SSDI Benefits

SSDI Eligibility Criteria

To qualify for SSDI benefits, you must meet both medical and non-medical criteria established by the Social Security Administration.

These criteria ensure that benefits are provided to individuals who have contributed to the Social Security system through their work history and are unable to engage in substantial gainful activity due to a severe medical condition.

Who Qualifies for SSDI Benefits?

To be eligible for SSDI benefits, you must meet two main criteria:

• Work Credits: You must have worked long enough and recently enough under Social Security to earn sufficient work credits. The number of credits needed varies depending on your age, but generally, you need 40 credits, 20 of which were earned in the last 10 years ending with the year you became disabled.
• Medical Condition: Your condition must be severe enough to prevent you from engaging in substantial gainful activity (SGA) for at least one year or is expected to result in death.

While SSDI benefits are based on your work credits, individuals with little or no income or insufficient work history may qualify for Supplemental Security Income, a program designed to assist those with limited financial resources.

SSI benefits are available to those with limited income and resources, regardless of work history.

TruLaw can explain these requirements and assess your eligibility for SSDI benefits.

What to Expect After SSDI Approval?

Once approved for SSDI, you can expect the following:

• Monthly Benefit Payments: These typically begin the sixth full month after your established disability onset date.
• Medicare Coverage Eligibility: You become eligible for Medicare after a 24-month waiting period from the time you start receiving SSDI benefits.
• Family Benefits: Certain family members, such as your spouse or children, may also be eligible for benefits based on your work record.
• Combination of Benefits: Some individuals may qualify for SSI and SSDI, receiving benefits from both programs.

TruLaw can guide you through the post-approval process and help you understand your new benefits.

How to Appeal an SSDI Denial?

If your initial SSDI application is denied, you have the right to appeal the decision through a four-stage process:

1. Reconsideration: A complete review of your claim by someone who did not take part in the first decision.
2. Hearing by an Administrative Law Judge (ALJ): If reconsideration is denied, you can request a hearing before an ALJ.
3. Appeals Council Review: If you disagree with the ALJ’s decision, you can request a review by the SSA’s Appeals Council.
4. Federal Court Review: If the Appeals Council denies your request or you disagree with its decision, you can file a lawsuit in a federal district court.

Each stage has specific deadlines and procedures that TruLaw can guide you through, but you can also seek assistance at your local Social Security office.

They can help you gather additional medical evidence, prepare for hearings, and meet critical deadlines to maximize your chances of overturning a denial.

If you are unsure whether you qualify for SSDI or Supplemental Security Income SSI, TruLaw can help determine the best course of action.

When to Apply for SSDI Benefits?

You should apply for SSDI benefits as soon as possible if:

• You Become Disabled: Apply immediately after you become disabled and expect to be out of work for at least one year.
• You Have a Terminal Condition: Specifically if your condition is expected to result in death.

Filing your claim promptly can help avoid potential loss of benefits due to delays.

TruLaw can help you file your claim efficiently.

Common Reasons for SSDI Benefit Denials?

SSDI applications are often denied for various reasons, including:

• Insufficient Medical Evidence: Lack of adequate medical documentation to prove the severity of your disability.
• Short-Term Disability: Your condition is not expected to last at least one year or result in death.
• Ability to Engage in Substantial Gainful Activity: The SSA believes you can perform work despite your condition.
• Non-Compliance with Treatment: Failing to follow prescribed medical treatments without a valid reason.
• Lack of Cooperation: Not providing requested information or failing to attend scheduled medical examinations.

SSDI attorneys can review your application before submission, identify potential weaknesses, and help you gather comprehensive medical evidence to strengthen your claim and improve your chances of approval.

SSDI Backpay and Financial Support

When approved for SSDI, you may be eligible for backpay, which covers the period between your disability onset date and the date your application is approved.

These disability benefits can provide essential financial support during this time.

The SSA typically allows backpay for up to 12 months before your application date.

It’s important to note that there is a five-month waiting period from the onset of disability before SSDI benefits begin.

This means your backpay will start from the sixth full month after your established disability onset date.

SSDI Backpay and Past-Due Benefits

SSDI backpay and past-due benefits can provide significant financial relief for approved applicants.

