Philadelphia Disability Lawyers Explain and Compare Social Security Disability and Supplemental Security Income
Often our Philadelphia disability clients ask us what’s the difference between Social Security disability and Supplemental Security Income, which is often referred to as SSI. The Social Security Administration, in Philadelphia and nationwide, pays disability benefits through two programs: the Social Security disability program and the Supplemental Security Income program.
Both Social Security programs require that you establish, through sufficient medical evidence, that you are disabled. Social Security law states that you are disabled only if your physical or mental impairment is so severe that you are unable to do your previous work and you cannot, considering your age, education, and work experience, do any other substantial gainful work that exists in the national economy. Your ability to work, age, education, and recent jobs are the key factors affecting disability determination. But the Social Security Administration’s evaluation process is complex and its determinations can sometimes defy common sense.
If your answers match the ones below, the Social Security Administration in Philadelphia is likely to award you Social Security disability benefits:
- Are you gainfully employed? NO
- Do you have a severe impairment? YES
- Will your impairment last 12 months or result in death? YES
- Does your disability meet one of Social Security Administration’s listed impairments? If YES, you qualify. If NO …
- Are you able to work? NO
For more information, see our video, Will you qualify for Social Security disability benefits?
Generally, it easier to obtain disability benefits when you are older (over 50, 55 or 60), less educated, have performed more physical work in the past, and/or have less transferable work skills. Sometimes, however, these are not important factors. For example, none of these factors are significant if your disability is based on emotional problems, such as depression.
An insurance plan vs. a welfare program
The Social Security disability insurance program acts like an insurance plan. It pays benefits to Philadelphia disability applicants who worked long enough and paid Social Security taxes. Social Security disability recipients are eligible for Medicare, but only after they have received Social Security disability for two years, or if they are over 65. Medicare premiums are automatically deducted from the monthly Social Security disability benefits.
The SSI program is a federal welfare program for the disabled, blind, and those over 65. It makes monthly payments to people who have little resources and low income. If you are eligible for SSI, you are also entitled to Medicaid, and other social services administered by your state. Many states, including New Jersey, Delaware, and Pennsylvania, also supplement the federal SSI benefit. The state benefit amount varies from state to state.
While the Social Security Administration manages both programs, SSI is not paid for by Social Security taxes. SSI disability benefits are paid out of the U.S. Government’s general revenues while Social Security disability benefits are paid out of the Social Security trust fund.
Significant differences between Social Security disability and Supplemental Security Income that must be considered when applying for Philadelphia disability benefits
Social Security disability and Supplemental Security Income share many of the same concepts and terms, but there are many significant differences between the two programs that must be considered when applying for disability benefits in Philadelphia.
In addition to meeting the definition of disabled (as discussed above), to receive Philadelphia Social Security disability benefits, you must be “insured.” To be “insured,” you must have paid Social Security taxes over a sufficiently long period to be “fully insured” and paid such taxes recently enough to have “disability insured status.” After you stop working (and paying Social Security taxes), your insured status will lapse at a certain time, just like a private insurance plan.
For example, if you are 37 years old, you must have worked and paid taxes for five years out of the 10-year period prior to the calendar quarter your disability began. If you were younger than 31 at the time your disability started, your work requirement is reduced. Someone who is disabled prior to age 31 needs to have accumulated one half the number of quarters between the age of 21 and the age at onset of disability, but not less than six quarters. For example, if you became disabled at age 25, you would need eight quarters (two years of work) to qualify for benefits.
To be eligible for Philadelphia SSI disability benefits, you must also be found to be “disabled” using the same definition as is used for the Social Security disability program (as discussed above). There is no “insured” or earnings requirement and no work history is required. If you do not have the work history for Social Security disability benefits, then you may qualify for SSI benefits in Philadelphia. However, your income and assets must not exceed the SSI program’s income and asset limitations.
There are no asset limitations to receive Social Security disability benefits. Your assets (things you own) are not assessed by the Social Security Administration.
For SSI, the Social Security Administration assesses your assets. There is an asset limitation of $2,000 per individual and $3,000 per couple. Not counted in this limitation are a home of any value and one car of any value, if it is used for work or to obtain medical care.
For Social Security disability, you will not be found disabled if you are doing “substantial gainful activity.” To the Social Security Administration, substantial gainful activity means work that pays $1,000 per month or more and involves more than minimal duties. Therefore, if you make more than $1,000 per month at a job involving more than minimal duties you will be ineligible for Philadelphia Social Security disability benefits.
