What is SSDI? An Overview for Residents of Massachusetts and Other States

What is SSDI? An Overview for Residents of Massachusetts and Other States

Social Security Disability Insurance (SSDI) is a government program enacted to assist people who are unable to work due to serious and long-term physical or mental disabilities. The program aims to address the needs of injured individuals and their families who are struggling with finances as a result of their inability to work.  SSDI is funded with Federal Insurance Contributions Act (FICA) taxes, which are paid by both employees and employers from their payroll taxes.

Federal SSDI Benefits

SSDI benefits consist of monthly payments for individuals who have worked in a job covered by Social Security and who meet the federal definition of “disabled.” These federal benefits are available to residents of every U.S. state, including Massachusetts, New Hampshire, and Maine. Specifically, the Social Security Act provides that the worker must be unable to engage in any substantial gainful activity due to a medically determinable physical or mental impairment that is expected to last for a continuous period of at least one year or result in death. Generally, if a worker is earning more than a certain amount of money each month, he or she may be considered to be engaged in substantial gainful activity. For 2015, that amount is $1,090 (net of disability-related work expenses) for workers who are not blind, and $1,820 (net of disability-related work expenses) for workers who are blind. These amounts have historically increased for each passing year. If the Social Security Administration (SSA) determines that an applicant is engaged in substantial gainful activity they will deny SSDI benefits.

An SSDI applicant must also meet both the earnings requirement and the disability requirement to qualify for benefits. The earnings tests require the applicant to have worked for a certain period of time prior to his disability in a job covered by Social Security, although the requirements are somewhat less restrictive for blind applicants. This information is set forth by the SSA in published tables. The disability determination is not made by one’s local Social Security field office, but rather by the Disability Determination Services (DDS) office in the applicant’s state. DDS will evaluate all of the medical evidence and decide whether the applicant’s condition meets the federal definition of a disability. DDS employs a five-step process in reaching its decision, evaluating 1) whether the applicant is working (that is, earning substantial gainful wages), 2) whether the applicant’s medical condition constitutes a severe medical impairment (that is, meets the criteria of one of the medical conditions on the List of Impairments), 3) whether the applicant can do the work he or she did before (called their past relevant work), and finally 5) whether the applicant is able to do any other type of work.

Once a worker qualifies for SSDI benefits, the amount awarded is determined by a formula based on his or her past earnings and work history. On average, the SSDI benefit for a disabled individual is around $1,146 a month ($13,752 a year), while the average benefit for a family is $1,919 per month. However, the amount of SSDI benefits may be affected if the worker receives other government benefits, typically based on disability.  In addition, payment of SSDI benefits could be stopped upon a criminal conviction or a probation or parole violation.

On top of monetary payments, SSDI beneficiaries may also take advantage of additional programs and benefits available to them. Injured workers receiving SSDI benefits will automatically receive Medicare coverage after two years. There are also work incentives that allow beneficiaries to test their ability to work without losing their monthly SSDI benefits, as well as education and training assistance under the Ticket to Work program, if they are eligible for it. Depending on the applicant’s employment history, certain family members of disabled workers may also receive benefits under the program. They include spouses who are 62 or older, or who are caring for a child who is disabled or under the age of 16.  In addition, a child (and, in some situations, a stepchild or grandchild) under the age of 18 may qualify for benefits under another program called the Supplemental Security Income program (called SSI).  Moreover, an unmarried child who is 18 or older may qualify for SSDI benefits under an insured parent’s record, if he or she has a severe medical impairment that has kept them disabled prior to the age of 22 and they have remained dependent on an insured worker receiving benefits or their insured parent is now deceased.

A call to the Law Offices of Russell J. Goldsmith at 1-800-773-8622 can help you determine which benefits are right for you and can assist you with an application for benefits at this time.

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