.


The numbers don’t like. It is difficult to get approved for SSDI. And it’s getting more difficult each year. The percentage of cases approved has increased significantly since 2000, when more than 56% of all applications for disability benefits were approved.


Other Advantages of Qualifying for SSDI Benefits


There are additional benefits to qualifying for Social Security Disability Insurance benefits. These include:


Protected Retirement Benefits at a Higher Rate


When you reach retirement age your SSDI benefit will end and you will start to receive regular Social Security retirement benefits. By applying for and obtaining SSDI benefits you freeze your primary insurance amount, which is the calculation that determines the amount of your monthly benefit payment. Because the years in which you receive SSDI benefits are not counted against your earnings record, your Social Security retirement benefits may be higher than they otherwise would have been because many people start to work less as they get closer to retirement age, which reduces their earnings.


Medical Coverage


You will become eligible for Medicare Part A (hospital benefits) and Medicare Part B (other medical benefits) 24 months after the date you become entitled to SSDI benefits. For many of you this may be the first time in years that you have medical coverage that allows you to choose the health care providers you treat with and to receive the specialized care you need for your physical and mental health impairments.


Prescription Drug Coverage


You will also become eligible for Medicare Part D 24 months after the date you become entitled to SSDI benefits. Medicare Part D helps pay for prescription drugs that you may need to treat your medical conditions and control your symptoms so that you have a better quality of life.


Extended COBRA Benefits


Many of you had health care coverage through an employer in the past. When you could no longer work because of your disability your coverage may have ended around the same time as your job. You then had the option of keeping health care coverage through COBRA for a limited period of time and at a high cost. If you get approved for SSDI benefits you can extend your COBRA benefits an additional 11 months, which should help you keep coverage until you become Medicare eligible.


Long Term Disability Benefits


Many long term disability insurance (LTD) policies require you to file an application for SSDI to keep your LTD benefits. If you refuse to file for SSDI benefits then you may lose your LTD benefits. So by going after disability insurance benefits you are protecting your finances. Long term disability lawyer Corey Pollard can help you navigate the two systems at the same time.


Increased Chance of a Workers Compensation Settlement


A severe work-related injury can affect your ability to return to work. If this describes your situation you should consider applying for Social Security Disability Insurance benefits. When the workers compensation insurance carrier finds out that you’re applying for SSDI benefits it may be more likely to offer a fair workers compensation settlement to avoid having to deal with a Medicare Set-Aside (MSA). Further, a workers comp settlement that is structured properly can reduce any offset in SSDI benefits and increase the total amount of compensation you get in your pocket.


Opportunities to Return to Light Duty Work


When you receive disability insurance benefits the SSA will provide you with opportunities to try to return to work at a reduced capacity while still paying you monthly disability insurance benefits. You don’t have to worry about losing your SSDI benefits unless you return to work for an extended period making above the substantial gainful activity (SGA) level.


A Disability Lawyer You Can Trust to Help You Get Approved for SSDI Benefits

Due to an increase in the number of applications for SSDI, the shrinking amount of funds available to pay the benefits, and the volume of applications decided, the majority of SSDI claims are denied at the initial application level. At the reconsideration stage of appeal, more than 80% of SSDI claims are denied.


The standard for receiving is SSDI benefits in Virginia, North Carolina, and Maryland is strict. Given how difficult it has become to get approved, having the best Social Security attorney on your side can be very helpful.


Having representation ensures that you will know and understand your options, that your case is being presented effectively to the SSA, and that you won’t have to deal with paperwork. The SSDI application process is overwhelming. Having a disability lawyer on your side helps.


If you are disabled and feel that you should be entitled to SSDI benefits, call or e-mail us today for a free consultation: 804-251-1620 or 757-810-5614.