Supplemental Security Income (SSI) is a government program that provides aid to individuals who are disabled. It is a needs based program, funded by general taxes, rather than from Social Security. The funds are meant to provide for basic necessities, such as shelter, food, and clothing. Individuals who qualify to receive SSI benefits likely qualify for other government aid programs such as Medicaid and food stamps as well.
What is required to be eligible for SSI benefits?
In order to qualify for benefits from the SSI program, an individual must meet a number of criteria. They must be either:
- Disabled; or
- At least 65 years old.
Additional requirements include:
- Limited income, limited resources and limited assets
- A citizen of the United States, or a qualifying alien
- Resides within the United States or Norther Mariana Islands
- Does not spend 30 days or more, or a full month of the year in another country
- Is not hospitalized, imprisoned, or otherwise confined in an institution paid for by the government
- Gives the SSA access to financial records and permission to contact financial institutions for information
- Applies for other benefits and payments that he or she may qualify for, including pensions and Social Security
While an individual who meets all of these criteria might be eligible, there might be additional requirements.
How are the decisions for SSI coverage made?
The Social Security Administration will review your claim sequentially. The first test is whether you meet all of the non-medical criteria, including the limited income and assets, citizenship and residency in the United States. Assuming you meet the non-medical criteria, your application will be reviewed to determine if you meet the requirements for being considered disabled under the act. If you are over 18 years of age, the process will look something like this:
- Is he or she working?
If the answer is yes, the applicant is performing a “substantial gainful activity,” then your application will be denied on the grounds of not meeting the requirements for being disabled. An individual making more than a specified monthly income will not qualify.
- Is the applicant suffering from a severe medical impairment?
To qualify the impairment must be medically determinable, which basically means diagnosed by a doctor. It also must be expected to last a minimum of 12 months, or result in the death of the applicant.
- Does the individual meet any “Listings?”
The “Listings” consist of descriptions of various conditions and the associated impairments caused by those conditions. If a claimant meets a “Listing,” then he or she should be considered disabled and therefore his or her application should be approved. If a claimant does not meet a “Listing,” the review will continue.
- Can the individual perform past relevant work?
The SSA will look at the type of work the individual did prior to their disability. If the individual can no longer do this work, they will proceed to the next question, of they can, then they are not disabled, and their claim will be denied.
- Can the individual do other work?
The SSA will determine whether, based on the level of the individual’s disability, and his or her age, experience and education, work in another field is possible.
What happens if my claim is denied?
It is common for claims to be denied, but that denial is far from final. Once you receive a denial of benefits, you may file an appeal. If the appeal is unsuccessful, you can take your claim to a hearing in front of an Administrative Law Judge (ALJ). The hearing in front of the ALJ gives you an opportunity to plead your case in front of someone who has the authority to decide to grant your benefits. You must be present at the hearing, and the ALJ will ask you questions. There might also be a vocational expert or medical expert there to offer opinions on your ability or inability to work.
Can someone help me with my SSI claim and appeals process?
You may appoint a representative to help you with your claim and the appeal process. It is advisable to have an attorney represent you and work with you on your claim. This is particularly important at the ALJ hearing, which is the most likely time for an appealed case to be approved. These hearings go better for claimants when they have an experienced attorney on hand to help them through the process, to prepare them for the questions they might receive, and to cross-examine the vocational or medical experts.
Contact Stern Law, PLLC for A Free Consultation
At Stern Law, PLLC, we have compassionate and caring attorneys ready to work with you on your disability related legal matters. Contact Stern Law, PLLC today at (844) 808-7529 for a free consultation with an experienced disability attorney.