This is a commonly asked question that involves many different variables. First of all, The Social Security Administration (“SSA”) will look at whether you are working at or above Substantial Gainful Activity Levels (“SGA”), as discussed in some earlier blog posts. If you are working below SGA, then you need to know which of the two disability programs you should apply under. Eligibility for Supplemental Security Income (“SSI”) requires not only severe medical conditions that prevent working at SGA, but also that you meet SSA’s financial need requirements. Like other “need-based” benefit programs, SSA will look at your income and resources, and also may look at the income of other households and family members depending on the specific circumstances.
Eligibility for Disability Insurance Benefits (“DIB”) also requires severe medical conditions that prevent working at or above SGA, and you must also have paid enough into the Social Security benefits programs. When you pay FICA taxes, you earn what are called “quarters of coverage.” To be eligible for DIB benefits, you must have earned sufficient quarters of coverage and you must have earned sufficient quarters of coverage RECENTLY enough to still be covered. Thus, if you worked a lot many years ago, but haven’t worked very much recently, even though you may have earned sufficient quarters of coverage, you may not have been covered when your claim for disability began. While this area gets a little complicated, the easiest way to think about it is to focus on the INSURANCE portion of the Disability Insurance Benefits program. DIB works like most insurance policies in that you pay a premium and then get a specified period of coverage. If your claim falls within your coverage period, then the insurer must pay on it, if it falls outside of your coverage period then they don’t.