Typical American workers face around a 20% chance of becoming disabled for at least a three month period during their working life. Far too few workers have disability insurance policies, and a worker who becomes disabled without insurance to replace his income could experience substantial financial hardship.
The good news is, Social Security does operate a disability benefits program to provide income to disabled workers. In fact, there are two separate programs you could potentially receive income from if you're too disabled to work: Supplemental Security Income and Social Security Disability Insurance.
The problem is, both have strict qualification requirements and high denial rates. The difficulty in becoming eligible for benefits means Social Security Disability may not cover you if something goes wrong.
Your options for Social Security Disability benefits
Social Security Disability Income (SSDI) is a dedicated program aimed at providing protection for long-term disabled workers. SSDI is funded through payroll tax deductions and you earn work credits when you earn your paychecks.
If you've earned a sufficient number of work credits at the time of your disability -- the number varies based on age -- SSDI is the benefits program to turn to if you're disabled. SSDI is not a means-tested program; even wealthy disabled workers are entitled to benefits. Your monthly SSDI income is determined based on how much you paid in while working and you can check your benefit amount at SSA.gov.
If you don't qualify for SSDI because you haven't earned enough work credits, you may be eligible to receive Supplemental Security Income (SSI) if you're disabled. You are eligible only if you have limited household income and few financial resources, and the maximum SSI benefit is $750 per month as of 2018.
When can you get disability benefits?
Getting covered by either SSDI or SSI is difficult. First, you need to prove you meet the basic eligibility requirements, which means having enough work credits or having limited financial resources.
You'll also need to show that you meet the SSA's very strict definition of disabled. The SSA provides disability income only to the most severely disabled workers, so to become eligible for benefits, you'll need to:
- Have a disability that has lasted a year, will last a year, or will end in your death.
- Have a disability listed on the Social Security's Listing of Impairments (also called the Blue Book) or have a condition equivalent in severity to those listed.
- Have documented proof you experience specific symptoms or limitations because of your condition. The Blue Book defines specific criteria to meet for each potentially covered condition. For example, if you qualify for coverage based on epilepsy, you must show a certain level of seizure activity.
- Experience impairment due to your disability that prevents you from doing any job for which you might be qualified.
More than half of all disability benefits applications are denied, so getting covered is challenging.
While there is a multi-stage appeals process, it can take well over a year to appeal your benefits denial in most parts of the country. While some back pay is available, you'll still go a long time without income.
There is an exception for those with especially severe conditions, such as metastatic cancers. If your condition is listed on the Social Security Administration's Compassionate Allowances list, your chances of approval are much better and you can qualify for benefits much more quickly.
What are your alternatives?
If you are not able to obtain Social Security Disability income, your alternatives are limited, unless you have purchased private disability insurance.
If you were hurt at work or can prove your injury or illness is work-related, you may be eligible to receive workers' compensation disability benefits. Some states also offer more protections for workers. In California, for example, short-term disability benefits are available .
Unfortunately for many workers, Social Security is the only option for disability income. If you aren't able to get covered on your own and you believe you have a qualifying condition, getting legal help could be your best course of action.