Reasons to Apply for Disability Benefits From Social Security

The monthly cash benefit is the main reason to apply for disability. But you'll also qualify for medical benefits.

By , Attorney · UC Law San Francisco

Why should you apply for disability benefits (either SSDI or SSI disability) from the Social Security Administration (SSA)? The monthly cash benefits are the main reason most people apply. But a significant number of disability applicants apply for disability benefits to get medical benefits. (SSI recipients get Medicaid right away, and SSDI recipients get Medicare about two years after their disability began.)

So, when does it make sense to file a disability claim, and when are you likely to be approved? Here are two lists that should help you decide whether or not to apply for disability benefits.

Reasons to Apply for Social Security Disability

There are many reasons to apply for SSDI or SSI disability benefits, including the following:

  • The average SSDI recipient receives more than $1,500 per month.
  • Additional SSDI benefits might be available for your family members, with a combined benefit for a family averaging more than $2,700 per month.
  • Most disability recipients also get medical benefits.
  • You can still work some while you receive disability (as long as you don't earn a substantial income).
  • Social Security will pay you for the time you waited for your disability benefits to be approved (called "back pay").

Of course, you can only reap these benefits if you apply and are approved for disability.

Reasons for Disability Approval

If all of the following reasons for approval apply to you, and you can hold off on working while you wait for a decision, you should consider filing for disability benefits:

  • You have a mental or physical condition that's serious and medically determinable (meaning you can prove it).
  • You expect your medical condition to last at least a year or longer.
  • Your condition is severe enough that it prevents you from doing a substantial amount of work.

When deciding if you should apply for disability, ask yourself whether you're able to work more than Social Security allows disability recipients to work.

How Much Can You Work?

Social Security generally considers earning more than $1,550 per month (in 2024) doing substantial work. If you're legally blind, the limit is $2,590 per month.

If you're applying for SSI and you're legally blind, there's no dollar limit to what you can earn from work and still be considered disabled. But you'll still need to qualify under the SSI income limit.

Does Your Condition Prevent You From Working?

Being unable to work often means you can't stand on your feet for up to two hours a day or you can't lift more than 10-20 pounds frequently. But not every medical condition has physical limitations that fit into a neat box of disabled vs. not disabled.

Being unable to work can also include when you can't be productive 15% or more of your time at work (for instance, due to pain, inability to concentrate, or having to take breaks) or having to be absent from work 10% of the time or more. (This is because you'd be unlikely to be able to keep a job in either of these situations, and Social Security takes that into account.)

So, even if you could work full-time, Social Security should consider you disabled if either of the following are true:

  • You can't remain on-task or productive for 85%-90% of the time, or
  • You'll miss more than a couple of days of work per month due to your medical condition.

If you believe your physical or mental condition will last 12 months or longer and will prevent you from working and maintaining a full-time job, you might want to talk to your doctor about your physical or mental limitations. If your doctor feels that you have significant limitations that could prevent you from working, asking the doctor to document this will help you qualify for disability.

Reasons Not to Apply for Social Security Disability

You might want to hold off on applying for Social Security disability benefits if the following apply to you:

  • You're still working a good amount, and you don't expect to quit.
  • You expect your medical condition to be temporary and to be able to get back to working full-time in less than a year. (You might qualify for temporary disability benefits through your employer or state government instead.)
  • You've already reached full retirement age. (You can't collect SSDI benefits and Social Security retirement benefits at the same time. But you can simultaneously receive SSI and Social Security retirement benefits if your income is low.)

If you have a serious medical condition and have trouble working, but aren't sure if you'd qualify for disability benefits, consider the following to be red flags, or reasons not to apply for disability:

If any of these apply to your situation, you might not have much chance of qualifying for disability benefits. For instance, it's difficult to qualify for disability if you don't have a supportive statement from your doctor that shows you have signs and symptoms of a severe impairment and serious functional limitations that prevent you from working.

If you're unsure whether you're financially eligible for SSDI or SSI, contact Social Security for help determining this.

It's worth your time to do some homework before you apply, because you can't work while waiting for a decision on your SSDI or SSI application—and it can take a year or two to get a final decision on your case. If you're denied, that's a long time to go without income you can't get back.

Learn more about medical and financial eligibility for SSDI and SSI benefits.

Are Disability Benefits Worth the Trouble?

There aren't really any negatives of getting Social Security disability, once you're approved. The only disadvantage of SSDI might be not being able to have a job you enjoy, if receiving benefits keeps you from doing part-time work that you're able to handle.

But to decide whether or not SSDI or SSI disability benefits are worth the time and effort it takes to get them will depend on three things:

  • what benefits you'll receive
  • how long it takes to get benefits, and
  • how likely you are to be successful.

What Benefits Do SSDI and SSI Disability Provide?

Exactly what you'll receive will depend on whether you're getting SSDI or SSI disability benefits. Both programs provide monthly payments and health care benefits.

SSDI: Your SSDI benefit amount is based on your lifetime earnings. The maximum is about $3,800 per month (for 2024), but the average monthly benefit amount is about $1,500.

Your entitlement to cash benefits begins five months after your established disability onset date—when Social Security says your disability began.

Two years after you're entitled to SSDI payments, you'll also get access to Medicare. (Part A is free, but Part B is not, though you can get help from your state to pay your health care costs.) If you're receiving SSDI because of end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS), the two-year wait doesn't apply.

SSI: Monthly SSI payments are based on the federal benefit rate of $943 for individuals and $1,415 for couples (in 2024). But how much you'll actually receive depends on whether you have any other countable income (including in-kind income), which reduces your monthly SSI payment. The average SSI payment is $600.

Where you live is also a factor. Some states provide a supplemental payment, raising your monthly SSI benefit amount by a few dollars or a few hundred dollars. Plus, if you're awarded SSI disability benefits, you'll automatically qualify for Medicaid in most states.

How Long Does It Take to Get Social Security Disability Benefits?

Social Security reports that it takes four to seven months to get an initial disability decision. But most disability applications are initially denied for medical reasons or technical reasons—meaning you'll likely have to file an appeal and wait for the disability hearing judge to decide your claim. That can take several months to a couple of years.

You'll also have a five-month waiting period before your SSDI benefits begin. (There's no waiting period for SSI.)

How Likely Are You to Qualify for Disability Benefits?

Social Security initially denies about more than 60% of all disability claims. And more SSI claims are denied than SSDI claims. Your odds are better after an appeal hearing.

You're more likely to be approved for SSDI benefits if you:

  • are over 55
  • have worked consistently, and
  • have regular medical treatment.

Hiring a disability lawyer also improves your odds. So does quitting working altogether before you apply for benefits.

Learn more about what it takes to win an SSDI or SSI case.

How to Apply for Disability Benefits

If you have good reason to think you'd qualify for benefits, and you think it's worth applying, you can get help with your application by reading our article on filing an application for disability benefits. You can file online, over the phone, or at your local field office. Don't hesitate to do this, because the time required to receive a decision on a disability claim can be lengthy, and your medical condition could worsen by then.

If you're not sure whether it's worth the trouble to apply, think about talking to an experienced disability attorney. A lawyer can tell you how strong your case is, help you gather the right medical documents and opinions, and handle communications with the SSA. Learn more about how lawyers handle disability claims.

Sources:

SSI Annual Statistical Supplement, 2023
Social Security Fact Sheet, 2024

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