SSI Handbook

7/29/2019 SSI Handbook

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Disability Benefts


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Contacting Social Security

Visit our websiteOur website, www.socialsecurity.gov, is a valuable

resource or inormation about all o Social Securitysprograms. At our website you also can:

Apply or retirement, disability, and Medicare benefts;

Review your Social Security Statement;

Get the address o your local Social Security ofce;

Request a replacement Medicare card; and

Find copies o our publications.

Call our toll-ree numberIn addition to using our website, you can call us toll-ree

at 1-800-772-1213. We treat all calls confdentially. We cananswer specifc questions rom 7 a.m. to 7 p.m., Mondaythrough Friday. Generally, youll have a shorter wait timei you call during the week ater Tuesday. We can provide

inormation by automated phone service 24 hours a day.(You can use our automated response system to tell us anew address or request a replacement Medicare card.) I youare dea or hard o hearing, you may call our TTY number,1-800-325-0778.

We also want to make sure you receive accurate andcourteous service. That is why we have a second Social

Security representative monitor some telephone calls.
http://www.socialsecurity.gov/http://www.socialsecurity.gov/applyforbenefitshttp://www.socialsecurity.gov/mystatementhttps://secure.ssa.gov/apps6z/FOLO/fo001.jsphttp://www.socialsecurity.gov/medicarecardhttp://www.socialsecurity.gov/pubshttp://www.socialsecurity.gov/pubshttp://www.socialsecurity.gov/medicarecardhttps://secure.ssa.gov/apps6z/FOLO/fo001.jsphttp://www.socialsecurity.gov/mystatementhttp://www.socialsecurity.gov/applyforbenefitshttp://www.socialsecurity.gov/


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Whats inside

Disability beneits 4

Who can get Social Securitydisability beneits? 4

How do I apply or disability beneits? 7

When should I apply and whatinormation do I need? 7

Who decides i I am disabled? 8

What happens when myclaim is approved? 12

Can my amily get beneits? 12How do other paymentsaect my beneits? 13

What do I need to tell Social Security? 13

When do I get Medicare? 14

What do I need to knowabout working? 14

The Ticket to Work program 15


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Disability benefts

Disability is something most people do not like to thinkabout. But the chances that you will become disabledprobably are greater than you realize. Studies show that

a 20-year-old worker has a 3-in-10 chance o becomingdisabled beore reaching ull retirement age.

This booklet provides basic inormation on SocialSecurity disability benefts and is not intended to answerall questions. For specifc inormation about your situation,you should talk with a Social Security representative.

We pay disability benefts through two programs:

the Social Security disability insurance program andthe Supplemental Security Income (SSI) program. Thisbooklet is about the Social Security disability program. Forinormation about the SSI disability program or adults, seeSupplemental Security Income (SSI) (PublicationNo. 05-11000). For inormation about disability programs orchildren, reer to Benefts For Children With Disabilities

(Publication No. 05-10026). Our publications are availableonline at www.socialsecurity.gov.

Who can get Social Security disability benefts?

Social Security pays benefts to people who cannot workbecause they have a medical condition that is expectedto last at least one year or result in death. Federal law

requires this very strict defnition o disability. While someprograms give money to people with partial disability orshort-term disability, Social Security does not.

Certain amily members o disabled workers also canreceive money rom Social Security. This is explained onpages 12-13.
http://www.ssa.gov/pubs/11000.htmlhttp://www.ssa.gov/pubs/11000.htmlhttp://www.ssa.gov/pubs/11000.htmlhttp://www.ssa.gov/pubs/10026.htmlhttp://www.ssa.gov/pubs/10026.htmlhttp://www.ssa.gov/pubs/10026.htmlhttp://www.socialsecurity.gov/http://www.socialsecurity.gov/http://www.ssa.gov/pubs/10026.htmlhttp://www.ssa.gov/pubs/11000.html


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How do I meet the earnings requirement ordisability benefts?

In general, to get disability benefts, you must meet twodierent earnings tests:

1. A recent work test based on your age at the time youbecame disabled; and

2. A duration o work test to show that you worked longenough under Social Security.

Certain blind workers have to meet only the duration owork test.

