OTDA Home → Programs & Services → Division of Disability Determinations → Frequently Asked Questions
Frequently Asked Questions (FAQ)
Following are some of the most frequently asked questions asked about SSA disability programs. Click in the question area to access answers. Answers will provide still further links for further information.
- Who can get disability benefits under Social Security?
- How is the disability determination made?
- When do disability benefits start?
- Can individuals receiving disability benefits or payments get Medicare or Medicaid coverage?
- Can someone work and still receive disability benefits?
Who can get disability benefits under Social Security?
Under the Social Security disability insurance Program (Title II of the Social Security Act), there are three basic categories of individuals who can qualify for benefits on the basis of disability:
- A disabled insured worker under 65.
- A person disabled since childhood (before age 22) who is a dependent of a deceased insured parent or a parent entitled to Title II disability or retirement benefits.
- A disabled widow or widower age 50-60 if the deceased spouse was insured under Social Security.
Under Title XVI or SSI there are two basic categories under which a financially needy person can get payments on the basis of disability:
- An adult age 18 or over who is disabled.
- A child (under age 18) who is disabled.
How is the disability determination made?
SSA's regulations provide for disability evaluation under a procedure known as the "sequential evaluation process." For adults, this process requires sequential review of the claimant's current work activity, the severity of his or her impairment(s), the claimant's residual functional capacity, his or her past work, and his or her age, education, and work experience. For children applying for SSI, the process requires sequential review of the child's current work activity (if any) and the severity of his or her impairment(s).
When do disability benefits start?
The law provides that, under the Social Security disability program, disability benefits for workers and widows usually cannot begin for 5 months after the established onset of the disability. The 5-month waiting period does not apply to individuals filing as children of workers. Under SSI, disability payments may begin as early as the date the individual files an application.
In addition, under the SSI disability program, an applicant may be found "presumptively disabled" and received cash payments for up to 6 months while the formal disability determination is made. If it is finally determined the individual is not disabled; he or she is not required to refund the payments. There is no provision for a finding of presumptive disability under the Title II program.
Can individuals receiving disability benefits or payments get Medicare or Medicaid coverage?
Medicare helps pay hospital and doctor bills of disabled or retired people who have worked long enough under Social Security to be insured for Social Security benefits. It generally covers people who are 65 and over; people who have been determined to be disabled and have been receiving benefits for at least 24 months; and people who need long-term dialysis treatment for chronic kidney disease or require a kidney transplant.
Individuals who qualify for SSI disability payments also qualify for Medicaid. The program covers all of the approved charges of the Medicaid patient. Medicaid is financed by federal and State matching funds.
Can someone work and still receive disability benefits?
Social Security rules make it possible for people to test their ability to work without losing their rights to cash benefits and Medicare or Medicaid. These rules are called "work incentives." The rules are different for Title II and Title XVI, but under both programs they may provide:
- Continued cash benefits;
- Continued help with medical bills;
- Help with work expenses; or,
- Vocational training.
For more information about work incentives, ask any Social Security office for the publication: "A Summary Guide to Social Security and Supplemental Security Income Work Incentives for People with Disability"; or visit SSA's Website at www.ssa.gov.