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SSI and Social Security Disability

SSI and Social Security Disability

September 2018

What are SSI and Social Security disability?

SSI and Social Security disability are federal programs that provide cash assistance to people who cannot work because of a disability.

  • Social Security Disability Insurance (SSDI) benefits are based on a person's work and earnings history.
  • SSI is a needs-based program for people who have not earned enough to get benefits based only on their work record. The amount of the benefit increases slightly each year.

How serious must my disability be?

Your disability is considered serious if it will

  • prevent you from working for one year or more, or
  • cause you to die.

What kinds of medical problems show that my disability is serious?

A physical condition that

  • makes it hard for you to do things like sit, stand, walk, lift, carry; or
  • causes you pain, tiredness, shortness of breath, or other serious symptoms that affect your ability to work.

A mental health condition that causes problems with

  • your memory, thinking, understanding, moods, or concentration; or
  • your ability to work with other people.

¿Cuales son las incapacidades por el Seguro Social y SSI?

SSI e Incapacidades por el Seguro Social son programas federales que brindan ayuda en efectivo a personas que no pueden trabajar debido a una incapacidad.

  • Los beneficios por Incapacidad del Seguro Social (SSDI, por su sigla en inglés) se basan en el trabajo de una persona y sus antecedentes de ingresos.
  • SSI es un programa que se basa en las necesidades de una persona, cuando esta no ha ganado lo suficiente para recibir beneficios de acuerdo a sus antecedentes laborales. El monto de los beneficios aumenta levemente todos los años.

¿Qué tan grave tiene que ser mi incapacidad?

Su incapacidad se considera grave si

  • le impide trabajar por un año o más, o
  • le causará la muerte.

¿Qué tipos de problemas médicos demuestran que mi incapacidad es grave?

Un problema físico que

  • le hace difícil sentarse, ponerse de pie, caminar, levantar o transportar objetos; o
  • le causa dolor, cansancio, falta de aliento u otro síntoma grave que afecta su capacidad para trabajar.

Un problema de salud mental que le causa problemas graves con  

  • su memoria, pensamiento, comprensión, estado de ánimo, concentración; o
  • su capacidad para trabajar con otras personas.

How do I apply for SSI or Social Security disability?

You should apply for both programs if you have worked. You can apply

When should I apply?

Apply as soon as you become disabled. There is no deadline, but the sooner you apply, the sooner you could get benefits. If your disability makes it hard for you to apply, you can ask SSA for help. Tell them about your disability and the kind of help you need. For example, you may need help

  • filling out forms,
  • getting documents to support your application, or
  • getting to the SSA office (SSA could interview you at your home).

If you are eligible for disability benefits based on your work history but you wait too long after you become disabled to apply, you would not be able to get SSDI benefits. In that case, if SSA finds that you are disabled, you could be eligible for SSI benefits instead.

Tips for applying

To get ready to apply, read the Disability Starter Kit online at https://www.ssa.gov/disability/disability_starter_kits.htm.

If you want to help the application process move along quickly, you should do these things:

  • Apply online.
  • Be ready to meet with SSA.
  • Find all the documents and information that SSA may ask for.
  • Go to any doctor appointments SSA makes for you with their doctors.
  • Call or write to SSA if you move or change your phone number.
  • Keep copies of all documents you give to SSA.
  • Call every two months to check on your application.

Tips for filling out your application

  • Give complete information about the medical problems that cause you to be disabled, even if you are waiting to see a doctor or the problem is embarrassing. Explain how your disability has changed your life. Be honest and don't try to hide or downplay any problems. Describe things you did before that you can no longer do (or you cannot do as well as you did before), such as cooking and cleaning, driving, shopping, being with others, caring for yourself or others, and more.

    You can also give SSA reports about your disability from doctors, nurse practitioners, chiropractors, therapists, social workers, teachers, and other agencies such as DSS.
     
  • Go to your medical appointments and follow your treatment plan. Make sure you update the person who is treating you for your medical problems; they can change over time.
  • SSA may send you to a doctor for a medical or mental health exam. You must go to this appointment so that SSA can have current information about your health. You will not have to pay for the appointment. Make a note of how long the appointment lasts, what exams the doctor does, and what questions the doctor asks you.
  • If sobriety is an issue for you, get help now. Try to maintain a solid period of sobriety so your disabilities stand out from the substance abuse issues.
  • If you have a medical problem that appears now and then, such as seizures, having trouble getting to the bathroom in time, severe migraines, or dizziness, keep a record of when that happens.
  • Answer questions about your work history. Fully describe the kinds of work you had to do  and list any problems you had at work because of your disability.
  • Describe your education. Put the last grade you completed, and if you were in special education, tell them how long.

What happens after I submit my application?

Someone from SSA will interview you at the SSA office or by phone. The interview takes about an hour. SSA will mail you a decision within 3 to 5 months.

What if I need money or other benefits while SSA is deciding?

If you need HUSKY medical and you have minor children in your care or your income is less than about $1,400 per month for one person, contact AccessHealthCT (AHCT) at 1-855-905-4325.

If you need cash assistance and SNAP or if AHCT says you cannot get HUSKY from them, you can apply at DSS

  • online at www.ct.gov/dss;
  • by calling the DSS call center at 1-855-626-6632; or
  • at your local DSS office (call 2-1-1 for your local DSS address).

What if SSA denies my application?

