How to Apply for Social Security Disability Benefits (SSDI) — In Plain Words

What this page is about

The Social Security Administration, called SSA on this page, pays disability benefits through two programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).

The publication this page is based on is about the SSDI program.

This page stays on applying for SSDI and on the decision process.

A separate plain-words page from the same maker, “SSI vs SSDI: What Is the Difference?”, covers the difference between the two programs.

SSA’s strict definition of disability

SSA pays disability 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 a partial or short-term disability, SSA does not.

SSA pays no partial disability.

SSA pays no short-term disability.

Certain family members of workers with disabilities can also receive benefits from SSA.

This page explains that in the “Can my family get benefits?” section below.

The two earnings tests

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 developed a disability.
• 2. A duration of work test, to show that you worked long enough under Social Security.

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

You earn Social Security credits (formerly called quarters of coverage) when you work in a job and pay Social Security taxes.

SSA bases your credits on the amount of your earnings.

SSA cannot pay benefits if you don’t have enough credits.

Each year the amount of earnings needed for credits goes up slightly as average earnings increase.

For more information about credits and how many you need to get benefits, SSA names this publication: How You Earn Credits (Publication No. 05-10072).

That publication is named here in plain text, as SSA names it.

The recent work test, as SSA states it

SSA bases the rules in this part on the calendar quarter in which you turned or will turn a certain age.

The calendar quarters are:

• 1st Quarter: January 1 through March 31
• 2nd Quarter: April 1 through June 30
• 3rd Quarter: July 1 through September 30
• 4th Quarter: October 1 through December 31

If you develop a disability in or before the quarter you turn age 24, then you generally need:

• 1.5 years of work during the 3-year period ending with the quarter you developed a disability.

If you develop a disability in the quarter after you turn age 24 but before the quarter you turn age 31, then you generally need:

• Work during half the time for the period beginning with the quarter after you turned 21 and ending with the quarter you developed a disability.

SSA’s example: If you developed a disability in the quarter you turned age 27, then you would need 3 years of work out of the 6-year period ending with the quarter you developed a disability.

If you develop a disability in the quarter you turn age 31 or later, then you generally need:

• Work for 5 years out of the 10-year period ending with the quarter you developed a disability.

The duration of work test, as SSA states it

SSA gives this formula for how many credits you need to meet the duration of work test:

In general, you take the year you developed a disability and subtract the year you reached age 22 to get the number of credits necessary to meet the duration requirement.

NOTE, as SSA prints it: You must have a minimum of six credits to meet the duration requirement.

This minimum requirement also applies to those who have not yet reached age 22 and may apply for disability based on their own earnings.

SSA also prints this note about the list below: This table is an estimate only and does not cover all situations.

The list below is SSA’s list, printed as the publication gives it. It shows how many years of work are generally needed, by the age when a disability develops:

• Before age 28 — 1.5 years of work
• Age 30 — 2 years
• Age 34 — 3 years
• Age 38 — 4 years
• Age 42 — 5 years
• Age 44 — 5.5 years
• Age 46 — 6 years
• Age 48 — 6.5 years
• Age 50 — 7 years
• Age 52 — 7.5 years
• Age 54 — 8 years
• Age 56 — 8.5 years
• Age 58 — 9 years
• Age 60 — 9.5 years

How to apply for disability benefits

There are two ways you can apply for disability benefits.

You can:

• 1. Apply online at www.ssa.gov/disability.
• 2. Call SSA’s toll-free number, 1-800-772-1213, Monday through Friday, 8 a.m. – 7 p.m., to make a telephone or in-person appointment to apply. The appointment lasts about one hour. If you’re deaf or hard of hearing, you may call SSA’s toll-free TTY number, 1-800-325-0778.

After you schedule an appointment, SSA will send you a Disability Starter Kit to help you prepare.

The Disability Starter Kit is available online at www.ssa.gov/disability/disability_starter_kits.htm.

Those web addresses are printed here as plain text, not links.

