Our world is built for neurotypical, able individuals. As such, those with new or persistent disability can quickly become overwhelmed by the various disability programs, their barrage of eligibility requirements, and the paperwork needed to get a disability record on file.
As a lawyer, I wanted to put together a list of the various benefits for people with disabilities while making their associated eligibility requirements easy-to-reference.
What is Disability
Most people have a preconceived notion of what disability looks like. These beliefs are driven by media and worst case scenarios— leaving many people who are legitimately disabled unsure of whether they qualify for assistance.
The truth is, there are many different levels of disabilities individuals can experience ranging from cognitive, physical, mild, and severe. Depending on where people fall on this spectrum, they can experience a wide variety of challenges in day to day life. For many, this means a challenge in completing work-related tasks.
When work suffers, so does the ability to make an income and qualify for employer sponsored health insurance plans.
If you have reached this point, there are likely social safety nets that may help you meet daily demands.
Income Supplements: SSI vs SSDI
Under Supplemental Security Income (SSI), individuals are entitled to $735 a month and up to $1,103 a month for couples. Under Social Security Disability Insurance (SSDI), the disbursements have a broader range with amounts ranging anywhere from $700-1,700 a month depending on the extent of care needed.
Needs Based vs. Entitlement Based Income Support
Another point individuals must be aware of is that SSI is a needs-based disability benefit while SSDI is an entitlement-based disability benefit. This creates considerable differences in eligibility requirements.
Under SSI, people must be nearly impoverished to qualify. This includes income and asset caps. In 2020, individuals must earn less than $783 per month and own less than $2,000 in countable assets to qualify. For couples, they cannot collectively make more than $1,175 per month or own $3000 in countable assets.
As such, individuals who qualify for SSI often qualify for other government benefits as well including healthcare through Medicaid and nutritional assistance through SNAP.
For SSDI, these restrictions are much more lenient as you have paid into the program over time through working and contributing through taxes. Individuals applying for SSDI still need to remain under an income cap of $1,070 per month, however, they can own as many countable assets as they desire. Furthermore, if they are married, the income of their spouse will not affect or be counted toward their eligibility.
SSDI and Work Credits
In addition to income caps, the Federal Government requires people with disabilities to qualify in work credits. While this is only true for those who may qualify for SSDI, it’s a necessary consideration.
Work credits are calculated by giving a set number of credits per year based on your income. You can earn up to four credits a year— the equivalent of 4 quarter’s worth of work. Furthermore, the number of credits you ultimately need to qualify depends on your age as a reasonable indicator of how many years you would have reasonably worked.
For those who cannot meet these requirements, they are unlikely to receive SSDI coverage. While this may be unfortunate for people who wanted both SSDI and SSI disability, it does not prohibit them from collecting on other disability benefits.
Similar to the difference in SSI and SSDI, there are differences between Medicare and Medicaid when it comes to eligibility and their impact on the disabled population.
Medicaid, similar to SSI, is a needs-based program. This means that if you are disabled, low income, and otherwise unable to afford marketplace coverage, you can still apply for medicaid to help cover both long term and short term healthcare needs. Similar to SSI, there are income caps that determine your eligibility: for individuals your income cannot exceed $1,064 a month and for couples your joint income cannot exceed $1,437 a month.
Medicaid is regulated at the state level and so coverage options may vary on your geographic location. However, most medicaid programs cover routine medical exams, prescription drugs, vision, dental, and other health care services. This coverage is often offered at little to no monthly premium to allow the financially disadvantaged to still afford health insurance.
Medicare is slightly different as there is no eligibility requirement based on income. In this way it is more similar to SSDI. Instead of income, your eligibility is shown through either having a documented disability or being over the age of 65.
Medicare coverage also works more similarly to marketplace plans as they often require applicants to pay a premium for coverage, have various plans and coverage options, and have different levels of healthcare coverage depending on the policies (known as parts) you select.
The Ticket to Work program
One final disability benefit that acts as a bookend to some individual’s disability journey is the Ticket to Work Program. This program is offered for free through the SSA for individuals who are enrolled in SSI or SSDI and want to return to the workforce but need assistance to do so.
For these individuals, they are placed in a category where they can receive job support and vocational assistance while still retaining their current level of disability benefits such as health insurance and income support.
This program works as an exchange– the SSA offers free services for the likelihood that the individual participating in this program will eventually return to the workforce and no longer rely on government benefits to make ends meet. The timeline of this transfer is discussed with the program employees as you develop a schedule where you set a goal you must meet in a timely manner to fulfil your end of the program.
If you are not able to meet these demands or find that you are not able to return to work as you had hoped, you will still be able to re-enroll in your benefits. In some cases, you will find this out sooner rather than later and potentially not lose your benefits at all.