The ollowing table shows the rules or how much work

you need or the recent work test based on your age whenyour disability began. The rules in this table are based onthe calendar quarterin which you turned or will turn acertain age.

The calendar quarters are:

First Quarter: January 1 through March 31;Second Quarter: April 1 through June 30;Third Quarter: July 1 through September 30; andFourth Quarter: October 1 through December 31.

Rules or work needed or the recent work test

If you become disabled... Then you generally need:

In or beore the quarter you

turn age 24

1.5 years o work during the three-year

period ending with the quarter yourdisability began.

In the quarter ater youturn age 24 but beore thequarter you turn age 31

Work during hal the time or theperiod beginning with the quarterater you turned 21 and ending withthe quarter you became disabled.Example: I you become disabled inthe quarter you turned age 27, thenyou would need three years o workout o the six-year period ending withthe quarter you became disabled.

In the quarter you turn age31 or later

Work during fve years out o the 10-year period ending with the quarteryour disability began.
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The ollowing table shows examples o how much workyou need to meet the duration o work test i you becomedisabled at various selected ages. For the duration o worktest, your work does not have to all within a certain periodo time.

NOTE: This table does not cover all situations.

Examples o work needed or the duration o work test

If you become disabled... Then you generally need:

Beore age 28 1.5 years o work

Age 30 2 years

Age 34 3 years

Age 38 4 years

Age 42 5 years

Age 44 5.5 years

Age 46 6 years

Age 48 6.5 years

Age 50 7 years

Age 52 7.5 years

Age 54 8 years

Age 56 8.5 years

Age 58 9 years

Age 60 9.5 years


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How do I apply or disability benefts?

There are two ways that you can apply or disabilitybenefts. You can:

1. Apply online at www.socialsecurity.gov; or

2. Call our toll-ree number, 1-800-772-1213, to makean appointment to fle a disability claim at your localSocial Security ofce or to set up an appointment orsomeone to take your claim over the telephone. Thedisability claims interview lasts about one hour. I youare dea or hard o hearing, you may call our toll-reeTTY number, 1-800-325-0778, between 7 a.m. and 7

p.m. on business days. I you schedule an appointment,we will send you a Disability Starter Kit to helpyou get ready or your disability claims interview.The Disability Starter Kit also is available online atwww.socialsecurity.gov/disability.

When should I apply and what

inormation do I need?You should apply or disability benefts as soon as you

become disabled. It can take a long time to process anapplication or disability benefts (three to fve months)To apply or disability benefts, you will need to completean application or Social Security benefts and the AdultDisability Report. You can complete the Adult Disability

Report online at www.socialsecurity.gov/disabilityreport.You also can print the Adult Disability Report, complete itand return it to your local Social Security ofce. We maybe able to process your application aster i you help us bygetting any other inormation we need.

The inormation we need includes:

Your Social Security number;

Your birth or baptismal certifcate;

Names, addresses and phone numbers o the doctors,caseworkers, hospitals and clinics that took care o youand dates o your visits;
http://www.socialsecurity.gov/http://www.socialsecurity.gov/disabilityhttp://www.socialsecurity.gov/disabilityreporthttp://www.socialsecurity.gov/disabilityreporthttp://www.socialsecurity.gov/disabilityhttp://www.socialsecurity.gov/


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Names and dosage o all the medicine you take;

Medical records rom your doctors, therapists, hospitals,clinics and caseworkers that you already have in yourpossession;

Laboratory and test results; A summary o where you worked and the kind o work

you did; and

A copy o your most recent W-2 Form (Wage and TaxStatement) or, i you are sel-employed, your ederal taxreturn or the past year.

In addition to the basic application or disability benefts,

there are other orms you will need to fll out. One ormcollects inormation about your medical condition and howit aects your ability to work. Other orms give doctors,hospitals and other health care proessionals who havetreated you permission to send us inormation about yourmedical condition.

Do not delay applying or benefts i you cannot get all o

this inormation together quickly. We will help you get it.

Who decides i I am disabled?

