There is an article on this website that is fairly similar to this one and it's title is, How can I get disability? So, why this article on SSI? Aren't Social Security disability benefits and SSI disability benefits essentially the same thing?Well, yes and no. First of all, let's discuss the difference between SSD (Social Security disability) and SSI (Supplemental Security Income).
Social Security disability is a disability benefit program administered by the Social Security Administration (SSA). It falls under Title II of the Social Security Act and is available to any individual who is deemed to have coverage. To have coverage -- that is, to be eligible to receive Social Security disability insurance benefits -- a claimant must have earned enough "work credits." Credits are earned by working and paying FICA taxes. In other words, if you've worked enough, you'll have enough credits to be eligible for disability benefits. SSD is paid for out of the Social Security trust fund.
SSI is a disability benefit program that is also administered by SSA. (States used to run their own low-income disability programs as part of their general welfare programs, until Nixon worked to federalize these programs into the SSI program in 1972.) SSI falls under Title 16 of the Social Security Act and is paid for out of the general treasury, not the Social Security trust fund.
SSI is available to individuals who have either never worked or who have not worked enough work quarters to qualify for Social Security disability insurance. However, eligibility is subject to income and asset limits. SSI is also available to individuals who once worked and were eligible to receive Social Security disability but are now no longer eligible because they have not worked in a long time (and, thus, their coverage has lapsed) and to children who are disabled, whose families have low income and assets.
Learn more about the basics of SSI.
To have an application taken for SSI disability, you go to a Social Security field office. The actual application is taken by a Social Security claims representative. Claims reps work at Social Security field offices and, in addition to a host of other duties that include inputting retirement claims, take SSI disability applications. After an SSI disability application is taken, it is processed and sent off to another agency that specializes in doing nothing but rendering medical determinations on SSI (and SSDI and Medicaid) claims. In most states, this agency is known as Disability Determination Services, or simply DDS.
When an SSI disability application arrives, this is what happens at DDS. The file is immediately assigned to an individual who will process the medical portion of the claim. This individual is known as a specialist, or disability examiner. On the same day that the SSI claim arrives on the examiner's desk, the examiner will begin to send out letters to the claimant's treatment sources (hospitals, doctors, counselors, etc.) requesting the claimant's medical records. Since many medical providers (especially large hospitals) are particularly slow when it comes to copying and sending records, sometimes the wait for medical records can stretch out to a period of months, despite the fact that multiple status calls may be made by the disability examiner along the way.
At some point, however, the records will arrive. After they do, they will be evaluated by the DDS disability examiner, who will consult with a physician who acts as a medical consultant (DDS disability examiners work in units composed of supervisors, other examiners, and both a medical and a psychological consultant).
When an applicant files for disability, the Social Security office will determine whether or not the claim will be for Social Security disability, SSI, or even both types of benefits. Filing for both SSD and SSI is known as a concurrent disability claim, and it is available to individuals who have coverage for SSD benefits, but whose monthly benefit amount might be particularly low.
Whether you will be approved for a disabililty comes down to what is in your medical records. For this reason, it is particularly important that you keep going to a doctor so that, when your SSI claim is reviewed, not only will you be able to present a medical history, but recent medical records as well (the examiner needs to have access to records that are no older than 60 days, in order to determine that you are currently disabled). Likewise, it is also important that you have a supportive doctor, because your treating physician's notes may have a large impact on whether or not you get SSI.
Your medical records should indicate what you are still physically and/or mentally capable of doing. What you are capable of doing is referred to as your residual functional capacity.
Lean more about the medical records required for disability benefits.
How does your RFC, or residual functional capacity, play into whether or not you will get SSI disability? Your residual functional capacity will be used to determine whether or not you are capable of going back to any of the jobs you did in the past. If it is decided that you are not capable of going back to your past work, an evaluation will be made to determine whether or not you are able to perform "other work" of some kind, given their age, education, and skill set. Most SSI applicants who are denied SSI benefits are turned down on the basis of being able to do other work; that is, the DDS decides that although they aren't able to do their prior job, they are capable of doing some form of work other than what they did in the past.
Learn more about the RFC disability process.
Without a doubt, the SSI disability process is a fairly difficult one, except in the most clear-cut cases. Most SSI applications are initially denied. So to win most SSI claims, you have to be willing to appeal the initial decision and go to a hearing. Whether you need a lawyer may depend on where you are in the process. If you have just applied for SSI, having a lawyer may not make a difference (though in some cases it may, if you have an energetic lawyer who doesn't mind doing some real work on your SSI claim before it gets to the hearing stage). If your SSI case has been denied by the SSA, you should probably consider finding a lawyer to represent you at the hearing. The lawyer will help organize your medical records and get the evidence you need to prove that yor medical impairments are disabling.
Learn more about hiring an SSI lawyer.
By: Tim Moore, former Social Security disability claims examiner