New Jersey Public Health Plan for Disabilitis - Social Security Disability Insurance (SSDI)

Social Security Disability Insurance (SSDI)

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Program Details

What is Social Security Disability Insurance (SSDI)?

The Social Security and Supplemental Security Income disability programs are the largest of several Federal programs that provide assistance to people with disabilities. Social Security Disability Insurance pays benefits to you and certain members of your family if you are "insured," meaning that you worked long enough and paid Social Security taxes.

Who is it for?

Disabilitis

Who is Eligible?

Must suffer from a permanent condition that prevents you from working. The disabling condition must have lasted, or be expected to last, a minimum of 12 months and you must be unable to earn an income greater than $1,070 per month (110% FPL). You also need to have earned sufficient work credits, which depend on how old you were when you became disabled. Common examples of necessary work credits:

  • If you become disabled before age 24, you generally need 1½ years of work (six credits) in the three years before you became disabled.
  • If you are 24 through 30, you generally need credits for half of the time between age 21 and the time you became disabled.
  • If you are disabled at age 31 or older, you generally need at least 20 credits in the 10 years immediately before you became disabled.

What is Covered?

Your first Social Security benefit will be paid for the sixth full month after the date Social Security determines your disability began. The amount of your monthly disability benefit is based on your lifetime average earnings covered by Social Security. If you don't already have an estimate, you can use one of these Benefit Calculators to determine what your payments may be.

How much is it?

$0 to apply. Amount of monthly benefit is dependent on your lifetime average earnings covered by Social Security.

How to Apply?

Complete the online Application and submit it, along with copies of your sign-up checklist items, to your local Social Security office.

Who can get Social Security disability benefits?

Social Security pays benefits to people who can't work because they have a medical condition that's expected to last at least one year or result in death. Federal law requires this very strict definition of disability. While some programs give money to people with partial disability or short-term disability, Social Security does not.Certain family members of disabled workers can also receive money from Social Security.

How do I meet the earnings requirement for disability benefits?

In general, to get disability benefits, you must meet two different earnings tests:

  1. A recent work test, based on your age at the time you became disabled; and
  2. A duration of work test to show that you worked long enough under Social Security.

Certain blind workers have to meet only the duration of work test.

How do I apply for disability benefits?

There are two ways that you can apply for disability benefits. You can

  1. Apply online at www.socialsecurity.gov; or
  2. Call toll-free number, 1-800-772-1213, to make an appointment to file a disability claim at your local Social Security office or to set up an appointment for someone to take your claim over the telephone. The disability claims interview lasts about one hour. If you're deaf or hard of hearing, you may call our toll-free TTY number, 1-800-325-0778, between 7a.m. and 7 p.m. on business days. If you schedule an appointment, SSA will send you a Disability Starter Kit to help you get ready for your disability claims interview. The Disability Starter Kit also is available online at www.socialsecurity.gov/disability.

You have the right to representation by an attorney or other qualified person of your choice when you do business with Social Security. More information is in Your Right To Representation (Publication No. 05-10 075), which is also available from Social Security.

When should I apply and what information do I need?

You should apply for disability benefits as soon as you become disabled. Processing an application for disability benefits can take three to five months. To apply for disability benefits, you'll need to complete an application for Social Security benefts. You can apply online at www.socialsecurity.gov. SSA may be able to process your application faster if you help us by getting any other information SSA need.
The information SSA need includes:

  • Your Social Security numbers;
  • Your birth or baptismal certificate;
  • Names, addresses and phone numbers of the doctors, caseworkers, hospitals and clinics that took care of you and dates of your visits;
  • Names and dosage of all the medicine you take;
  • Medical records from your doctors, therapists, hospitals, clinics, and caseworkders that you already have in your possession;
  • Laboratory and test results;
  • A summary of where you worked and the kind of your you did; and
  • A copy of your most recent W-2 Form (Wage and Tax Statement) or, if you're self-employed, your federal tax returns for the past year.
In addition to the basic application for disability benefits, you'll also need to fill out other forms. One form collects information about your medical condition and how it affects your ability to work. Other forms give doctors, hospitals and other health care professional who have treated you, permission to send us inofrmation about your medical condition.
Don't delay applying for benefits if you can't get all of this information together quickly. SSA will help you get it.