We will review your application to make sure you meetsome basic requirements or disability benefts. We willcheck whether you worked enough years to qualiy. Also,we will evaluate any current work activities. I you meet

these requirements, we will send your application to theDisability Determination Services ofce in your state.

This state agency completes the disability decision orus. Doctors and disability specialists in the state agency askyour doctors or inormation about your condition. Theywill consider all the acts in your case. They will use themedical evidence rom your doctors and hospitals, clinics

or institutions where you have been treated and all otherinormation. They will ask your doctors:

What your medical condition is;

When your medical condition began;


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How your medical condition limits your activities;

What the medical tests have shown; and

What treatment you have received.

They also will ask the doctors or inormation about

your ability to do work-related activities, such as walking,sitting, liting, carrying and remembering instructions.Your doctors are not asked to decide i you are disabled.

The state agency sta may need more medicalinormation beore they can decide i you are disabled.I more inormation is not available rom your currentmedical sources, the state agency may ask you to go or a

special examination. We preer to ask your own doctor, butsometimes the exam may have to be done by someone else.Social Security will pay or the exam and or some o therelated travel costs.

How we make the decisionWe use a fve-step process to decide i you are disabled.

1 Are you working?I you are working and your earnings average more

than a certain amount each month, we generally will notconsider you disabled. The amount changes each year. Forthe current fgure, see the annual Update (Publication No.05-10003).

I you are not working, or your monthly earnings average

the current amount or less, the state agency then looks atyour medical condition.

2 Is your medical condition severe?For the state agency to decide that you are disabled, your

medical condition must signifcantly limit your abilityto do basic work activitiessuch as walking, sittingand rememberingor at least one year. I your medicalcondition is not that severe, the state agency will notconsider you disabled. I your condition is that severe, thestate agency goes on to step three.
http://www.ssa.gov/pubs/10003.htmlhttp://www.ssa.gov/pubs/10003.htmlhttp://www.ssa.gov/pubs/10003.htmlhttp://www.ssa.gov/pubs/10003.htmlhttp://www.ssa.gov/pubs/10003.html


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3 Is your medical condition on the List o Impairments?The state agency has a List o Impairments that describes

medical conditions that are considered so severe that theyautomatically mean that you are disabled as defned by law.I your condition (or combination o medical conditions)is not on this list, the state agency looks to see i yourcondition is as severe as a condition that is on the list. I theseverity o your medical condition meets or equals that o alisted impairment, the state agency will decide that you aredisabled. I it does not, the state agency goes on to step our.

4 Can you do the work you did beore?

At this step, the state agency decides i your medicalcondition prevents you rom being able to do the work youdid beore. I it does not, the state agency will decide thatyou are not disabled. I it does, the state agency goes on tostep fve.

5 Can you do any other type o work?I you cannot do the work you did in the past, the state

agency looks to see i you would be able to do other work.It evaluates your medical condition, your age, education,past work experience and any skills you may have thatcould be used to do other work. I you cannot do otherwork, the state agency will decide that you are disabled. Iyou can do other work, the state agency will decide thatyou are not disabled.

Special rules or blind peopleThere are a number o other special rules or people

who are blind. For more inormation, ask or I YouAre Blind Or Have Low VisionHow We Can Help(Publication No. 05-10052).

We will tell you our decisionWhen the state agency reaches a decision on your case,we will send you a letter. I your application is approved,the letter will show the amount o your beneft and when
http://www.ssa.gov/pubs/10052.htmlhttp://www.ssa.gov/pubs/10052.htmlhttp://www.ssa.gov/pubs/10052.html


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your payments start. I your application is not approved,the letter will explain why and tell you how to appeal thedecision i you do not agree with it.

What i I disagree?I you disagree with a decision made on your claim,

you can appeal it. The steps you can take are explained inThe Appeals Process (Publication No. 05-10041), which isavailable rom Social Security.

You have the right to be represented by an attorney orother qualifed person o your choice when you do businesswith Social Security. More inormation is in Your Right To

Representation (Publication No. 05-10075), which is alsoavailable rom Social Security.

How we will contact youGenerally, we use the mail or call you on the phone when

we want to contact you about your benefts, but sometimesa Social Security representative may come to your home.

