Eligible or Not Eligible (Part II)

In my last blog, I shared examples of how a person who is applying for Social Security Disability benefits—either SSI or SSDI—must demonstrate that her/his conditions are expected to be long term and are significant enough to prevent the person from performing Substantial Gainful Activity (SGA), without special conditions, such as Impairment Related Work Expenses or Employer Subsidies.

As if the duration of disability and SGA criteria were not enough, each type of disability cash benefit has its own additional criteria.  In order to be eligible, a person must meet these criteria, also.  For example:

Supplemental Security Income (SSI) eligibility requires that a person with a disability have less than $2,000 in countable resources and total countable earned and unearned income that does not exceed the Federal Benefit Level, which is $994 for a single individual in 2026.

• Joe has Down syndrome that was diagnosed when he was three days old.  Joe receives a $1,100/month survivor’s benefit from his deceased father’s pension plan.  Joe has $1,500 in his checking account and $4,000 in his savings account.  Joe doesn’t qualify for SSI because his income is too high and his assets are too many.

• Lilly has Down syndrome that was diagnosed when she was three days old.  Lilly has $500 a month of income from her part time job, of which a little less than half “counts” under the SSI method of counting earned income.  She has $1,000 in her checking account and $5,000 in an ABLE account, which is exempt for SSI considerations.  Lilly does qualify for SSI, because her income and assets are within the limits.

Social Security Disability Insurance (SSDI) requires that a person be “insured” by having a sufficient number of Social Security credits (formerly “quarters”) earned within a certain period of time, prior to the date of application.

• ·Sandra is 23 and has a developmental disability.  She started working only very part-time during her transition program.  She earned 1 credit per year from 2020 to 2025 for a total of  6 credits.  At her age, she needs 6 credits to be insured for SSDI.  However, she needs to have accumulated those 6 credits within the 3 years, prior to applying for SSDI.  Since only 3 of her credits were earned within the 3 years prior to applying, she is not eligible.

• ·Don is 23 and has a developmental disability.  He started working part-time during his transition program.  He earned 2 credits per year for each of the two previous calendar years and the current year, accumulating the 6^th credit in November.  He applies for SSDI in December and is eligible because he acquired the 6 credits within the 3 years prior to application.

• At 30, Angela and her husband had a child who was born prematurely and required significant therapy and support.  Angela stayed home.  At 40, Angela returned to work.  At 43, she is diagnosed with an autoimmune disorder that significantly limits her capacity to work.  At her age, she needs to have at least 20 credits earned within the 10 years, prior to her application to be insured for disability benefits.  Because she was out of the workforce for 10 years and only accumulated 12 credits in the time between her return to work and when she needs the benefits, she is not eligible for SSDI. 

• At 30, Tom and his wife had a child who required significant therapy and support.  Since Tom’s job paid less, he stayed home.  At 40, he re-entered the workforce.  At 46, Tom was paralyzed in a skiing accident.  Although he was out of the workforce for 10 years, he had earned 20 credits in the time since he re-entered the workforce and the time when he needs benefits, he is thus eligible for SSDI as long as his condition prevents him from performing SGA.

Childhood Disability Benefits (CDB), also known as Disabled Adult Child (DAC) benefits, require the person to have continuously met the definition of “disabled” from before the age of 22 until the date that one of their parents files for Social Security retirement or disability. This is because a person is eligible for this benefit based on her/parent’s work record.  The parent must have sufficient Social Security credits.

• Pete developed a behavioral health disability at the age of 24.  Since his disability did not start before he turned 22, he will never be eligible for CDB/DAC benefit. If his disability prevents him from performing SGA, he may be eligible for SSI and if he works below the SGA level but accumulates sufficient credits, he may become eligible for SSDI based on his own work record.

• Leanne’s disability started before she turned 22.  However, she did find a job and over time, was able to work at a level where she exceeded the Substantial Gainful Activity level for a 10-year period.  Premature aging related to her disability caused her to stop working.  Leanne’s parents later filed for Social Security retirement benefits, but Leanne was not eligible for CDB/DAC because she ceased to meet the Social Security definition during her working years, after her age 22 and before her parents filed for their own benefits.  If Leanne has sufficient work credits, she may be eligible for SSDI on her own work record, now that she is no longer able to perform SGA. 

• Rose was diagnosed with intellectual disability at the age of 3.  Rose’s mother worked her whole career in a job where she did not pay Social Security tax.  Rose’s mother is 66 and has retired, but Rose is not eligible for CDB/DAC because her mother is not eligible for a Social Security Retirement benefit.  Rose’s father paid into the Social Security system but will delay filing for retirement benefits until he turns 70.  Rose will only become eligible for CDB/DAC once her father files for his Social Security Retirement benefit.

Have a disabling physical, mental or emotional impairment is necessary for a person to apply for SSI based on disability, SSDI based on her/his own work record or a CDB/DAC based on a parent’s work record.  However, having such a condition or conditions is not necessarily sufficient for a person to qualify for one of these benefits.  S/he also has to meet a combination of other criteria.