Here are some key points to understand about SSDI backpay:

• Backpay covers the period between your disability onset date and approval date
• You may receive up to 12 months of backpay before your application date
• There is a 5-month waiting period before benefits begin
• Backpay starts from the 6th full month after your established onset date

The amount of backpay you receive depends on your monthly benefit amount and how long you’ve been waiting for approval.

Backpay is typically paid as a lump sum after your application is approved.

Health Care Coverage with SSDI

Receiving SSDI benefits also opens the door to health insurance, which is a critical component for many recipients as it helps cover medical expenses associated with their disabilities.

For most SSDI recipients, eligibility for Medicare benefits begins after a 24-month waiting period.

However, certain individuals may qualify sooner based on the nature of their disability.

Automatic Medicaid Eligibility for SSDI Recipients

In addition to Medicare, some SSDI recipients may also be automatically eligible for Medicaid, depending on the state in which they reside.

Medicaid can be a vital resource for those who need additional health care coverage, especially if they require ongoing medical treatments or long-term care services.

Key factors about automatic Medicaid eligibility include:

• Medicaid eligibility rules vary by state, and not all SSDI recipients will automatically qualify.
• Some states provide immediate Medicaid eligibility upon SSDI approval, while others require a separate application process.
• Medicaid can help cover medical expenses, including hospital visits, prescription medications, and specialized care services.
• In some cases, Medicaid may offer coverage for services that Medicare does not, such as personal care assistance or home health services.

Medicaid is designed to assist individuals with limited income, providing vital health services.

If you qualify for both SSDI and Medicaid, you can receive comprehensive health care coverage that includes benefits from both programs.

This can greatly reduce your out-of-pocket medical costs and provide access to a wider range of health services.

Having a clear understanding of your health care options through SSDI can help you manage both your financial obligations and medical treatments as you adjust to life with a disability.

Additional Support for SSDI Recipients

Receiving SSDI benefits can provide critical financial relief, but it’s important to know that there are additional resources available to SSDI recipients.

These options can help you better manage your finances and plan for the future.

Accessing Early Retirement Funds Without Penalty on SSDI

For some SSDI recipients, accessing retirement savings early may be necessary to meet financial obligations.

Typically, withdrawing from retirement funds early results in a penalty, but there are certain exceptions for individuals receiving SSDI.

Key points to consider when accessing early retirement funds while on SSDI include:

• Penalty Exceptions: SSDI recipients may qualify for penalty-free early withdrawals from retirement accounts such as IRAs and 401(k)s under specific IRS hardship provisions.
• Tax Implications: While you may avoid penalties, income taxes will still apply to withdrawals from traditional retirement accounts.
• Roth IRA Considerations: If you have a Roth IRA, you can withdraw your contributions penalty-free at any time, but earnings may still be subject to taxes and penalties if you do not meet the qualified distribution requirements.
• Financial Planning: It is advisable to consult a financial advisor before withdrawing from retirement accounts, as early withdrawals can affect your long-term financial stability.

You can access the funds you need while minimizing financial consequences by considering all of your options and planning carefully.

TruLaw: Your SSDI Benefits Law Firm

If you are unable to work due to a disability, you may be eligible for Social Security Disability Insurance (SSDI) benefits.

The lawyers at TruLaw and our partner law firms are currently accepting clients who need assistance with their SSDI benefits claims.

A few reasons to choose TruLaw for your SSDI benefits case include:

• If We Don’t Win, You Don’t Pay: The SSDI benefits lawyers at TruLaw and our partner firms operate on a contingency fee basis, meaning we only get paid if you win.
• Expertise: We have years of experience handling Social Security Disability cases, which helps us anticipate what we can expect to see in your case and the regulations we will be required to meet.
• Successful Track Record: TruLaw and our partner law firms have collected over $3 billion dollars in compensation through verdicts and settlements on behalf of our clients in all 50 states.

If you or someone you love is struggling to obtain the SSDI benefits they deserve, you may be eligible to receive legal assistance.

Contact TruLaw today using the chat on this page to receive an instant case evaluation that can determine if you qualify for help with your SSDI benefits claim today.