Module 10: Background on SSDI: Disability Standard, No Income or Resources Test, Different Set of Work Incentives
SSDI’s disability standard is the same for both forms of SSDI discussed below. An applicant must show through medical evidence that he or she is unable to perform substantial gainful activity, i.e., through work that exists in the national economy, generally based on a condition that has lasted at least one year or is expected to last for at least one year. This disability standard also applies in the SSI program for adults age 18 or older.
No income or asset test. Unlike SSI, which is for individuals with limited income and resources, the SSDI program does not have an income or resources test. The SSDI payment amount is never reduced based on the amount of earned income. Most unearned income will not result in a reduced SSDI payment, but worker’s compensation benefits and some types of disability payments from a federal, state, or local government, for medical conditions that are not job-related, can result in a reduced SSDI payment. See How Workers’ Compensation and Other Disability Payments May Affect Your Benefits, Social Security Publication No. 05-10018 (July 2017), https://www.ssa.gov/pubs/EN-05-10018.pdf. Also, unlike SSI which limits an individual’s countable resources to $2,000, the SSDI program has no resource limit.
A different set of work rules and work incentives. In Toolkit #4, we explained the SSI rules for counting earned income and discussed key SSI work incentives. Unlike the SSI earned income exclusions, which allow for a gradual reduction of the SSI payment as wages increase, SSDI is an “all or nothing” benefit in this context. Wages above the “substantial gainful activity” level (in 2019, $1,220 per month for most beneficiaries and $2,040 for beneficiaries who are blind) will result in a suspension of benefits after a nine-month trial work period and three-month grace period. By contrast, if wages remain below the SGA amount and the disability continues, the beneficiary will continue to receive the full SSDI payment. A detailed explanation of the SSDI earned income rules and work incentives is beyond the scope of this toolkit and will be explored in more detail in an upcoming toolkit series related to SSDI benefits.
Module 10: SSDI Benefits for Youth Based on Their Past Earnings
If a youth has worked and paid money into the Social Security trust fund, through payroll deductions, he or she may eventually earn enough “credits” to qualify for SSDI on his or her own record. An individual can earn up to four credits (sometimes referred to as quarters of coverage) in a calendar year. In 2019, gross earnings of $1,360 are enough to earn one credit regardless of whether the money was earned in a short period of time or over a period of several months. Some youth with full-time employment may be able to earn the maximum four credits for a calendar year after only working for a few months. Once the individual has $5,440 in earnings during the 2019 calendar year, he or she has earned the maximum of four credits for the year. The amount needed to earn a credit is adjusted each year.
General rule: 20 credits are needed during last 10 years to establish disability “insured status” to qualify for SSDI benefits. Many adults who are served by the state VR agency will be subject to this rule. For example, an individual seeking to establish disability at age 45 would need 20 credits of coverage between age 35 and 45 to meet the SSDI insured status requirements.
Insured status rules are different if age 31 or under. Transition-aged youth (ages 14 to 25) will be subject to these less onerous rules:
Before age 24 – An individual may qualify with six credits earned in the three-year period ending when his or her disability starts.
Age 24 to 31 – An individual may qualify with credits for working roughly half the time between age 21 and the time he or she becomes disabled. For example, an individual who becomes disabled at age 27 needs 12 credits between ages 21 and 27. Those credits could be spread out over the 6-year period or could all occur within a three-year period.
Example: Tania, age 20, has received SSI since age 14 based on a bone disease that severely limits her mobility. After turning 18, the SSI program did an Age 18 Redetermination and completed that review just before her 19th birthday, finding that Tania meets SSI’s adult disability criteria. See Toolkit # 2, The Medical Continuing Disability Review and the Age 18 Redetermination, for detailed information on the Age 18 Redetermination.
Tania graduated from high school at age 18 in 2016 and worked three different part-time jobs between ages 18 and 20. Tania had no earnings in 2015, earned $1,400 during calendar year 2016 after graduating from high school (when $1,260 was needed for one Social Security credit), earned $4,800 during 2017 (when $1,300 was needed for one credit), and earned $3,500 during the first 6 months of 2018 (with $1,320 needed for one credit). When she applied for SSDI in July 2018, at age 20, she had earned 6 credits during the 3-year period ending June 2018 (1 during 2016, 3 during 2017, and 2 during the first 6 months of 2018). Since Tania was under age 24, this met the minimum 6-credit requirement for SSDI insured status.
Since the Social Security Administration (SSA) completed a full medical review as part of Tania’s Age 18 Redetermination one year earlier, it is likely they will adopt that disability decision for SSDI purposes and award a modest monthly SSDI payment without a new medical review. If her SSDI payment level turns out to be is about $600 per month, her SSI would continue at a much smaller payment amount. See https://www.ssdcservices.com/DisabilityCalculator (allows user to put in wage history and other information to obtain a general estimate of the likely SSDI payment amount).