Who decides if I am disabled?

SSA will review your application to make sure you meet some basic requirements for disability benefits. SSA will check whether you worked enough years to qualify. Also, SSA will evaluate any current work activities. If you meet thest requirements, SSA will process your application and forward your case to the Disability Dertermination Services office in your state.
This state agency completes the initial disability determination decision for us. Doctors and disability specialists in the state agency ask your doctors for information about your condition. They'll consider all the facts in your case. They'll use the medical evidence from your doctors, hospitals, clinics, or institutions where you've been treated and all other information. They'll ask your doctors about Your medical condition(s); When your medical condition(s) began; How your medical condition(s) limit your activities; Medical tests results; and What treatment you've received.
They'll also ask the doctors for information about your ability to do work-related activities, such as walking, sitting, lifting, carrying, and remembering instructions. Your doctors don't decide if you're disabled.
The state agency staff may need more medical information before they can decide if you're disabled. If your medical sources can't provide needed information, the state agency may ask you to go for a special examination. SSA prefer to ask your own doctor, but sometimes the exam may have to be done by someone else. Social Security will pay for the exam and for some of the related travel costs.

How SSA make the decision?

SSA use a five-step process to decide if you're disabled.

  1. Are you working?
    If you're working and your earnings average more than a certain amount each month, SSA generally won't consider you to be disabled. The amount changes each year. For the current figure, see the annual Update (Publication No. 05-10003).
    If you're not working, or your monthly earnings average to the current amount or less, the state agency then looks at your medical condition.
  2. Is your medical condition "severe"?
    For you to be considered to have a disability by Social Security's definition, your medical condition must significantly limit your ability to do basic work activities—such as lifting, standing, walking, sitting, and remembering-for at least 12 months. If your medical condition isn’t severe we won't consider you to be disabled. If your condition is severe, we proceed to step three.
  3. Does your impairment(s) meet or medically equal a listing?
    SSA's list of impairments (the listings) describes medical conditions that SSA consider severe enough to prevent a person from completing substantial gainful activity, regardless of age, education, or work experience. If your medical condition (or combination of medical conditions) isn't on this list, the state agency looks to see if your condition is as severe as a condition on the list. If the severity of your medical condition meets or equals the severity of a listed impairment, the state agency will decide that you have a qualifying disability. If the severity of your condition doesn't meet or equal the severity level of a listed impairment, the state agency goes on to step four.
  4. Can you do the work you did before?
    At this step, SSA decide if your medical impairment(s) prevents you from performing any of your past work. If it doesn't, SSA will decide you don't have a qualifying disability. If it does, SSA will proceed to step five.
  5. Can you do any other type of work?
    If you can't do the work you did in the past, SSA looks to see if there's other work you can do despite your impairment(s). We consider your age, education, past work experience, and any skills you may have that could be used to do other work. If you can't do other work, SSA will decide that you're disabled. If you can do other work, SSA will decide that you don't have a qualifying disability.

Special rules for blind people
There are special rules for people who are blind. For more information, ask for If You Are Blind Or Have Low Vision—How We Can Help (Publication No. 05-10052).

SSA will tell you our decision
When the state agency makes a determination on your case, SSA will send a letter to you. If your application is approved, the letter will show the amount of your benefit, and when your payments start. If your application isn't approved, the letter will explain why and tell you how to appeal the determination if you don't agree with it.

What if I disagree?

If you disagree with a decision made on your claim, you can appeal it. Your request must be in writing and delivered to any Social Security office within 60 days of the date you receive the letter containing the decision. The steps you can take are explained in The Appeals Process (Publication No. 05-10041), which is available from Social Security.

How SSA will contact you?