Our representative will show you identifcation beoretalking about your benefts. It is a good idea to call theSocial Security ofce to ask i someone was sent to see you.

I you are blind or have low vision, you can choose toreceive notices rom us in one o the ollowing ways. Yourchoices are:

Standard print notice by frst-class mail;

Standard print notice by certifed mail; Standard print notice by frst-class mail and a ollow-up

telephone call;

Braille notice and a standard print notice by frst-class mail;

Microsot Word fle on a data compact disc (CD) and astandard print notice by frst-class mail;

Audio CD and a standard print notice by frst-classmail; or

Large print (18-point size) notice and a standard printnotice by frst-class mail.
http://www.socialsecurity.gov/pubs/10041.htmlhttp://www.socialsecurity.gov/pubs/10041.htmlhttp://www.socialsecurity.gov/pubs/10075.htmlhttp://www.socialsecurity.gov/pubs/10075.htmlhttp://www.socialsecurity.gov/pubs/10075.htmlhttp://www.socialsecurity.gov/pubs/10075.htmlhttp://www.socialsecurity.gov/pubs/10075.htmlhttp://www.socialsecurity.gov/pubs/10075.htmlhttp://www.socialsecurity.gov/pubs/10041.html


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For more inormation, visit our website atwww.socialsecurity.gov/notices or call us toll-ree at1-800-772-1213. I you are dea or hard o hearing, you maycall our TTY number at 1-800-325-0778.

What happens when my claim is approved?We will send you a letter telling you that your application

is approved, the amount o your monthly beneft and theeective date. Your monthly disability beneft is based onyour average lietime earnings. Your frst Social Securitydisability benefts will be paid or the sixth ull month ater

the date your disability began.Here is an example: I the state agency decides yourdisability began on January 15, your frst disability beneftwill be paid or the month o July. Social Security beneftsare paid in the month ollowing the month or which theyare due, so you will receive your July beneft in August.

You also will receive What You Need To Know When

You Get Disability Benefts (Publication No. 05-10153),which gives you important inormation about your beneftsand tells you what changes you must report to us.

Can my amily get benefts?

Certain members o your amily may qualiy or beneftsbased on your work. They include:

Your spouse, i he or she is age 62 or older; Your spouse, at any age i he or she is caring or a child o

yours who is younger than age 16 or disabled;

Your unmarried child, including an adopted child, or, insome cases, a stepchild or grandchild. The child must beyounger than age 18 or younger than 19 i in elementaryor secondary school ull time; and

Your unmarried child, age 18 or older, i he or she hasa disability that started beore age 22. (The childsdisability also must meet the defnition o disabilityor adults.)
http://www.socialsecurity.gov/noticeshttp://www.ssa.gov/pubs/10153.htmlhttp://www.ssa.gov/pubs/10153.htmlhttp://www.ssa.gov/pubs/10153.htmlhttp://www.ssa.gov/pubs/10153.htmlhttp://www.ssa.gov/pubs/10153.htmlhttp://www.socialsecurity.gov/notices


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NOTE: In some situations, a divorced spouse mayqualiy or benefts based on your earnings i he or shewas married to you or at least 10 years, is not currentlymarried and is at least age 62. The money paid to adivorced spouse does not reduce your beneft or any

benefts due to your current spouse or children.

How do other payments aect my benefts?

I you are getting other government benefts, the amounto your Social Security disability benefts may be aected.For more inormation, you should see the ollowing:

How Workers Compensation And Other DisabilityPayments May Aect Your Benefts (PublicationNo. 05-10018);

Windall Elimination Provision (PublicationNo. 05-10045); and

Government Pension Oset (PublicationNo. 05-10007).

You can get these publications rom our website,or you can contact us to request them.

What do I need to tell Social Security?

I you have an outstanding warrant or your arrestYou must tell us i you have an outstanding arrest

warrant or any o the ollowing elony oenses: Flight to avoid prosecution or confnement;

Escape rom custody; and

Flight-escape.