If you learn that a youth has even a modest recent work history, he or she should urge the youth and his family to consider applying for SSDI benefits based on the youth’s own Social Security record.
Module 10: SSDI Benefits for Youth Based on a Parent’s Social Security Record
Social Security Childhood Disability Benefits (CDB), often referred to as Disabled Adult Child’s Benefits (DAC), are available to a youth at age 18 or older if:
The parent paid sufficient amounts into the Social Security trust fund through payroll withholding;
The parent is collecting Social Security retirement benefits, is collecting SSDI, or is deceased; and
The youth’s disability began before age 22. (The adult child could be much older – in their late 20s, 30s, or older for example – and meet this requirement as long as their disability began before age 22.)
The amount of the adult child’s CDB payments can be:
Up to 50 percent of the parent’s Social Security benefit (“primary insurance amount” or PIA), if the parent receives SSDI;
Up to 75 percent of the parent’s PIA if the parent receives retirement benefits or is deceased.
If one or more additional dependents is paid from the parent’s Social Security record, the youth will share the 50 or 75 percent (or a lower amount) with the other dependent(s).
Example: Ramon is 23, has received SSI since age 18, and currently receives $771 in monthly SSI payments (i.e., the 2019 Federal Benefit Rate with no State Supplement). His father just started receiving Social Security retirement benefits of $1,500 per month. Ramon has a brother and sister, ages 14 and 27 who do not have disabilities. Ramon should be eligible for Social Security CDB as he meets all the criteria:
His father paid into the Social Security trust fund and now gets retirement benefits; and
Ramon has a disability that began before age 22.
Both Ramon and his 14 year old brother should qualify for what Social Security calls “auxiliary benefits”: Ramon would get CDB payments; and his brother would get childhood dependent’s benefits.
$1,125 is available to pay auxiliary beneficiaries (.75 x $1,500). Ramon and his brother will split that amount, with each getting a $562 per month.
Ramon should qualify for CDB payments indefinitely, so long as his disability continues. His younger brother will qualify through age 18 or 19 (if still in elementary school or high school). When the brother’s benefits end, Ramon will qualify for the full $1,125 per month as he will be the only auxiliary beneficiary.
Ramon’s SSI payment will be reduced to $229 per month, with countable income of $542 ($562 – 20) subtracted from his $771 base SSI rate. If he lives in one of 41 states in which Medicaid is automatic for SSI recipients, he will continue to qualify for Medicaid. When Ramon qualifies for the higher, $1,125 per month CDB payment, his SSI payments will stop but he might qualify for continued Medicaid through another provision. See our Print and Go Toolkit, Potential for Medicaid Eligibility after SSDI Payments Begin.
If you learn that a youth’s parent receives SSDI, Social Security retirement benefits, or is deceased, he or she should suggest that the youth and his family look into eligibility for Social Security Childhood Disability Benefits.
Module 10: SSI Payments May Continue After SSDI Payments Begin
In Toolkit # 3, How Income and Resources Impact SSI Eligibility and Payment Amount, we explained how the SSI payment is calculated when the beneficiary receives some earned and/or unearned income other than the SSI payment. Countable income is subtracted from a state’s SSI base rate (Federal Benefit Rate plus optional State Supplement, if any) to determine if SSI is reduced to a lower amount or terminated/suspended.
Example: Tania, from the example above, receives SSI of $771 per month. After accumulating the minimum of 6 Social Security credits, between ages 17 and 20 she now qualifies for SSDI, on her own account, of $600 per month. Here is how her new monthly SSI payment is calculated.
|$600 SSDI payment||$771 SSI base rate|
|- 20 General income exclusion||- 580 Countable income|
|$580 Countable income||$191 New SSI payment|
If Tania lives in one of 41 states in which Medicaid is automatic for SSI recipients, she will continue to qualify for Medicaid automatically.
Module 10: Using the Youth’s SSDI in a Plan to Achieve Self Support (PASS)
The PASS work incentive allows an individual to use countable income, such as SSDI payments, to help pay for expenses to support a vocational goal. When the SSI program approves, for example, the use of SSDI for this purpose that money is excluded and does not count in determining SSI eligibility or payment amount.
Example: Tania, from the example above, now receives SSDI of $600 and SSI of $191 per month. She will soon start working part time at a small hardware store that she can walk to but is unable to commute to similar full-time positions at larger stores because public transportation is not available to get there. She proposes a PASS to save $580 of her SSDI toward the purchase of a dependable used car that will allow her to pursue full-time employment as a cashier in the retail industry. If approved, the full $580 is excluded and her SSI will go up to the maximum of $771 per month.
For more information on the PASS work incentive, see Toolkit # 7, Supporting Asset Development and Accumulation (discussing the PASS in detail).
When a youth transitions from SSI to SSDI benefits, with or without a partial SSI payment continuing, you can suggest that the youth consider a Plan to Achieve Self Support to pay for items and services not available through the state VR agency.