SSI is a needs-based program. The SSI income limit is based on the monthly SSI benefit amount after several different kinds and amounts of unearned and earned income are not counted. A part of your earned income is not counted under a formula designed to encourage SSI recipients to work. The income amount left after the Social Security Administration has made all of its allowable deductions is referred to as “countable income.” If your monthly countable income is over the SSI benefit amount, you cannot receive benefits. And the more countable income you have, the less your benefit will be. If you qualify for state welfare and/or medical assistance, you will most likely meet the SSI program’s income and resource requirements.
Amount of payment
For Social Security disability, the amount you receive is based on your earnings record. This amount may be reduced if an individual is receiving or has received (in the recent past) workers’ compensation benefits, benefits under a pension resulting from non-covered earnings (i.e. earnings for which Social Security taxes were not paid), and/or public disability benefits (for example, certain state and civil disability benefits). Your other income or assets do not affect this payment amount. Your monthly payment may be adjusted each year to account for changes in cost-of-living.
The SSI disability amount you receive is a federal amount set by Congress plus a state supplement, if any, set by your state. New Jersey, Delaware, and Pennsylvania each provide SSI state supplements. Your state supplement amount may vary according to your living arrangements. Your countable income will be subtracted from the federal amount before the state supplement is added. The SSI federal amount is adjusted each year based on cost-of-living changes.
Waiting period to receive benefits
For Social Security disability benefits, you must wait a full five months from the date of the onset of your disability. There is a retroactivity period of one year – meaning that you may be eligible for payment of up to 12 months of benefits prior to your application, if you were disabled during that time and all other requirements are met. If you apply for Philadelphia disability benefits before the expiration of the five-month waiting period and are awarded benefits, your benefits will not begin until after the five-month waiting period has ended.
For SSI, there is no waiting period. Your SSI payment will begin with the first month after all the SSI requirements are met or when the definition of disability is met, whichever is later. There is no retroactivity period – you will only be eligible for benefits beginning the month after your application.
Additional benefits for children and/or spouses
For Social Security disability, benefits may be paid to your dependent family members if they meet certain conditions. Children are eligible for benefits under this program until the age of 18, or 19, if still in high school. Disabled children over age 19 may also be eligible for Social Security disability benefits. Your spouse can also receive a payment if he or she is caring for children who are under age 16 or are disabled. There is an income limit for your spouse’s payment.
For SSI, only the disabled individual can receive SSI benefits. There is no increased federal payment for a child or spouse, but some state SSI supplements will add money for children and/or spouses.
Under SSI, however, children with disabilities may be eligible for SSI benefits. A child qualifies as disabled if the child has a medically determinable impairment (physical or mental) that causes marked or severe functional limitations for more than one year, or is likely to result in death. The Social Security Administration considers the overall affects of various impairments.
Whether or not SSI benefits are paid to a disabled child also depends upon household income. Generally speaking, the income level must be low enough to qualify for welfare and/or food stamps. Similar to adult SSI benefits, for children, income eligibility is determined using a complex formula that accounts for many deductibles. Also, a parent’s assets can operate to make the child ineligible for payments if the child lives with the parent.
There are no state supplements provided with the Social Security disability program.
Many states, including New Jersey, Delaware, and Pennsylvania, pay some individuals who receive SSI benefits an additional state supplement. The amounts and qualifications for these state supplements vary state-to-state. Some states manage their own supplement programs and make payments to you separately. Other states work with the Social Security Administration to combine their supplemental payment with the federal SSI payment so you receive one monthly check.
Some Philadelphia disability claimants are eligible for both types of benefits
Many Philadelphia disability claimants may apply or be eligible for benefits under both programs. Generally, you may receive both Philadelphia Social Security disability and SSI benefits if your Social Security disability benefits are low enough. An individual whose Social Security disability benefits are less than the amount of the SSI benefit can apply for SSI in Philadelphia to increase the total benefits up to the level that would otherwise be paid by SSI. In these instances, household income and resources will be taken into account in determining whether SSI benefits are payable.
However, even when high Social Security disability benefits disqualify you from receiving SSI, you may get SSI during the five-month waiting period after becoming disabled when no Social Security disability benefits are paid, assuming your assets and any other income are small enough.
Assistance from knowledgeable and experienced Philadelphia Social Security disability lawyers
The decision about when and to which program to apply is an important one for a Philadelphia disability claimant. We have been practicing Social Security disability law for over 30 years, and have handled many Philadelphia SSI benefits and Social Security disability cases.
If you want our help with your Philadelphia Social Security disability or Supplemental Security Income claim, give us a brief description of your situation using the form to the right. Or contact us at:
Silver & Silver
Philadelphia disability attorneys
Silver & Silver
42 West Lancaster Avenue
Ardmore, Pennsylvania 19003