How are My Benefits Determined?

Determination of benefits is accomplished by the Social Security Administration through calculations that depend on the type of benefit for which claimant is applying.

For both Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), claims based on disability are only awarded for total disabilities. For SSDI, the agency will additionally analyze one’s employment history and “work credits,” while benefits for SSI will depend largely on one’s available income and resources. There may be other public benefits that could also affect the total amount a person takes home.

It’s a complex process with which the Boston disability lawyers at Jeffrey Glassman Injury Lawyers are closely familiar.

The first step to determining whether you will receive benefits is assessing whether a condition meets the program definition of “disabled.” Both SSDI and SSI have the same definition of the term.

Disabled – A total disability characterized by a physical, mental, emotional or learning impairment that is terminal or substantially limits a person’s ability to function or engage in gainful activity or employment for 12 months or longer.

Unlike other kinds of benefits programs, such as workers’ compensation, neither SSI nor SSDI provide benefits for temporary disability or for partial disabilities. These programs are only for the assistance of those with long-term, total disabilities.

Although not all SSI recipients are disabled (a fair portion are either over the age of 65 or blind), many do meet this criteria.

While SSI is available to children and adults, SSDI is limited to adults with a work history that involves contribution to Social Security Administration (SSA) payroll taxes.

If a person meets the disability criteria for SSDI, the next step is to determine how many “work credits” he or she has accrued over the course of a career.

These credits are based on how long a person has worked and how much they have earned.

In 2015, workers were able to receive one credit for every $1,220 of annual earnings. Workers can receive a maximum of four credits yearly. For every year of work, the necessary earnings credit increases slightly. These credits will follow you from job-to-job and they aren’t lost if there is a gap in work history.

There may be special rules about how credits are earned for those employed in some of the following:

• Farm work;
• Domestic work;
• Employment for a church or related organization that doesn’t pay Social Security taxes.

Other than that, the required credits depend on how old a claimant is when he or she becomes disabled. So for example:

• A person disabled before age 24 will typically need at least 1.5 years of work in the three years prior to the disability. This would equal six credits.
• A person between 24 and 30 will usually need credits for half the time between ages 21 and the date of disability.
• A person who is 31 or older will probably need at least 20 credits in the 10 years immediately preceding the onset of disability.

The number of needed credits and years of work history increases slightly every two years beyond that.

Dependents can also obtain benefits, and may need to apply for survivors’ benefits if the original recipient dies. Eligible dependents may include:

• Spouses age 62 and older or those carrying for a child who is under-16 or disabled;
• Ex-Spouses who were married for 10 years or more to recipient;
• Children who are younger than 18 and unmarried;
• Adult children who are full-time secondary school students under 19 or who are disabled with a condition that onset prior to age 22;
• Grandchildren who were dependent;
• Parents who were dependent.

The number of credits necessary for survivors’ benefits depends on the age of the disabled person when they die. However, no one is going to need more than 40 credits, which usually equals 10 years of work.

SSI provides benefits to those who are elderly, blind and/or disabled who are in dire straits to meet basic needs, such as food, shelter and medication.

The maximum Supplemental Security Income one can receive changes annually based on the Consumer Price Index. As of 2016, the most one can take home is $733 per individual or $1,100 for eligible couple. Children also may be eligible to receive benefits, assuming they qualify under specified conditions.

Some states, including Massachusetts, provide a state supplemental payment that is based on one’s income, living arrangements and other factors.

The federal program will take into account:

• Whether you have countable income and resources that would decrease your payment
• Whether you are married to an eligible spouse

The state program is based on one’s eligibility in the federal program.

Generally, a person with $1,000 or more of monthly income (including from SSDI, unemployment, pensions or Social Security retirement) and/or more than $2,000 in resources (or $3,000 per couple) will be ineligible for benefits.

The agency will also for SSI calculation purposes take into account “deemed income” – or income of a spouse, parents or others with whom the applicant lives. That is not the case for SSDI applicants.

In some cases, individuals may qualify for both SSI and SSDI. These are called concurrent claims. The most one can receive through a concurrent claim is the maximum SSI allowance rate.

Recognize too that other forms of assistance and income – including aid from family and friends, workers’ compensation, unemployment benefits and private disability insurance – could impact eligibility or final benefit sums for these programs.