Social Security Disability Insurance (SSDI)
SSDI is a federal disability insurance program designed to provide basic economic support for persons that are unable to do substantial work due to disability. Individuals with disabilities become eligible for SSDI benefits in one of 2 ways. One is by working and becoming “insured” through paying FICA payroll taxes. The other is by being a disabled adult child of an insured worker.
To qualify for SSDI benefits, a person must be determined to be medically disabled AND be unable to perform substantial work. The Social Security Administration uses the concept of Substantial Gainful Activity (SGA) to define substantial work. In 2008, countable earnings of $940.00 or more per month is considered SGA.
SSDI monthly payment amounts are based a worker’s lifetime work record. The more earnings history and FICA taxes an individual had paid, the higher the SSDI payment.
SSDI benefits come with Medicare. Medicare provides basic coverage for the cost of health care. SSDI beneficiaries are covered by Medicare after receiving payments for 24 months.
There are several work incentives available to SSDI beneficiaries that serve to protect the benefit while working. Below are brief descriptions of SSDI work incentives.
- Continued Payment Under a Vocational Rehab Program (Section 301): Benefits can continue for a individual who is determined to be no longer disabled as the result of a Continuing Disability Review (CDR), but is participating in a vocational rehabilitation program.
- Trial Work Period (TWP): An opportunity to test one’s ability to work for at least nine months. SSDI payments continue no matter how high the earnings. In 2008, a month is considered a TWP month when earnings are $670.00 or more. To complete the TWP, all 9 months must fall within a 5 year period.
- Substantial Gainful Activity (SGA): A standard used by the SSA to evaluate whether a person’s work activity, after completion of the TWP, is considered substantial. In 2008, countable gross earnings of $940.00 or more is considered SGA.
- Extended Period of Eligibility (EPE): The EPE is a consecutive 36 month period beginning the month after completion of the TWP. During the EPE, SSDI beneficiaries are eligible for a payment in any month work is not considered SGA. In months work is considered SGA, beneficiaries are not eligible for a payment. Upon completion of the EPE, the first month that work is considered SGA will cause SSDI benefits to terminate.
- Unsuccessful Work Attempt (UWA): An attempt to work at an SGA level which stops after a relatively short time (6 months or less) for impairment related reasons or the removal of supports. Earnings from such an attempt to work will not be considered in determining SGA.
- Impairment-Related Work Expenses (IRWE) Out-of-pocket expenses related to both one’s disability and work are not counted when determining SGA.
- Subsidy and Special Conditions: When the value of an individual’s work is less then the pay because of supports and accommodations(e.g. less demanding duties, extra breaks, job coaching) SSA will only consider the value of the work in making SGA decisions.
- Expedited Reinstatement (EXR): When work earnings cause SSDI benefits to terminate, an individual can once again be considered for SSDI benefits through EXR. EXR must be requested within 5 years from the termination of SSDI. Under EXR, an individual can begin to receive provisional payments for up to 6 months while a medical disability determination is being made. A new TWP and EPE will become available after 24 months of payments.
- Extended Period of Medicare Coverage (EPMC): Medicare coverage will continue for SSDI beneficiaries for at least 93 months after the completion of the TWP.
Additional Resources:
- SSA Red Book: http://www.socialsecurity.gov/redbook/. The Red Book is a general reference source about the employment-related provisions of SSDI and the SSI programs.
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