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Frequently asked questions about SSDI.

• Is MS recognized as a “disability” by the Social Security Administration that could qualify me for disability benefits?
• How does SSA decide if I am disabled?
• What is Social Security Disability Insurance (SSDI)?
• What is Supplemental Security Income (SSI)?
• How do I apply? Can I file online?
• How do I know whether I have paid enough in Social Security taxes (or FICA) to qualify for SSDI?
• How much income can I earn and still receive SSDI?
• How long will the initial application and approval processes take?
• Can a representative or caregiver help with the application process?
• Once I am approved for SSDI, are the payments retroactive to the onset of my disability?
• What if I cannot prove my work history?
• What if I cannot document my medical history?
• Do I receive Medicare when I qualify for Social Security disability benefits?
• If I go back to work, will I lose all my benefits including Medicare?
   

Is MS recognized as a “disability” by the Social Security Administration that could qualify me for disability benefits?

The Social Security Administration recognizes multiple sclerosis as a chronic illness or “impairment” that could cause disability severe enough to prevent someone from working. If any of the following conditions, or other common MS symptoms, prevent you from working, you might qualify for Social Security disability benefits:

• Difficulty with walking and other motor skills.
• Difficulty seeing.
• Difficulty concentrating or completing simple tasks.
• Difficulty remembering.
• Extreme fatigue, regardless of sleep.
• Speech impairment.
• Side effects of medication(s).

For more information on the MS criteria, review the National MS Society's Social Security Disability Guidebook for People Living with MS (.pdf).

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How does SSA decide if I am disabled?

First, the Social Security Administration will determine whether you are insured for disability benefits by making sure that you have worked and paid enough Social Security taxes. Next, SSA will make sure you are not currently earning too much income from work. Finally, SSA will determine whether your MS symptoms and/or other conditions meet one or more of the four disability criteria in the official SSA Listing of Impairments and therefore entitle you to benefits. The criteria for MS include:

• Disorganization of motor function
• Visual impairment
• Mental impairment
• Fatigue

If your MS symptoms and/or other conditions do not meet the criteria of SSA's MS Listing, you could still qualify. SSA will go on to consider:

• The limitations from your MS symptoms.
• Any other physical or mental medical conditions you might have.
• The work you have done in the past.
• Your age, education, and work experience.

SSA must have medical evidence to support those criteria and your claim for disability. It is very important, but not enough, for your doctor(s) to simply say that you are “disabled” or that your MS symptoms meet a criterion on the MS Listing.

For more information, review the National MS Society's Social Security Disability Guidebook for People Living with MS (.pdf).

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What is Social Security Disability Insurance (SSDI)?

Social Security Disability Insurance, or SSDI, is a federal insurance program. It is not a welfare program, because individuals pay into the system through taxes withheld from their paycheck. SSDI provides cash benefits to replace some of the income that a person living with MS might no longer earn due to disability. It can give people living with MS the resources they need to remain active and involve in their community.

To be eligible for SSDI benefits, a person living with MS must:

• Have worked and paid enough Social Security taxes (FICA).
• Have a severe disability that is caused by disease or injury severe enough to prevent them from working at any job.
• Have a severe disability that is expected to result in death or has lasted, or is expected to last, for a continuous period of at least 12 months.

For more information on SSDI, visit: www.ssa.gov/d&s1.htm

Note: While SSDI and SSI provide different benefits, SSA uses the same disability determination process for both. You can even qualify for both at the same time.

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What is Supplemental Security Income (SSI)?

Supplemental Security Income, or SSI, is an SSA program similar to SSDI, but it provides cash benefits to assist people who have very limited income, elderly, blind, and/or disabled and have limited means.

To be eligible for SSI benefits, an individual must:

• Have a severe disability that is caused by disease or injury severe enough to prevent them from working at any job.
• Have a severe disability that is expected to result in death or has lasted, or is expected to last, for a continuous period of at least 12 months.
• Have limited income and assets low enough to meet certain thresholds.
  Unlike SSDI, an individual does not need a work history to qualify, but must have very little or no income and resources.

For more information on SSI, visit: www.ssa.gov/ssi

Note: While SSDI and SSI provide different benefits, SSA uses the same disability determination process for both. You can even qualify for both at the same time.

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How do I apply? Can I file online?

You can apply for Social Security disability benefits online, in-person, or on the phone. You should consider how MS affects you when making your decision on how you want to apply.

In person. If you want to apply in person you can find the most convenient Social Security office at www.socialsecurity.gov/locator/. Applying in person will allow you to meet directly with SSA personnel and ask questions in real time. Of course, you will need to travel to your nearest office or be prepared to wait a few days for an appointment. To schedule an appointment in a local SSA office, call 1-800-772-1213

On the phone. Call 1-800-772-1213 to schedule a phone appointment. This will allow you to have some contact with the local SSA office without having to travel to the local office. If you are deaf or hard of hearing, call the toll-free "TTY" number, 1-800-325-0778, between 7 a.m. and 7 p.m. Monday through Friday.

Online. Apply online at www.socialsecurity.gov/applyfordisability. The online application allows you to save your work and come back later to finish. You won't need to leave your home, but you might not be able to readily talk to a live person for guidance.

The National MS Society recommends that you consider applying in person or via phone, so you have a direct contact person for your questions. For more information, review the National MS Society's Social Security Disability Guidebook for People Living with MS  (.pdf).

For more general information, request the SSA Disability Starter kit by calling 1-800-772-1213 or visit: www.socialsecurity.gov/disability/disability_starter_kits.htm

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How do I know whether I have paid enough in Social Security taxes (or FICA) to qualify for SSDI?

