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The Social Security Disability Insurance (SSDI) program pays benefits to people who have a work history and become disabled. In some cases SSDI pays benefits to certain family members of a disabled person who has a work history. To qualify for SSDI, you must meet the Social Security Administration’s (SSA) definition of being disabled and the work history test. There is another SSA disability program that does not look at work history. That program is called Supplemental Security Income (SSI). To learn, read An Overview of Supplemental Security Income (SSI).
There are special rules for deciding if a person who is blind or has low vision can get SSDI. To learn more, read If You’re Blind or Have Low Vision on the SSA website.
How the SSA Decides If You Are Disabled
The SSA works with Disability Determination Services (DDS) offices in Michigan when reviewing disability claims. DDS has doctors and disability specialists working for it. When you file a disability claim, DDS employees contact the medical professionals treating you. They ask about your condition and your ability to work. The SSA and DDS use the information they get to decide if you are disabled.
There is a five-step process to decide if you are disabled. DDS will go through all five steps. The first step looks at whether you are working. If you are, DDS looks at how much you earn each month. DDS does not consider your condition in this first step. If you earn above a certain amount, DDS will not consider you eligible for SSDI. That amount is called “substantial gainful activity” and it changes each year. To learn more, read Substantial Gainful Activity on the SSA website. If you are not working, or if you earn less than that amount, DDS moves on to the next step and looks at your medical condition.
The second step looks at how severe your condition is. To get SSDI, your condition must significantly limit your ability to work. Some examples are having problems lifting, standing, sitting, walking, or remembering. Your condition must be expected to last at least 12 months. If DDS decides your condition is severe, it will move to the next step and decide if your condition meets an SSA medical impairment listing.
The third step is to match your condition with an SSA impairments listing. These listings describe medical conditions the SSA considers severe enough to prevent you from doing any type of work. Each listing has information about the findings needed to meet the requirements of that condition. There is also information about how a condition can be medically equal to a listing. Being medically equal to a listing means a condition is just as severe and will last as long as the one in the listing. If DDS finds your condition meets or is medically equal to a listing, it will decide you are disabled. Then it will move to the next step.
The fourth step has DDS look at whether you can do work you have done in the past. If your condition prevents you from doing past work, then DDS will move to the next step.
For the last step, DDS looks at whether you can do any work with your condition. DDS will consider your age, experience, and education when deciding if there is any work you can do. If there isn’t any other work you can do, DDS will find you are disabled.
The Work History Tests
In general, to be eligible for SSDI, you must pass two different work history tests. The first is a recent work history test based on your age and when you became disabled. The second test looks at your total work history to see whether you have worked long enough to get SSDI. These tests look at different things. It is possible for your work history to pass one but not the other. However, your work history must pass both tests to qualify for SSDI.
The SSA uses calendar quarters for both work history tests. The calendar quarters are:
- First Quarter: January 1 through March 31
- Second Quarter: April 1 through June 30
- Third Quarter: July 1 through September 30
- Fourth Quarter: October 1 through December 31
The Recent Work History
The SSA will look at your recent work history to decide if you can get SSDI. The age when you became disabled determines the term of work history the SSA will look at. If you became disabled in or before the quarter you turned 24, you need at least one-and-one-half years (or six calendar quarters) of work history during the three-year period ending with the quarter you became disabled. For example, if you became disabled in the quarter you turned 23, you must have worked at least one-and-one-half years between when you were 20 and when you became disabled.
If you became disabled in the quarter after you turned 24 but before the quarter you turned 31, you need to have worked at least half the time from the quarter after you turned 21 and the quarter you became disabled. For example, if you became disabled in the quarter you turned 27, you need at least three years of work. That is because three years is half the amount of time between when you turned 21 and 27.
If you became disabled in or after the quarter you turned 31, you need to have worked at least five years out of the 10-year period ending in the quarter you became disabled. For example, if you became disabled in the quarter you turned 35, you need to have worked at least five years from when you were 25.
