WINNING AN SSI CLAIM BUT GETTING NO PAY

It is possible to be found "disabled" by Social Security and yet not qualify for a check.  How does this happen?

It can happen when a person files a claim for Supplemental Security Income or SSI.  This is a welfare based program that has two requirements:

1.  The claimant must be medically disabled or not able to work based on a medical condition.  This is called the "medical requirement."

2.  The second requirement is, the claimant must meet the financial resource, income and living arrangements required by SSI.  This is called the "financial requirements."

Generally, an individual with more than $2,000 in resources will not qualify for SSI benefits.  A couple with over $3,000 in resources will not qualify.  In addition, there are strict limitations on household income.  So, a person may meet the medical requirements (be disabled) but fail to meet the financial requirements.

These statements apply only to Supplemental Security Income or SSI, also called Title 16 benefits.  They do not apply to Social Security disability benefits (SSDI), also called Title 2 benefits.

SSDI is a program based on the claimant's work record.  He or she has worked and paid FICA tax into Social Security over the years, by payroll deduction, thus earning coverage under Title 2. There are no "financial requirements" for this person. However, persons filing for SSI have generally never worked, or have not worked enough to be covered by Title 2.   They must meet both the medical and financial requirements established by SSI in order to get paid a benefit.

These programs are confusing and individuals often don't know which program they have filed under.  The benefits are also very different.  For example, the maximum benefit for SSI is $733 per month, while the maximum benefit for SSDI is over $2,600 per month.  There is not waiting period for SSI, but SSDI does not pay for the first 5 months of disability.  As I have already explained, there are income limits for SSI but not for SSDI.

If you have worked at least 5 out of the most recent 10 year period, then you want to file for SSDI.  You only want to file for SSI if your work record won't support an SSDI claim--or in certain cases where the SSDI benefit will be very low (below $735 per month).

If you're confused by all this, seek out a representative or advocate who is qualified for Direct Payment of Fees by the Social Security Administration.  He or she will be able to advise you on the best type of claim to file.

SOCIAL SECURITY JUSTICE: THE FORSYTHE FIRM