The Social Security Administration (SSA) has a distinctive definition of disability that sets it apart from typical disability insurance programs. However, the comforting news is that this definition remains consistent for both the Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) programs.
Understanding the SSA’s Definition:
Social Security defines disability as the inability to engage in any substantial gainful activity (SGA) due to a medically determinable physical or mental impairment that has lasted or is expected to last at least one year or result in death. This universal definition applies to both SSDI and SSI applications.
Examples of Qualifying Physical Impairments:
- A person diagnosed with multiple sclerosis, unable to work due to muscle weakness and fatigue.
- Someone with a spinal cord injury, rendering them unable to stand or walk.
Examples of Qualifying Mental Impairments:
- Severe depression preventing an individual from leaving their home or holding a job.
- Schizophrenia leading to severe hallucinations and delusions.
For children under 18, the definition adjusts slightly. They are deemed disabled if they suffer from a medically determinable physical or mental condition resulting in marked and severe functional limitations, lasting at least one year or leading to death.
SSDI – A Federal Program for Workers:
SSDI is a federal program funded by payroll taxes designed for workers who, though not yet at retirement age, face restrictions due to a severe physical or mental condition, expected to last at least one year or result in death.
To qualify for SSDI, the person must have earned “quarters of coverage” in at least 20 of the last 40 quarters (5 of the last 10 years) before being impaired. Essentially, SSDI acts as insurance for workers unable to work due to a medically determinable impairment.
Examples of SSDI Qualification:
- A construction worker with chronic back pain preventing fieldwork.
- A teacher diagnosed with cancer and unable to work due to chemotherapy.
SSI – A Means-Tested Government Program:
SSI, on the other hand, is a means-tested government program for individuals over 65 and those of any age who are disabled. The definition of disability for SSI aligns with that of SSDI.
Funded through general tax revenue and administered by the SSA, SSI recipients typically qualify for healthcare through Medicaid.
Examples of SSI Qualification:
- A retiree over 65 with limited income and assets.
- A disabled person unable to work with limited income and assets.
Strategic Considerations with Fee-Only Professionals:
Fee-Only financial advisers, accountants, and attorneys specializing in social security can assist in maximizing benefits based on individual circumstances. Regardless of marital status, strategic considerations ensure the potential for receiving the maximum benefits available. Careful consideration of all factors, with the help of Fee-Only professionals, ensures optimal outcomes in Social Security benefits.
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