Disability benefits in the United States provide essential financial assistance and medical coverage to individuals who are unable to work due to a disabling condition. Navigating the system can be complex, with multiple programs and eligibility criteria to consider. This guide will explore the various types of Disability Benefits in the US available, who qualifies, the application process, and key factors to keep in mind when applying.

Walker Firm, operating under the client-facing brand Casa de la Justicia, helps Spanish-speaking clients with their Social Security Disability Insurance (SSDI) claims. Based in Los Angeles, CA, and founded in 2022, we maintain a remarkable over 70% hearing win rate, surpassing the national average of 55%. With our robust media strategy, we attract over 2,000 clients annually. In addition, we partner with other local attorneys to ensure the thousands of injured Latinos that call us daily have access to experienced Spanish-speaking attorneys for all their needs, including worker’s compensation, auto accidents and slip and fall cases. For expert SSDI support and broader legal services, we are your go-to resource.

Types of Disability Benefits

The primary sources of disability benefits in the U.S. come from federal programs administered by the Social Security Administration (SSA), including Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Additional programs include workers’ compensation, veterans’ disability benefits, and state-based disability programs.

Social Security Disability Insurance (SSDI)

SSDI is a federal program designed to provide financial assistance to individuals who have worked and paid into Social Security but are now unable to work due to a severe disability. The amount of benefits received is based on the individual’s work history and average lifetime earnings.

Eligibility for SSDI

To qualify for SSDI, applicants must meet specific criteria:

1. Work Credits: Applicants must have earned enough work credits by contributing to Social Security through payroll taxes. Typically, 40 credits are required, 20 of which must have been earned in the last 10 years before the onset of the disability. Younger workers may need fewer credits.
2. Severe Disability: The condition must be expected to last at least 12 months or result in death. It must also prevent the applicant from engaging in “substantial gainful activity” (SGA), which for 2024 is earning more than $1,470 per month.
3. Medical Condition: The SSA maintains a list of qualifying medical conditions, although individuals with conditions not listed can still qualify if they can demonstrate significant impairment.

Supplemental Security Income (SSI)

SSI is a needs-based program designed for individuals with limited income and resources who are disabled, blind, or aged (65 or older). Unlike SSDI, SSI benefits are not tied to an individual’s work history, and payments are funded through general tax revenues, not Social Security taxes.

Eligibility for SSI

The eligibility criteria for SSI include:

1. Income and Resource Limits: To qualify, an individual must have limited income and resources. As of 2024, the resource limits are $2,000 for an individual and $3,000 for a couple. Certain resources, such as a home or car, may be excluded.
2. Disability or Age: Like SSDI, the individual must have a disabling condition that significantly limits their ability to work or be at least 65 years old.
3. U.S. Residency: Applicants must reside in the U.S. or meet specific residency requirements, such as being a legal resident.

Workers’ Compensation

Workers’ compensation is a state-run program that provides benefits to employees who are injured or become disabled due to work-related activities. Unlike SSDI and SSI, workers’ compensation does not require permanent or total disability. It is designed to cover medical expenses, rehabilitation costs, and lost wages.

Eligibility for Workers’ Compensation

Eligibility for workers’ compensation varies by state but generally requires:

1. Work-Related Injury or Illness: The injury or illness must have occurred as a direct result of job-related activities.
2. Employment Status: The individual must be classified as an employee at the time of the incident.
3. Timely Reporting: Employees are typically required to report the injury or illness to their employer within a specific time frame, which varies by state.

Veterans’ Disability Benefits

Veterans who become disabled as a result of their military service are eligible for veterans’ disability benefits. The U.S. Department of Veterans Affairs (VA) administers these benefits, which provide financial support based on the severity of the service-connected disability.

Eligibility for Veterans’ Disability Benefits

To qualify for veterans’ disability benefits, the following criteria must be met:

1. Service-Connected Disability: The disability must be directly related to the individual’s military service.
2. Discharge Status: The individual must have been honorably discharged.
3. Medical Documentation: Applicants must provide medical documentation linking their disability to their military service.

The Application Process

Applying for disability benefits can be a lengthy and complex process. The steps vary depending on the type of benefit being sought, but common elements include submitting medical records, filling out forms, and attending hearings or medical examinations.

Applying for SSDI and SSI

1. Initial Application: Individuals can apply for SSDI or SSI online, by phone, or in person at a local Social Security office. Applicants will need to provide information about their work history, medical condition, and income.
2. Medical Evidence: It is crucial to provide thorough medical documentation that supports the claim. This can include doctor’s reports, hospital records, lab results, and information about how the condition affects daily activities.
3. Decision: After reviewing the application, the SSA will make a decision. For SSDI, the process may take three to five months, while SSI decisions can take up to six months or longer.
4. Appeal Process: If the application is denied, the applicant has the right to appeal the decision. The appeals process can include several levels, such as reconsideration, a hearing before an administrative law judge, and review by the Appeals Council.

Applying for Workers’ Compensation

1. Report the Injury: The first step is to report the injury or illness to the employer within the required time frame.
2. Medical Evaluation: Workers will need to undergo a medical evaluation to confirm the extent of their disability and its connection to their job.
3. File a Claim: Once the injury is reported, a formal claim must be filed with the state’s workers’ compensation agency. The employer may also file a claim on behalf of the employee.
4. Approval or Denial: After reviewing the claim, the workers’ compensation board will either approve or deny the benefits. If denied, workers can appeal the decision.

Applying for Veterans’ Disability Benefits

1. File a Claim with the VA: Veterans can file a disability claim through the VA’s website, by mail, or in person. Supporting documentation such as service records, medical records, and a statement of how the disability occurred must be provided.
2. VA Review: The VA will review the claim, possibly requiring additional medical evaluations. Veterans will receive a disability rating that reflects the severity of their condition.
3. Decision and Appeals: If the claim is approved, benefits are awarded based on the disability rating. Veterans can appeal unfavorable decisions through the VA appeals process.

Key Factors to Consider When Applying for Disability Benefits

1. Time Frames: The approval process for disability benefits can be lengthy. It’s important to apply as soon as possible and to be prepared for delays, especially if an appeal is necessary.
2. Legal Assistance: For complex cases, particularly when benefits are denied, hiring a disability attorney or advocate can improve the chances of a successful outcome. Attorneys typically work on a contingency fee basis, meaning they only get paid if benefits are awarded.
3. Medical Documentation: Comprehensive and well-organized medical documentation is critical. Failure to provide sufficient evidence of a disabling condition is a common reason for denial.
4. Program Differences: It’s important to understand the distinctions between SSDI, SSI, workers’ compensation, and veterans’ benefits. Each program has different eligibility requirements and application processes, and individuals may qualify for more than one type of benefit.

Conclusion

Understanding disability benefits in the U.S. is vital for individuals with disabling conditions seeking financial and medical support. From federal programs like SSDI and SSI to state-run workers’ compensation and veterans’ benefits, each program has its unique qualifications and application procedures. Applicants should ensure they meet the necessary criteria and provide comprehensive medical documentation to improve their chances of receiving benefits. Navigating the process can be challenging, but with careful preparation and persistence, individuals can access the support they need to maintain financial stability.