Are SSD and SSI disability cases decided differently or the same way in terms of Eligibility?

SSD and SSI are two separate programs. And there are a number of facts about each program that make them distinctly different.

SSD, or Social Security Disability eligibility, is for indviduals who have attained an insured status. This means they have become eligible for SSD benefits--assuming that they are found to be medically eligible after a review of their records--as a result of having earned enough credits through their work activity.

SSI eligibility (supplemental security income disability), on the other hand, is for individuals who are not insured for Social Security Disability benefits. This includes children, indivduals who have never worked, individuals who have worked but not enough to become insured for SSD, and individuals who were once insured for SSD, but because they have not worked for quite some time have lost their insured status for SSD.

Other differences:

With SSI, a person may receive access to medicaid. However, eligibility for medicaid is subject to resource limitations (what you have in assets), similar to the resource limitations for the SSI program.

With SSD, a person does not receive medicaid, but receives medicare coverage after a 24 month waiting period.

Note: the fact that there is a 24 month waiting period does not automatically mean that every person who is approved for SSD will actually have to wait 2 years for medicare benefits to kick in. There are a number of factors involved in "the wait", such as when the claimant's onset is determined, i.e. when their disability is thought to have begun as well as how long it has taken social security to reach a decision on a claim. Very often, by the time a person finally receives SSD benefits, their two year medicare waiting period will already be over.

Having said all of this, though, it can be stated that both Social Security Disability and SSI disability claims are decided in exactly the same way.

What do we mean by this? Simply that both types of claims are processed by disability examiners (at the agency responsible for making disability claim decisions for SSA, that agency being DDS, or disability determination services) using the same set of rules and procedures. There is no difference in case processing, or in how disability decisions area made. An SSD case is no more likely, or less likely, to be approved than an SSI case, or vice-versa. They are determined in the same way, using the same procedures.

The only real differences between the two programs (SSD eligibility versus SSI eligibility) are the following:

A) How a person attains non-medical eligibility. For SSD, it is through having worked and attained insured status. For SSI, insured status is not an issue, but having too much in assets is. The asset - resource limit for SSI is $2000 per person, and $3000 for a couple (which would be one individual receiving SSI and a spouse who is not receiving SSI).

B) The types of medical coverage that comes with the monthly disability benefit. For SSD, this is medicare and for SSI it is medicaid.

C) How assets are viewed. For SSD, since it is a benefit that has been earned as a result of work activity, there is no limit on what a person can have in assets. An individual could have hundreds of thousands of dollars in property and investments and it would not affect their eligibility for SSD in the least. For SSI, a single person cannot have more than $2000 in assets and if they are married, the asset limit is $3000.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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