SSDI is an earned disability benefit program that the Social Security Administration (SSA) offers. It is considered “earned” because one must be insured in order to collect this benefit. People reach insured status by working and earning quarters of coverage. You can earn up to 4 credits per year. To find out if you’re insured, you can go on to your ssa.gov account or call your local Social Security field office. Everyone must meet Social Security’s definition of disability in order to be eligible, which is they must not be able to engage in any substantial gainful activity (SGA) because of a medically determinable physical or mental disability(ies) that is either:

• Expected to result in death.
• Has lasted or is expected to last for a continuous period of at least 12 months.

Disabled Adult Child Benefits are the same as Childhood Disability Benefits. Disabled Adult Child Benefits are disability benefits offered to an adult child off their parent’s work record. This is also considered an earned benefit because the parent, aka number holder, is the insured worker. People become eligible for this benefit at age 18 and must have been diagnosed with a disability prior to age 22. Their parent must fall into one of three qualifying categories for them to be eligible:

1. The parent is receiving Social Security Disability Insurance (SSDI). This is NOT SSI

or

2. The parent is receiving Retirement benefits from the Social Security Administration

or

3. The parent is deceased and was fully insured at the time of their death. This means the parent had a work history and paid enough into the Social Security system through payroll taxes (FICA taxes).

If both parents start collecting retirement at the same time, the “child” should collect from the parent who had higher earnings. The child cannot collect off both parents. Social Security will screen for this to ensure the child is getting the highest benefit they’re entitled to. If the parent who had lower earnings starts collecting retirement first, the child can transition to the other parent’s record when they start collecting their retirement benefit.

In order to be eligible for Social Security Disability Insurance (SSDI) or Disabled Adult Child Benefits (DAC), one must be unable to engage in SGA. In plain terms, SGA is the income limit for someone who is working and collecting benefits or applying for benefits. SGA is the value of someone’s earnings after work incentives have been deducted. Each year, the value of SGA changes based on the national average wage index. SGA also refers to the type of work being done and what physical or mental effort is required to perform at such a level for pay or profit.

• Call your local field office and make an appointment, either face-to-face or over the phone
• Call the national SSA office and make an appointment at your local office by calling 1-800-772-1213
• Submit an application online by going to ssa.gov
• People who are deaf or hard of hearing can call the toll-free “TTY” number, 1-800-325-0778.

• Have a list of current diagnosis(es)
• Be prepared to elaborate on how the disabling condition prevents you from working
• Have an updated list of medications, what each is prescribed for, and who prescribes them
• A list of medical providers that are seen on a routine basis and why. Know when you first saw this provider, when you last saw this provider, and any future appointments that are scheduled
• Any recent hospitalizations, along with the reason and length of stay

• Applications generally take 90-120 days for a medical decision to be made
• Medical decisions are not made at the local field offices. They are sent to the corresponding Disability Determination Services Office (DDS).
• Some people may be required to have an Independent Medical Assessment (IMA) in order to be evaluated. IMA contracts with SSA and assesses people’s ability to work and whether they meet the medical criteria for disability benefits.
• If you are still working at the time of application, your earnings must be below Substantial Gainful Activity (SGA) in order to be considered disabled. The value of SGA changes every year. Look up that year’s SGA limit before applying by referring to the SSA Fact Sheet.

After SSA determines the established onset date (EOD), cash benefits begin after a 5-month waiting period (the waiting period is waived for people with ALS). The established onset date (EOD) is when Social Security recognizes the disabling condition officially began, which prevents someone from working substantially. This date may differ from what someone put on their application as the alleged onset date (AOD). Social Security reviews medical evidence, work history, and amount of earnings when determining the EOD. The onset date is very important because with SSDI, there is the potential for retroactive pay, up to 12 months before the application date, depending on when someone became unable to work. The onset date also determines when someone becomes automatically eligible for Medicare.