You have the right to representation by an attorney or other qualified person of your choice when you do business with SSA.

For more information, SSA names this publication: Your Right to Representation (Publication No. 05-10075).

When should you apply, and what information do you need?

You should apply for disability benefits as soon as you develop a disability that prevents you from working.

Processing an application for disability benefits takes on average, six to eight months.

SSA may be able to process your application faster if you provide information SSA needs, such as:

• Names, addresses, and phone numbers of the doctors, therapists, hospitals, clinics, and caseworkers who took care of you, and dates of your visits
• Names and dosages of all the medicines you take
• Medical records that you already have in your possession
• Laboratory and test results
• A summary of where you worked and the kind of work you did
• A copy of your most recent W-2 Form (Wage and Tax Statement) or, if you’re self-employed, your federal tax return for the previous year

Don’t delay applying for benefits if you can’t get all this information together quickly.

SSA says: We’ll help you get it.

Two other forms, as SSA names them

In addition to the application for disability benefits, you’ll also need to fill out other forms.

The SSA-3368 collects information about your medical condition and how it affects your ability to work.

The SSA-827 gives doctors, hospitals, and other health care professionals who have treated you, permission to send SSA information about your medical condition.

Who decides if you have a qualifying disability?

SSA will review your application to make sure you meet basic requirements for disability benefits.

SSA will check whether you worked enough years to be eligible.

Also, SSA will evaluate any current work activities.

If you meet these requirements, SSA will send your case to the Disability Determination Service (DDS) in your state.

This state agency makes the initial disability determination and considers all the facts in your case.

Doctors and disability specialists will ask your medical providers for information about your medical condition or conditions.

They’ll ask about:

• When your condition or conditions began
• How your condition or conditions limit your activities
• Results of medical tests
• What treatment you’ve received

The state agency will 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 meet SSA’s definition of disability.

The state agency staff may need more medical information before they can decide if you have a disability.

If your medical sources can’t provide needed information, the state agency may ask you to go for a special examination.

SSA prefers to ask your own doctor, but sometimes the exam may have to be done by someone else.

SSA will pay for the exam and some related travel costs.

How is the decision made? The five steps

The state uses a five step evaluation process to decide if you have a qualifying disability.

1. Are you working? If you’re working and your earnings average more than a certain amount each month, you generally won’t meet SSA’s definition of disability. The amount (referred to as “substantial gainful activity”) changes each year. For the current figure, read SSA’s annual Update (Publication No. 05-10003). This page does not print that amount. If you’re not working, or your monthly earnings are less than the “substantial gainful activity” level, the state agency proceeds to step 2.
2. Is your medical condition “severe”? For you to be considered to have a disability based on SSA’s definition, your medical condition must significantly limit your ability to do basic work activities — such as walking, sitting, lifting, standing, carrying, and remembering instructions — for at least 12 months. If your medical condition isn’t severe, you won’t be considered to have a qualifying disability. If your condition is severe, the state agency proceeds to step 3.
3. Does your medical condition meet or medically equal a listing? SSA’s listing of impairments describes medical conditions that SSA considers severe enough to prevent a person from doing any gainful activity. These conditions are deemed severe regardless of age, education, or work experience. Within each listing, experts specify the objective medical and other findings needed to satisfy the criteria of that listing. If your medical condition meets or medically equals (meaning it is at least equal in severity and duration to) the criteria of a listing, the state agency will decide that you have a qualifying disability. If your medical condition doesn’t meet or medically equal a listing, the state agency proceeds to step 4.
4. Can you do the work you did before? At this step, the state agency decides if your medical condition or conditions prevent you from performing any of your past work. If your condition doesn’t prevent you from doing the work you did before, agency staff will decide you don’t have a qualifying disability. If you cannot perform your previous work, the state agency proceeds to step 5.
5. Can you do any other type of work? If you can’t do the work you did in the past five years, agency staff determine if there’s other work you can adjust to despite your medical condition or conditions. The state considers your age, education, past work experience, and any skills you may have that could be used to adjust to other work. If you can’t do other work, the state agency decides that you have a qualifying disability. If you can adjust to other work, you don’t have a qualifying disability.