You cannot receive regular disability benefts, or anyunderpayments you may be due or any month in which

there is an outstanding arrest warrant or any o theseelony oenses.
http://www.ssa.gov/pubs/10018.htmlhttp://www.ssa.gov/pubs/10018.htmlhttp://www.ssa.gov/pubs/10018.htmlhttp://www.ssa.gov/pubs/10018.htmlhttp://www.ssa.gov/pubs/10045.htmlhttp://www.ssa.gov/pubs/10045.htmlhttp://www.ssa.gov/pubs/10045.htmlhttp://www.ssa.gov/pubs/10007.htmlhttp://www.ssa.gov/pubs/10007.htmlhttp://www.ssa.gov/pubs/10007.htmlhttp://www.ssa.gov/pubs/10007.htmlhttp://www.ssa.gov/pubs/10045.htmlhttp://www.ssa.gov/pubs/10018.html


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I you are convicted o a crimeTell Social Security right away i you are convicted o a

crime. Regular disability benefts or any underpaymentsthat may be due are not paid or the months a person is

confned or a crime, but any amily members who areeligible or benefts based on that persons work maycontinue to receive benefts.

Monthly benefts or any underpayments that may be dueusually are not paid to someone who commits a crime andis confned to an institution by court order and at publicexpense. This applies i the person has been ound:

Not guilty by reason o insanity or similar actors(such as mental disease, mental deect or mentalincompetence); or

Incompetent to stand trial.

I you violate a condition o parole or probationYou must tell us i you are violating a condition o

your probation or parole imposed under ederal or statelaw. You cannot receive regular disability benefts or anyunderpayment that may be due or any month in which youviolate a condition o your probation or parole.

When do I get Medicare?

You will get Medicare coverage automatically ater you

have received disability benefts or two years.

What do I need to know about working?

Ater you start receiving Social Security disabilitybenefts, you may want to try working again. SocialSecurity has special rules called work incentives that allowyou to test your ability to work and still receive monthly

Social Security disability benefts. You also can get helpwith education, rehabilitation and training you need inorder to work.


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I you do take a job or become sel-employed, it isimportant that you tell us about it right away. We needto know when you start or stop work; and i there areany changes in your job duties, hours o work or rate opay. You can call us toll-ree at 1-800-772-1213. I you are

dea or hard o hearing, you may call our TTY number,1-800-325-0778.

For more inormation about helping you return towork, ask or Working While DisabledHow We CanHelp (Publication No. 05-10095). A guide to all ouremployment supports can be ound in our Red Book,ASummary Guide to Employment Support or Individuals

with Disabilities Under the Social Security DisabilityInsurance and Supplemental Security Income Programs(Publication No. 64-030). Also visit our website,www.socialsecurity.gov/work.

The Ticket to Work program

Under this program, Social Security and SupplementalSecurity Income disability benefciaries can get helpwith training and other services they need to go to workat no cost to them. Most benefciaries will receive aticket that they can take to a provider o their choicewho can oer the kind o services they need. To learnmore about this program, ask or Your Ticket To Work(Publication No. 05-10061).
http://www.ssa.gov/pubs/10095.htmlhttp://www.ssa.gov/pubs/10095.htmlhttp://www.ssa.gov/pubs/10095.htmlhttp://www.ssa.gov/pubs/10095.htmlhttp://www.socialsecurity.gov/redbook/eng/main.htmhttp://www.socialsecurity.gov/redbook/eng/main.htmhttp://www.socialsecurity.gov/redbook/eng/main.htmhttp://www.socialsecurity.gov/redbook/eng/main.htmhttp://www.socialsecurity.gov/redbook/eng/main.htmhttp://www.socialsecurity.gov/workhttp://www.ssa.gov/pubs/10061.htmlhttp://www.ssa.gov/pubs/10061.htmlhttp://www.ssa.gov/pubs/10061.htmlhttp://www.ssa.gov/pubs/10061.htmlhttp://www.socialsecurity.gov/workhttp://www.socialsecurity.gov/redbook/eng/main.htmhttp://www.ssa.gov/pubs/10095.html


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Printed on recycled paper

Social Security AdministrationSSA Publication No. 05-10029ICN 456000Unit o Issue - HD (one hundred)June 2012 (July 2011 edition may be used)

Documents

SSI Handbook