Generally, SSA mail or call you when they want to contact you about your benefits, but sometimes, a Social Security representative may come to your home. SSA representative will show you identification before talking about your benefits. Calling the Social Security office to ask if someone was sent to see you is a good idea.
If you're blind or have low vision, you can choose to receive notices from us in one of the following ways:

  • Standard print notice by first-class mail;
  • Standard print notice by certified mail;
  • Standard print notice by first-class mail and a follow-up telephone call;
  • Braille notice and a standard print notice by first-class mail;
  • Microsoft Word file on a data compact dissc (CD) and a standard print notice by first-class mail;
  • Audio CD and a standard print notice by first-class mail; or
  • Large print (18-point size) notice and a standard print notice by first-class mail.

For more information, visit SSA website at www.socialsecurity.gov/notices or call their toll-free at 1-800-772-1213. If you're deaf or hard of hearing, you may call their TTY number at 1-800-325-0778.

What happens when my claim is approved?

SSA will send a letter to you telling you your application is approved, the amount of your monthly benefit, and the effective date. Your monthly disability benefit is based on your average lifetime earnings. Your first Social Security disability benefits will be paid for the sixth full month after the date your disability began.
You'll also receive What You Need To Know When You Get Disability Benefits (Publication No. 05-10153), which gives you important information about your benefits and tells you what changes you must report to SSA.

Can my family get benefits?

Certain members of your family may qualify for benefits based on your work. They include:

  • Your spouse, if he or she is age 62 or older;
  • Your spouse at any age, if he or she is caring for a child of yours who is younger than age 16 or disabled;
  • Your unmarried child, including an adopted child, or, in some cases, a stepchild or grandchild. The child must be younger than age 18 (or younger than 19 if still in highschool);
  • Your unmarried child, age 18 or older, if he or she has a disability that started before age 22. The child's disability must also meet the definition of disability for adults.

NOTE: In some situations, a divorced spouse may qualify for benefits based on your earnings, if he or she was married to you for at least 10 years, is not currently married, and is at least age 62. The money paid to a divorced spouse doesn't reduce your benefit or any benefits due to your current spouse or children.

How do other payments affect my benefits?

If you're getting other government benefits, the amount of your Social Security disability benefits may be affected.

What do I need to tell Social Security?

  • If you have an outstanding warrant for your arrest
    You must tell SSA if you have an outstanding arrest warrant for any of the following felony offenses:
    • Flight to aviod prosecution or confinement;
    • Escape from custody; and
    • Flight-escape.

    You can't receive regular disability benefits, or any underpayments you may be due, for any month in which there is an outstanding arrest warrant for any of these felony offenses.
  • If you're convicted of a crime
    Tell Social Security right away if you're convicted of a crime. Regular disability benefits, or any underpayments, that may be due aren't paid for the months a person is confiined for a crime, but any family members who are eligible for benefits based on that person's work may continue to receive beneifts.
    Monthly beneifts, or any underpayments that may be due, are usually not paid to someone who commits a crime and is confined to an institution by court order and at public expense. This applies if the person has been found
    • Not guility by reason of insanity or similar factors (such as mental disease, mental defect, or mental incompetence); or
    • Incompetent to stand trial.
  • If you violate a condition of parole or probation
    You must tell SSA if you're violating a conidition of your probation or parole imposed under federal or state law. You can't receive regular disability benefits or any underpayment that may be due for any month in which you violate a condition of your probation or parole.

When do I get Medicare?

You'll get Medicare coverage automatically after you've received disability benefits for two years. You can find more information about the Medicare program, in Medicare (Publication No. 05-10043).

What do I need to know about working?

