If you have a disability or a serious medical condition that gets in the way of earning a living, you may be thinking of applying for Supplemental Security Income (SSI) benefits. What are your chances of getting SSI? And what can you do to improve those chances? To help answer these questions, we surveyed readers around the country who recently went through the SSI application process. Here's what we learned.
Overall, only a little over a third (36%) of our readers who applied for SSI were ultimately approved for benefits. No doubt, that sounds discouraging. But it may help to understand more about how the process works and when approval rates go up.
First, a bit of background on SSI and the approval procedure: SSI pays a small benefit to people who are disabled and have little or no income or assets. In contrast to Social Security Disability Insurance (SSDI), you may be eligible for SSI no matter how little you've worked in the past. After you file an application, the Social Security Administration (SSA) will first decide whether you meet the financial eligibility requirements for SSI. If you pass that step, a disability examiner will look at the medical evidence and approve your claim if you meet the medical eligibility requirements for disability benefits. Only one in five (20%) of our readers successfully made it through both of these initial financial and medical steps. Government statistics for applications filed in 2018 show that 18% of SSI applications were denied because they didn't meet the financial requirements. Data for the same year show a 37% initial approval rate based only on medical eligibility—considerably higher than for all SSI applications at the application level.
Second, a denial at this initial application isn't necessarily the end of the process. Applicants can appeal a denial by requesting a hearing before an administrative law judge. (Most states require them to go through a reconsideration review first.) Once our readers got to the hearing stage, their chances of success more than doubled; more than four in ten (43%) of SSI applicants were approved for benefits after a hearing. Despite that huge improvement, less than half (47%) of those who were initially denied actually requested a hearing. That's a shame because those who give up or miss the deadline for filing an appeal pass up their best opportunity to receive benefits.
Another survey result showed an even more striking difference than the approval rates at the application and hearing stages. Readers who hired an attorney at some point in the process (usually for the hearing) were 2.7 times more likely to receive SSI benefits than those who proceeded without a lawyer (68% compared to 25%).
There are several good reasons for these results. Disability attorneys understand what Social Security needs to see before it will approve someone for SSI benefits. They know what medical evidence to gather, how to prepare applicants for the hearing, and how to question the government's experts at the hearing. (For more on the attorney's role, see our statistics showing the difference a disability attorney makes.)
It may also help to know that you won't pay a disability lawyer anything unless and until you win benefits. Social Security disability lawyers receive a percentage of the past-due benefits (or backpay), up to 25% of the award or $6,000, whichever is less. But they usually receive less than the $6,000 maximum. Our readers told us their SSI lawyers received an average of $2,900 from their SSI backpay.
Some of our readers applied for benefits from both SSI and SSDI at the same time (known as "concurrent benefits"). To understand concurrent benefits, it helps to understand the differences between SSDI and SSI. Although medical eligibility for these two programs is the same, the other eligibility requirements are different. While SSI is a need-based program, SSDI is a federal insurance program for people who've worked and paid taxes for a certain amount of time before they become disabled. Applicants may receive concurrent benefits when they've worked enough to qualify for SSDI, but their benefits under that program are so low (probably because they worked intermittently or earned low wages) that they also meet the financial eligibility requirements for SSI (assuming they don't have many assets). When that's the case—and applicants are approved for both programs—their combined benefits may be increased up to the SSI maximum. (Learn more about how concurrent SSDI/SSI benefits work.)
Our survey showed that concurrent applications had poorer outcomes than other claims. Only 15% of readers who filed for both programs were approved at the initial application stage, while the approval rate more than doubled (to 36%) at the hearing stage. That's still lower than SSI-only applications and considerably below SSDI-only approval rates (30% at the application level and 55% after a hearing).
Why the lower approval rate for concurrent applications? People who apply for benefits from both programs tend to be younger and are more likely to apply when the labor market is poor. This means that concurrent applicants are more likely to be only marginally qualified for disability benefits. And according to a report from Social Security, concurrent applicants are more likely to file for mental conditions (like depression) and musculoskeletal conditions (like back pain) than SSDI-only applicants; these conditions have relatively low rates of approval. Finally, compared to those who apply for only SSDI, concurrent applicants face many of the same obstacles that apply to SSI-only applicants (more on that below).
Along with the nature and severity of your disability, our survey highlighted several other factors that seem to make a difference in whether you're likely to be approved for benefits. Some of these factors can be particularly challenging for SSI applicants, including:
While you may not be able to do anything about some of these obstacles to getting SSI, the main takeaway from our survey is that you can do the most to help yourself by requesting a hearing if your initial application is denied, and by hiring an experienced disability attorney for the hearing. Even if you can't find a lawyer to take your case, you may be able to get help from a disability advocate who's not a lawyer. Our survey showed that readers who used nonlawyer representatives were less likely to get benefits compared to those with lawyers, but they were still more likely to win their cases than other readers who went through the process on their own. (For details, see our survey results on the role of nonlawyer disability advocates.)
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