Special rules for people who are blind

SSA has special rules for people who are blind.

As printed above, certain workers who are blind have to meet only the duration of work test.

For more information, SSA names this publication: If You Are Blind or Have Low Vision— How We Can Help (Publication No. 05-10052).

SSA also states how it will contact you.

Generally, SSA mails a letter or calls you.

If you’re blind or have low vision, you can choose how you prefer to receive notices from SSA.

SSA offers several options.

For more information, SSA gives this plain-text web address: www.ssa.gov/people/blind/

SSA also gives this plain-text phone number for that information: 1-800-772-1213.

If you’re deaf or hard of hearing, you may call SSA’s TTY number at 1-800-325-0778.

SSA will tell you the decision

When the state agency makes a determination on your case, SSA will send a letter to you explaining the decision.

What if you disagree?

If you disagree with a decision made on your claim, you can appeal it.

The steps you can take are explained in this publication, as SSA names it: Your Right to Question the Decision Made on Your Claim (Publication No. 05-10058).

What happens when your claim is approved?

SSA will send a letter 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.

Generally, there is a five month waiting period, and SSA will pay your first benefit the sixth full month after the date SSA finds your disability began.

Here is SSA’s example: If the state agency decides your disability began on January 15, your first disability benefit will be paid for the month of July.

SSA pays benefits in the month following the month for which they are due, so you’ll receive your July payment in August.

NOTE, as SSA prints it: There is no five month waiting period if your disability results from amyotrophic lateral sclerosis (ALS), better known as Lou Gehrig’s disease.

The second Social Security page named in the Sources box states the same waiting-period point this way: SSDI benefits have a five month waiting period, which means that benefit payments will not begin before the sixth full month of disability. The SSDI waiting period begins the first full month after the date SSA decides your disability began. There is no waiting period if your disability results from amyotrophic lateral sclerosis (ALS) and you are approved for SSDI benefits on or after July 23, 2020.

SSA will send you What You Need to Know When You Get Disability Benefits (Publication No. 05-10153).

It provides 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 be eligible for benefits based on your work.

They include:

• Your spouse age 62 or older
• Your spouse at any age if they are caring for your child who is younger than age 16 or who has a disability
• 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 high school).
• Your unmarried child, age 18 or older, if they have a disability that started before age 22. The child’s condition or conditions must also meet the definition of disability for adults.

NOTE, as SSA prints it: In some situations, a divorced spouse may be eligible for benefits based on your earnings. They must have been married to you for at least 10 years, be currently unmarried, and be 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.

When do you get Medicare?

You’ll get Medicare coverage automatically after you’ve received disability benefits for two years.

There is no waiting period for disability beneficiaries with ALS (Lou Gehrig’s disease) and End Stage Renal Disease (ESRD).

You can find more information in Medicare (Publication No. 05-10043), as SSA names it.

What do you need to know about working?

After you start receiving SSDI benefits, you may want to try working again.

SSA has special rules called work incentives that allow you to test your ability to work and still receive monthly disability benefits.

You can also get help with education, rehabilitation, and training you may need to work.

If you start a job or become self-employed, tell SSA right away.

SSA needs to know when you start or stop work and when there are any changes in your job duties, hours of work, or rate of pay.

For more information about working while receiving disability, SSA names these publications: Working While Disabled—How We Can Help (Publication No. 05-10095) and the Red Book (Publication No. 64-030), a guide to all SSA’s employment supports for people with disabilities.

The Ticket to Work program

Under the Ticket to Work, you can get help with training and other services you need to work at no cost to you.

You can select an approved provider who agrees to work with you and can offer the services you need.

To learn more about this program, SSA gives this plain-text web address: www.ssa.gov/work

SSA also names this publication: Your Ticket to Work (Publication No. 05-10061).

This page is general information only. It is not legal advice and it is not medical advice.