SOCIAL SECURITY BENEFITS
FOR PERSONS WITH
DISABILITIES
Adrienne J. Arkontaky, Esq.
The Cuddy Law Firm, P.C.
50 Main Street
White Plains, New York 10606
www.cuddylawfirm.com
Many people with disabilities are
eligible for benefits through the
Social Security Program.
The programs are designed to
provide an individual with disabilities
with the basic necessities of life
including
food,
shelter
and
healthcare.
Programs are grouped into two
categories
• Needs Based Programs such as Supplemental
Security Income and Medicaid. These programs are
available to individuals with disabilities who satisfy
certain needs based requirements related to assets and
income.
• Social Insurance Programs such as Social Security
and Medicare.
These programs are available
regardless of how much income or assets you may have.
These benefits become available because of the
amounts you paid into the Social Security system.
Who Operates These Programs?
• Some are operated by the Federal
Government.
• Some are operated by the States.
• Others are jointly funded by the Federal
Government and the States.
Some Basic Rules
• If your disability occurred before reaching the
age of 22, Social Security benefits become
available when you or your spouse die, reach
retirement age, or become disabled.
• If a child developed a disability after age 22,
Social Security will be available only if your child
had a significant employment history before
becoming disabled.
Basic Rules (Continued)
• If you have limited income and assets and are
disabled, you will likely be entitled to
Supplemental Security Income benefits upon
reaching the age of 18. For some lower-income
families, children under the age of 18 may also
be eligible.
• If you are eligible for Supplemental Security
Income benefits, you will likely be eligible for
Medicaid.
Social Security and Medicare
• If you have been eligible for Social
Security benefits for at least two years,
you will likely be eligible for Medicare. It
does not matter if you actually received
the benefits just that the eligibility
requirements were satisfied.
Establishing Disability
• In order for you to qualify for the aforementioned
benefits, you will need to be considered to have
a disability within the rules of the Social Security
system.
• The Social Security regulations define disability
as “the inability to do any substantial gainful
activity by reason of any medically determinable
physical or mental impairment which can be
expected to last for a continuous period of not
less than 12 months.” (20 CFR Section
404.1505)
The Evaluation Process
•
•
1.
2.
3.
4.
5.
SSA must determine whether the person with a disability is able to earn
more than a threshold amount, which increases each year to account for
inflation.
There is a 5 step analysisIs the person working?
Does the disability significantly limit the person’s ability to do basic work
activities: (for example walking, sitting, seeing, and remembering)
If the person’s medical condition is considered severe, the SSA will look
at a list of disabling impairments to consider automatic qualifications.
If the person’s medical condition is severe but is not on the list, the SSA
will examine further when the person can possibly work in the future,
based on past work history.
If none of the above criteria are met, the SSA will consider whether the
disability will affect the person’s ability to sustain work at the “substantial
gainful employment” level in the future.
Common Reasons for Failing to
Qualify
• The single most common reason for failing to
qualify for benefits is a failure to submit
information sufficient to permit SSA to make a
determination that a person has a disability
within the scope of the SSA rules.
• If possible, a physician should review the
definition describing your disability as set forth in
the SSA regulations to make sure the report
contains the language that Social Security
requires.
Social Security Disability Insurance
“SSDI”
• One of two primary cash benefit programs
• It is generally available for workers who become
disabled prior to attaining age 65, if the worker’s
work history satisfies SSA requirements.
• It is also available to children (even adult
children) of retired, disabled or deceased social
security participants if the child had a disability
that developed before the child reached the age
of 22.
SSDI (continued)
• The benefit is based on the parent ’ s work
record.
• If the parent is retired or disabled, the benefit is
one-half of the parent’s benefit.
• If the parent is deceased, the benefit is three
fourth’s of the parent’s benefit.
• Benefits may be reduced if more than one
person receives benefits based on the parent’s
work history and will cease if the person marries
someone who is not entitled to SSA benefits.
Supplemental Security Income
“SSI”
• The SSI program is a needs based program
designed to supplement the income of people
who are elderly, blind, or disabled and lack
sufficient resources to provide for their own
needs.
• The Program provides a monthly cash stipend
and Medicaid.
• Disability is determined in the same manner as
SSDI.
• There is no requirement that the disability occur
before age 22.
Additional Information on SSI
Benefits
• There are limits on income and resources.
• There is a deeming of income and resources.
• A portion of your income and resources will
generally be considered available to your child if
your child lives with you and is under age 18.
• Once the child reaches age 18, the parents’
assets are no longer considered available to the
child.
• There is a reduction in benefits for certain
situations.
MEDICARE
• A federal health insurance program run by
the SSA. It is designed to pay the cost of
health care for people over the age of 65
and for people with disabilities who are
under the age of 65 and have been eligible
to receive SS benefits for at least two
years, or who need kidney dialysis
treatments or a kidney transplant. The
individual must only be eligible not receive
the benefit.
Conclusion
• It is important to assess a need for government
programs as early as possible.
• It is imperative to explore all potential
government benefits according the needs of the
individual.
• It is imperative that you work with advocacy
organizations, doctors and other professionals to
obtain appropriate documentation.
• It is imperative to have proper estate planning
and consider the use of a special needs trust to
protect a child’s assess to government benefits.
Resources
• Social Security Administrationwww.ssa.gov
• State Department of Health website www.health.state.ny.us.
Adrienne J. Arkontaky, Esq.
The Cuddy Law Firm, P.C.
50 Main Street, White Plains NY
www.cuddylawfirm.com
aarkontaky@cuddylawfirm.com