Benefit amounts are based on their own earnings or a parent’s earnings for DAC. Therefore, everyone collects a different amount. For DAC beneficiaries, their benefit does not negatively impact their parent’s retirement/disability benefit. It’s in addition to what their parent is eligible for. The amount of the DAC benefit is the same regardless of when their parent decides to take their retirement. For example, if a parent wants to retire early at age 62, the DAC benefit is the same as it would be if they waited until age 70. The DAC benefit increases after the parent passes away.

Title II benefits are all subject to the Cost of Living Adjustment (COLA) each year, which usually results in an increase.

Unlike SSI, someone’s living arrangement and resources have no impact on the benefit amount. Social Security does not impose a resource limit, but Medicaid does. Therefore, someone on OPWDD must adhere to the Medicaid resource limit. Certain income can also impact your SSDI/DAC amount, such as worker’s compensation or wages. However, if someone is enrolled in DAC budgeting with Medicaid in order to avoid paying a spenddown, they must keep their resources below $2,000.

In some cases, Social Security may assign a representative payee if the disabling condition impacts someone’s ability to manage their funds or the beneficiary is a minor. This can be a relative, trusted friend, or agency. Social Security will not allow someone to be the payee if they’ve ever been convicted of a barred crime. Examples of barred crimes are robbery, fraud, theft, forgery, or abuse/neglect. If someone has a representative payee but feels they can manage their own money, they will need to consult with their physician and notify Social Security. If someone needs to change payees, they should also consult with Social Security so the prospective payee can make an appointment to apply.

Direct Deposit: Funds are deposited into a bank account each month

Direct Express Card: Funds are loaded onto a prepaid debit card without needing a bank account

Representative Payee Account: Specific bank account that is in the payee’s name for the beneficiary. Allows the payee to control the funds in the best interest of the beneficiary. A letter from Social Security confirming the payee has been selected is required for the bank to open this type of account

Paper Check: If there’s no other option available, SSA will mail paper checks as a last resort

Can someone receive both SSI and SSDI or SSI and DAC?  It depends on the amount of the SSDI/DAC benefit, and whether they’re eligible for SSI from an income and resource standpoint. Sometimes, the amount of the SSDI/DAC is too high to allow someone to be eligibile for SSI. Other times, someone may be insured for SSDI, but their benefit amount is low. This could be because they did not have a significant work history due to their age. In these situations, SSI can supplement to get the total benefit amount up to the federal benefit rate, plus $20, assuming they meet all the eligibility requirements for SSI, such as keeping resources below $2,000.

For example, the federal benefit rate for SSI in 2025 is $967. After disregarding $20, the maximum allowable benefit amount for someone receiving concurrent benefits is a combined value of $987. Therefore, if someone’s SSDI/DAC benefit is more than $987, they will not be eligible for SSI to supplement.

Someone may qualify for Medicare prior to age 65 based on their SSDI/DAC disability benefit. Once someone’s onset date has been established, they become automatically eligible for Medicare after a 24-month waiting period. For someone on OPWDD who already has Medicaid, becoming eligible for Medicare does not end their Medicaid. Medicare then becomes the primary insurance and Medicaid secondary, which has no impact on their services. People do have the option to refuse Medicare coverage, but they should know that a penalty fee may apply if/when they need the coverage later in life. The penalty fee is 10% of the premium for each year they declined coverage. This is not a one-time fee. It becomes their new premium amount, which can be costly. If someone wishes to refuse Medicare coverage, they need to speak to their local Social Security office.

• SSI is paid on the 1^st of the month.
• If someone receives both SSI and SSDI (concurrent benefits), SSI is received on the 1^st and SSDI on the 3^rd. These are two different deposits.
• If someone began receiving SSDI before May 1997, they receive their SSDI check on the 3^rd
• SSDI on your own work record is based on your birthday.
• DAC based off a parent will be paid out according to the parent’s birthday:
• 1^st-10^th is paid on the 2^nd Wednesday
• 11^th-20^th is paid on the 3^rd Wednesday
• 21^st-31^st is paid on the 4^th Wednesday