SSA denies many new applications. If your application is denied or SSA says you are not disabled, you should appeal right away. Many people who appeal get approved for SSI or Social Security disability.

You have 65 days from the date on the denial letter to appeal. If you have a good reason for missing the deadline, Social Security may let you appeal late.

How do I appeal?

If you file a Request for Reconsideration, SSA will look at your claim again, along with any new evidence. To appeal you can

  • get the Request for Reconsideration form from Social Security by calling 1-800-772-1213 (TTY: 1-800-325-0778);
  • file your request online at https://www.ssa.gov/benefits/disability/appeal.htm; or
  • write a letter to your local SSA office that says you still cannot work and you want to appeal the denial.

If SSA denies your Request for Reconsideration, ask for an Administrative Law Judge (ALJ) hearing.  To request an ALJ hearing you can

  • get the ALJ hearing appeal form from Social Security by calling 1-800-772-1213 (TTY: 1-800-325-0778);
  • file your request online at https://www.ssa.gov/benefits/disability/appeal.html; or
  • write a letter to your local SSA office that says you still cannot work and you want to appeal for an ALJ hearing.

You have 65 days from the date on the denial letter to appeal. If you have a good reason for missing the deadline, you can ask Social Security to let you appeal late.

Should I get a lawyer to help me with my appeals?

You don't need a lawyer to file the appeal paperwork, but your chances of winning an appeal are much better if you have one, especially if you are appealing for an ALJ hearing.

Try to talk to a lawyer as soon as you file your appeal. You can hire a private lawyer or call Statewide Legal Services at 1-800-453-3320 for help.

But be sure to file your appeal on time.

NOTE: If you get a lawyer to represent you, it is always best to get a lawyer who handles all levels of appeals. Many cases are denied after an ALJ hearing, and it helps to have a lawyer who will appeal further. When you talk to lawyers, you can ask

  • what appeal levels they handle, and
  • if they have taken appeals to the Appeals Council and Federal District Court.

How long do I have to wait for a hearing?

It takes about one year to get a hearing. SSA will mail you a notice with the date and time of the hearing at least 75 days before the hearing. If you miss your hearing, you may have to wait four months or longer for a new one.

How can I get ready for the hearing?

Make sure your medical and mental health professionals have given SSA all of your records about your disability. If you aren't sure which of your records SSA has, ask them to send you a list of all the records they have. If there is any new information or medical records about why you cannot work, send SSA copies of that information right away.

What will happen at the ALJ appeal hearing?

At your hearing, an Administrative Law Judge (ALJ) will look at the evidence SSA has about why you cannot work. If a medical provider's records are not in the SSA file, tell the ALJ that they are missing and ask SSA to request those records and add them to your case.

The ALJ may ask an employment and/or medical expert to testify about your condition and your ability to work. You can also give the ALJ other information about your disability by

  • bringing witnesses who can testify about your disability; and
  • showing letters from doctors, co-workers, and family about your disability.

If the ALJ denies your application, you can

  • file a new application; or
  • appeal to the Appeals Council within 65 days of the date on the denial letter. It usually takes at least a year to get a decision from the Appeals Council.

NOTE: If you do not appeal your ALJ decision, it becomes final. Depending on the timing of when you last worked and the ALJ decision, a final ALJ decision could cut off your ability to get SSDI benefits based on your work record. It could also affect the amount you get in retirement benefits if you earned enough to be eligible later in life. This is another reason to have a lawyer represent you at the ALJ hearing if possible.

How to appeal to the Appeals Council

Fill out a Request for Review of Hearing Decision/Order (HA-520-U5, https://www.ssa.gov/forms/ha-520.html) and mail it to:

Appeals Council, SSA/OHO
5107 Leesburg Pike
Falls Church, VA 22041-3255

You can also get the form at

  • your local Social Security Administration office;
  • an Office of Hearings Operations in New Haven or Hartford; or
  • by calling SSA toll-free at: 1-800-772-1213 (it is not easy to get through by phone).

Keep a copy for your records.

What do I do after I get disability benefits?

Note: If you get disability benefits or you win your appeal, learn the rules of your disability program(s) to avoid an overpayment and possible fraud charges.

  • Overpayments can lead to the lowering or loss of your disability benefits and even fraud charges.
  • Overpayments and fraud charges are most common when people work and do not report that they are working, or they don't report their income on time (by the 10th day of the following month).
  • Learn the SSA definitions of income and report that income to SSA on time.  Keep a record of your reports to SSA, since SSA is often behind in adjusting benefits.

SSI and SSDI have different rules about how working affects your benefits.

  • SSI also has additional rules that affect the amount of your benefit. Examples include:
    • how much money or other personal property (such as savings accounts) you can have and still get SSI;
    • when food or shelter provided to you must be counted in calculating your monthly benefit; and
    • whether a spouse's or parent's income must be partly counted in calculating your monthly benefit.
  • If your SSDI is supplemented by SSI, the rules of both programs will apply to you.
  • Report all changes, in addition to work, that could affect your benefits.
  • Being in the Ticket to Work program does not protect you from being overpaid. Know the rules.
  • It is possible to work while you get disability benefits but you must know the rules.

Contact Statewide Legal Services (SLS) if you think you need legal help. Apply online at https://www.slsct.org or call 1-800-453-3320.

Get Help From Legal Aid

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Under age 60: Find legal help or apply online.
Not from Connecticut? Find help in another state.

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Dial 2-1-1 or go to 211ct.org for help with services in your community.

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