Qualification for Social Security Disability Insurance (SSDI) does not depend on the amount of money you have paid, but rather it is based on your work history in a Social Security-covered job and the Social Security (or FICA) taxes you have paid. The Social Security Administration classifies that history in “work credits.”

The number of work credits you need depends on your age and when you became disabled. Generally, you need 20 credits earned in the past 10 years, ending with the year you become disabled. Younger workers could qualify with fewer credits.

For information on how you earn credits and the number of credits you need to qualify for disability benefits, call SSA at 1-800-772-1213 or visit: www.socialsecurity.gov/pubs/10072.html

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How much income can I earn and still receive SSDI?

If you are still working but not earning very much money, you might still qualify for disability benefits. In 2008, you cannot receive more than $940 per month in wages to qualify for SSDI (this amount is $1,500 for someone who is statutorily blind). For 2007, the maximum amount was $900.

SSA uses this maximum income cap, called substantial gainful activity (SGA), to assess the impact of your MS symptoms on your ability to work. If you earn more than this amount, SSA will deny your application. SSA increases the SGA income cap annually. SGA applies only to income from work. For SSDI purposes, SSA does not count income you get from other sources, such as interest or investments.

If you have not worked enough, or have not worked recently enough to have the required insured status, you cannot receive SSDI benefits. But if you have limited income and assets, you might still be entitled to Supplemental Security Income (SSI).

SSA has established a variety of “work incentive” programs that can help you keep your cash benefits and Medicare while you test your ability to work. Based on your participation in these programs, you can earn additional income and continue to receive SSDI benefits. For information, visit: www.socialsecurity.gov/pubs/10095.html

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How long will the initial application and approval processes take?

The initial application and approval process can be lengthy — generally a minimum of three to five months. If you claim goes through the appeals process the timeframe can take years. After you submit your SSDI application, it goes through a three-step process:

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Can a representative or caregiver help with the application process?

A friend, family member, or caregiver can assist with any parts of your application. They can assist with the application process, such as gathering and organizing all the necessary work and medical records into a folder or keeping a journal. They can accompany you on visits to your doctor(s) and SSA, sit beside you, and help answer tough questions. They also can help fill out the worksheets in the Social Security Disability Guidebook for People Living with MS (.pdf).

If you have an authorized representative who will be acting on your behalf or in your absence to complete the entire application, you both must complete and sign Form SSA-1696 (Appointment of Representative). Download and complete at: www.socialsecurity.gov/representation

You do not need to do this if you are just having a friend or family member helping you with the process. If you want an authorized representative but don't know how to find one, ask your local SSA field office.

Note: A representative might charge a fee. But he or she cannot collect a fee from you unless SSA authorizes it or unless the person is your legal guardian and authorized by a court to charge a guardian fee. The fee agreed on is no more than 25 percent of past-due benefits or $6,000, whichever is less. For more information, visit: www.ssa.gov/pubs/10075.pdf.

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Once I am approved for SSDI, are the payments retroactive to the onset of my disability?

Yes, you can receive up to one year retroactive benefits on SSDI if SSA decides your disability started before you even filed. Keep in mind this is only after taking into account the five-month waiting period for benefits.

There are no retroactive payments for SSI.

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What if I cannot prove my work history?

In most cases if you have used your social security number (SSN) throughout your working life, then SSA should have record of your work history. If you have not used your SSN, then you would need to prove your work history though such documents as copy of tax returns.

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What if I cannot document my medical history?

In order to begin documenting your medical history, you need such information as:

• 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 caseworkers that you already have in your possession.
• Laboratory and test results.

SSA will ask your doctor(s) for this information directly but it is a good idea for you to get a copy for yourself if possible.

In addition, you will need to fill out a form that collects information about your medical condition, and how it affects your ability to work. There are other forms that you will give to doctors, hospitals, and other healthcare professionals who have treated you and give them permission to send SSA information about your medical condition.

If you cannot provide any medical history to support your claim, SSA might request a consultative exam with your doctor or another doctor. This is an attempt to obtain some evidence to support your claim.

Before you begin your application process, review the National MS Society's Social Security Disability Guidebook for People Living with MS (.pdf). This Guidebook contains MS-specific information that you and your doctors will need to prepare a successful disability application.

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Do I receive Medicare when I qualify for Social Security disability benefits?

If you qualify for SSDI benefits, you also become entitled to Medicare, but not until two years after you become entitled. To learn more about Medicare coverage for people living with disabilities, go to: www.socialsecurity.gov/pubs/10043.html

If you will lose healthcare coverage and cannot wait for Medicare coverage to begin after the two-year waiting period, talk to an SSA representative about other types of publicly-financed healthcare coverage. In many states (but not all), Supplemental Security Income (SSI) provides healthcare coverage through Medicaid. If you're approved for SSI, you could start receiving Medicaid coverage right away.

If you currently are receiving healthcare coverage through your employer, you could lose coverage when you stop working. When you leave employment, some employers offer group COBRA insurance. However, you must pay for the COBRA coverage. For more information, visit: www.cobrainsurance.com/

Find more information from the National MS Society on private insurance options and personal finances.

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If I go back to work, will I lose all my benefits including Medicare?

No, the Social Security Administration has several work incentives that can help you to return to work without losing your benefits. Some of SSA's work incentive programs also allow you to return to a disabled status without having to re-file if you are unable to continuing working due to your MS.

For more information about Social Security's work incentives, call SSA at 1-800-772-1213, contact your local Social Security office, or visit: www.socialsecurity.gov/work/.

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