After you start receiving Social Security disability benefits, you may want to try working again. Social Security has special rules called work incentives that allow you to test your ability to work and still receive monthly Social Security disability benefits. You can also get help with education, rehabilitation, and training you may need to work.
If you do take a job or become self-employed, tell SSA about it right away. SSA need to know when you start or stop work and if there are any changes in your job duties, hours of work, or rate of pay. You can call SSA toll-free at 1-800-772-1213. If you're deaf or hard of hearing, you may call SSA TTY number, 1-800-325-0778.
For more information about helping you return to work, ask for Working While Disabled—How We CanHelp (Publication No. 05-10095). A guide to all SSA employment supports can be found in its Red Book, A Summary Guide to Employment Support for Individuals with Disabilities Under the Social Security Disability Insurance and Supplemental Security Income Programs(Publication No. 64-030). Also visit website, www.socialsecurity.gov/work.

When your payments start?

Under the law, your payments can't begin until you've been disabled for at least five full months. Payments usually start with your sixth month of disability.
When Social Security tells you that you'll be receiving disability benefit payments, the notice explains how much your disability benefit will be, and when your payments start.
NOTE: If your family members are eligible for benefits based on your work, they'll receive a separate notice and booklet.

How long payments continue?

Generally, your disability benefits will continue as long as your medical condition has not improved and you can't work. Benefits won't necessarily continue indefinitely. Because of advances in medical science and rehabilitation techniques, many people with disabilities recover from serious accidents and illnesses. We'll review your case periodically to make sure you still have a qualifying disability.

When and how your benefits are paid?

Social Security benefits are paid each month. Generally, the day on which you receive your benefit depends on the birth date of the person on whose work record you receive benefits. For example, if you receive benefits as a retired or disabled worker, your benefit will be determined by your birth date. If you receive benefits as a spouse, your benefit payment date will be determined by your spouse's birth date.

Paying taxes on your benefits

Some people who get Social Security have to pay taxes on their benefits. About one-third of our current beneficiaries pay taxes on their benefits. You'll be affected only if you have substantial income in addition to your Social Security benefits.

  • If you file a federal tax return as an "individual," and your income is more than $25,000, you have to pay taxes.
  • If you file a joint return, you may have to pay taxes, if you and your spouse have a combined income that is more than $32,000.
  • If you're married and file a separate return, you'll probably pay taxes on your benefits.

For more information, contact the Internal Revenue Service.

What changes should be reported?

Please notify Social Security promptly by phone, mail, or in person whenever a change occurs that could affect your benefits. Family members receiving benefis based on your work also should report events that might affect their payments. Information you give to another government agency may be provided to Social Security by the other agency, but you also must report the change directly to Social Security. The changes include:

  • If you work while receiving disability payments
  • If you receive other disability benefits
  • If you're offered services under the Ticket to Work program
  • If you move
  • If you change direct deposit accounts
  • If you're unable to manage your benefits
  • If you get a pension from work not covered by Social Security
  • If you get married or divorced
  • If you change your name
  • If you care for a child who receives benefits
  • If you become a parent after entitlement
  • If a child receiving benefits is adopted
  • If you have an outstanding warrant for your arrest
  • If you're convicted of a crime
  • If you violate a condition of parole or probation
  • If you leave the United States
  • If your citizenship status changes
  • If a beneficiary dies
  • If you're receiving Social Security and Railroad Retirement benefits

How often your medical condition is reviewed?

How often your medical condition is reviewed depends on how severe it is and the likelihood it will improve. Your award notice tells you when you can expect your first review.

  • Medical improvement expected - If your condition is expected to improve within a specific time, your first review will be six to 18 months after you started getting disability benefits.
  • Improvement possible - If improvement in your medical condition is possible, we'll review your case about every three years.
  • Improvement not expected - If your medical condition is unlikely to improve, we'll review your case about every five to seven years

What happens during a review?

SSA will send a letter to you telling you that they are conducting a review. Soon after that, someone from your local Social Security office will contact you to explain the review process and your appeal rights. The Social Security representative will ask you to provide information about your medical treatment and any work that you may have done.

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  • Office Locations
    604 E KENNEDY BLVD
    LAKEWOOD, NJ 08701
604 E KENNEDY BLVD LAKEWOOD NJ, 08701

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