SSI, Social Security and Work Incentive Programs
The Social Security Administration pays disability benefits through two programs:
- Many people who are eligible for Supplemental Security Income (SSI) may also be entitled to Social Security benefits.
- In fact, the application for SSI is also an application for Social Security benefits. However, SSI and Social Security are different in many ways.
- Social Security benefits may be paid to you and certain members of your family if you are “insured” meaning you worked long enough and paid Social Security taxes.
- SSI benefits are not based on your prior work or a family member’s prior work. The U.S. Treasury general tax funds pay for SSI, not the Social Security trust funds.
- Workers who are receiving SSI or SSDI may work and maintain public benefits including health insurance by using work incentive programs which are described below.
YES, you can work and keep benefits – check out the Work Incentive Programs below!
Supplemental Security Income (SSI) program is a needs based disability assistance program that pays benefits to adults and children with disabilities who have limited income and resources.
- It provides cash to meet basic needs for food, shelter and clothing.
- The payment amount depends on an individual’s circumstances. The current (2021)maximum SSI payment is $794.00.00 per month.
- The Social Security Administration manages the program.
Child must be disabled as determined by Social Security Disability Determination Services.
Child must have little or no income and resources.
The family’s household income, resources, and other personal information are considered by Social Security in determining if your child qualifies for SSI.
Your child must meet all of the following requirements:
- Child must have a physical or mental condition that results in “marked and severe functional limitations” (your child’s condition must seriously limit their activities.)
- Child’s condition must have lasted, or be expected to last, at least 12 months in a row
- Child may not earn more than $1,930.00 monthly up to a yearly maximum of $7770.00 (This amount changes every year.)
To get started you must complete an SSI application in person at your local Social Security Administration office or on the phone. When you apply they will ask for detailed information about your child’s medical condition and how it affects his/her ability to function. They will ask for medical records and possibly need to speak with your child’s doctors, teachers, therapist and other professionals. This information is sent to Disability Determination Services to decide if your child is disabled. This process generally takes 3 to 5 months.
Certain medical conditions qualify for SSI to be received right away and up to 6 months while Disability Determination Services decides if your child is disabled. Qualifying conditions for Compassionate Allowance may be viewed here: Compassionate Allowance.
Once it is determined a child is eligible and starts to receive SSI, your child’s medical condition will be reviewed at least every three years for children under 18.
Your child is eligible to receive Medicaid if you are receiving SSI payments, however you must apply for benefits at your local Department of Social Services office.
Age 18 Redetermination Process in the SSI Program
In the SSI program there is a different definition of disability for children than there is for adults, with the childhood definition being less stringent. Because of this, all SSI recipients who turn 18 are required to have their eligibility reviewed under the adult disability standard without consideration of any previous disability determination. This is known as the “age 18 redetermination process ”. Because the age 18 redetermination uses a different disability standard than the one used for children it is possible for an individual to be found ineligible for SSI as an adult even though no change has occurred in medical condition or ability to function since being found eligible for childhood SSI benefits.
The age 18 redetermination is generally conducted at some point during the individual’s 18th year. If the person is found eligible for SSI as an adult, the monthly benefit check and Medicaid coverage continue uninterrupted. If the individual is determined ineligible for SSI under the adult standard, benefits will be payable for two more months after the notice of ineligibility is received and then will stop. At this point the individual would be considered ineligible for SSI cash payments and SSI related Medicaid coverage.
For disability purposes in the SSI program a child becomes an adult at age 18. Different rules are used at this time.
Income and resources of family members are no longer a factor when determining an adult’s eligibility.
If your child is already receiving SSI payments, the child’s medical information will be reviewed when they turn 18. Adult disability rules will be applied.
If your child was not eligible for SSI before his/her 18th birthday because of family resources and income they may be eligible at 18.
Adult eligibility requirements:
- Must have a medically determinable physical or mental impairment which:
- results in the inability to do any substantial gainful activity; (earnings averaging over $1,310 a month (for the year 2021) generally demonstrate SGA). and
- can be expected to result in death; or
- has lasted or can be expected to last for a continuous period of not less than 12 months.
- Meet financial and resource limitations. Adults may not have more than $2,000 in resources.
You are eligible to receive Medicaid if you are receiving SSI payments, however you must apply for benefits at your local Department of Social Services office.
SSDI pays benefits to adults with disabilities that began prior to age 22. This is considered a child’s benefit because it is paid on a parent’s Social Security earnings.
For an adult with a disability to be eligible for this benefit based on the parent, the parent:
- Must be receiving Social Security retirement or disability benefits or
- Must have died and worked long enough under the Social Security program.
Although your child does not need to have worked to be eligible for these benefits, a determination regarding their disability is used based on the criteria used for adults.
If you are working or are interested in working, you may continue to receive Social Security benefits and maintain benefits including Medicaid by utilizing work incentive programs.
Medicaid Works allows enrollees to continue Medicaid and have resources up to $41,399.00 and annual earnings of up to $75,000. Medicaid Works requires that you enroll before your monthly income goes above $851.00. (2021 amounts).
Help with Work Incentives Planning is available to people with disabilities who want to or are working to keep their benefits. Community Work Incentives Counselors and Benefits Specialists provide Social Security Administration disability beneficiaries (including transition-to-work aged youth) benefits planning and assistance services to help individuals with disabilities meet their employment goals.
Working and Receiving Benefits Guide: The Red Book is a self-help guide for youth, families, adult workers and others interested in the work incentive programs of Social Security Disability Insurance and the Supplemental Security Income Programs.