Articles Posted in The Basics of Social Security Disability Law

In order to receive benefits through the Social Security Disability Insurance (SSDI) program, a person must establish both (1) that they are eligible for benefits, and (2) that they have a disability that precludes gainful employment for at least a year. Eligibility is based on the amount of time a person has been employed and has paid into the Social Security system, usually through payroll taxes. People who are employed by a business, organization, or individual can often establish the amount of time they have worked with documents such as W-2 forms, pay stubs, and tax returns. Self-employed individuals do not always have the same documents to establish their employment history, but they can still demonstrate eligibility for SSDI benefits. Likewise, they can meet the second main requirement for SSDI by showing that their disability precludes them from either their normal gainful self-employment or other forms of gainful employment.

How Payroll Taxes Fund Social Security Benefits

When a person has an employer, they typically only pay one-half of their payroll tax liability. The employer withholds payroll taxes from their paychecks and matches that amount. It then pays the taxes directly to the Internal Revenue Service (IRS). At the end of each tax year, the employer reports the person’s wages and taxes to the Social Security Administration (SSA). A self-employed person is responsible for paying their entire payroll tax liability.

Medicare is a national health insurance program administered by the Centers for Medicare and Medicaid Services (CMS), an agency of the federal government. Unlike the programs administered by the Social Security Administration (SSA), which mainly make payments to beneficiaries, Medicare is a form of health insurance coverage that helps people manage healthcare costs. Older Americans who have paid above a certain amount into the system through payroll tax deductions are Medicare’s main beneficiaries, but coverage is also available to disabled people who receive benefits through the Social Security Disability Insurance (SSDI) program.

What is Medicare?

Medicare provides health insurance coverage to:

– Individuals who are 65 years old or older, who have been U.S. citizens or legal permanent residents for at least five years, and who worked and paid into the Medicare system for at least 10 years;
Disabled individuals under the age of 65 who have received SSDI benefits or Railroad Retirement Board benefits for at least 24 months;
– Individuals who are eligible for SSDI and have been diagnosed with amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease; and
– Individuals who are receiving dialysis treatment or are waiting for a kidney transplant because of end-stage renal disease. Continue Reading ›

The term “Social Security” can refer to several different types of benefits paid by the Social Security Administration (SSA). The agency is perhaps best known for its retirement and disability benefits programs. The Old Age, Survivors and Disability Insurance (OASDI) program includes the SSA’s retirement program and the Social Security Disability Insurance (SSDI) program. The SSA maintains another benefits program that may be available to disabled individuals, known as Supplemental Security Income (SSI). Since the abbreviations “SSDI” and “SSI” are nearly identical, some confusion quite understandably exists about the two programs and how they are different from each other. Disabled individuals in Massachusetts and elsewhere around the country should be familiar with how each program might benefit them.

Work History

Eligibility for SSDI benefits depends on a claimant’s work history. Claimants must show that they are “insured” by the program through their payroll tax contributions. The SSA typically measures work history in yearly quarters. A claimant must have worked a certain minimum number of quarters in their lifetime—at least six (and this is the bare minimum, with the minimum number depending on a variety of factors for each individual, including but not limited to one’s age) —to be “fully insured.” They must also be “currently insured,” meaning that they worked a certain number of quarters immediately prior to the month they became disabled. The number of quarters largely depends on the claimant’s age at the time of his or her disability.

The SSI program, meanwhile, has no work (and earned quarters of coverage) requirements. SSI benefits therefore might be available to people who do not have enough work history to qualify for SSDI or who may never have worked previously.

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In order to qualify for Social Security disability insurance (SSDI) benefits, it is necessary that one contribute sufficient Social Security payroll tax payments through their employment.  Most individuals do participate in Social Security Disability Insurance (SSDI) program via their Federal Insurance Contributions Act (FICA) contributions as part of their payroll taxes.  However, there are many individuals whose employer may take part in a state disability and retirement program (for example, many teachers that work for the state may contribute to their state retirement and disability program and may not have FICA taxes deducted from their payroll).  Assuming one has paid sufficiently sufficient Social Security taxes to qualify (and have earned sufficient “quarters of coverage”) , then if in fact they become unable to work due to a long-term medical condition, they may be entitled to payments under the SSDI program. Even with a long-term injury or medical condition (which may or may not be related to their job), one can receive SSDI benefits if they cannot perform what is called “substantial gainful activity” (or what is deemed at present to be the ability to earn $1090.00 per month on a regular and continuing basis).  These federal insurance benefits are available to residents of every state, including New Hampshire, Maine and Massachusetts.

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The Social Security Disability Insurance (SSDI) is a Federal program that pays benefits to individuals with disabilities and certain members of their family if they have worked long enough and paid Social Security taxes as part of that employment.  It is available to qualified residents of any state in the United States, including Maine, Massachusetts, and New Hampshire. Arguably, the most difficult part of qualifying for SSDI benefits is meeting the strict definition of “disability” under federal law. The Social Security Act defines “disability” as the inability to engage in any substantial gainful activity due to a severe medically determinable physical and/or mental impairment(s), which can be expected to result in death, or which has lasted, or can be expected to last, for a continuous period of one year or longer.

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