The Total Work History
The second work history test looks at the age you became disabled and your total work history. If you became disabled before you turned 28, you need at least one-and-one-half years (or six calendar quarters) of work history to get SSDI. This is the lowest amount of work history you must have to get SSDI. If you are 28 or older, your required total work history goes up gradually. The maximum amount of work history you could be required to have is nine-and-one-half years. You’re required to have that amount when you turn 60.
To learn more, read the section “How do I meet the earnings requirement for disability benefits?” of the Disability Benefits page on the SSA website.
Applying for SSDI
You can apply for disability benefits online or call the toll-free number, 1-800-772-1213 (TTY 1-800-325-0778). You can also choose to visit your local Social Security office to apply in person. If you decide to apply in person, it is best to call ahead to make an appointment to reduce your wait time. The disability claims interview lasts about one hour.
Documents You Will Need
Before applying, you will need to gather information. Below is a list of some of the most important things you will need:
- A Social Security card or record of your Social Security number
- A birth certificate or proof of your age
- Names, addresses, and phone numbers of your doctors, therapists, caseworkers, hospitals, and clinics that took care of you, and dates of your visits
- Names and dosage of all the medicine you take
- Any of your 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 federal tax returns for the past year
You should apply for SSDI as soon as you become disabled. It takes the SSA about three to five months to review and make a decision on your application. However, the process could take longer if you delay in responding to information and document requests.
To learn more about the application process and to get some helpful information, visit the Disability Starter Kits and What You Should Know Before You Apply for Social Security Benefits on the SSA website.
Getting Your Benefits
Once your benefits are approved, the SSA will send you a letter telling you when your payments will start and how much you will get each month. Your monthly benefit amount is based on your average lifetime earnings. That amount could change due to changes in your income, resources, or living arrangements, or to keep up with increases in the cost of living.
The first payment you get will be for the sixth full month after the date DDS decides your disability began. Benefits are paid the month after they are due. For example, if DDS decides your disability began in January 15, your first payment will be due in July. This means you will get it in August.
You will get your payments either by direct deposit into your bank account or Direct Express® Debit MasterCard® account. To learn more, read “Get Your Payments Electronically” on the SSA website.
Returning Wrong Payments
Mistakes happen. If you get more money than you are supposed to, you must return it. You can call or visit a local SSA office for instructions on how to do this.
If you can't afford to repay all the money you owe at once, you can ask the SSA to lower the repayment rate using the Social Security Change in Repayment Rate tool.
Getting Medicare
If you are younger than 63, after you get disability benefits for 24 months, you’ll be eligible for Medicare. If you turn 65 during the 24 month period, you will be eligible for Medicare then. You will get information about Medicare several months before your coverage starts. If you get Medicare and have low income, the state of Michigan may cover some of your medical premiums and out-of-pocket expenses. To learn more, read An Overview of Medicare and Medicare Savings Programs.
Your Family May Qualify for Benefits Based on Your Work
Certain family members may qualify for benefits based on your work. These family members can include:
- Your spouse if they are 62 or older
- Your spouse at any age if they care for your child who is younger than 16 or is disabled
- Your unmarried child, and in some cases stepchild or grandchild, who is younger than 18 or younger than 19 and still in high school
- Your unmarried child who is 18 or older who has a disability that started before they turned 22, and that disability meets the definition of disability for adults
Under certain circumstances, a divorced spouse of yours may be eligible for benefits based on your earnings if they were married to you for at least 10 years. Your ex-spouse must not be married, and be at least 62 to be eligible. Their benefits will not reduce your benefits or any benefits due to your children or current spouse.
Reporting Changes That Might Affect Your Eligibility
If something happens that could affect your eligibility, contact the SSA as soon as possible. If you do not, it could result in you being overpaid since your benefits haven’t been adjusted based on the change. If you are overpaid, you will have to repay the overpayment amount.
Some examples of things you must report are:
- Change of address
- Change of living arrangements
- Change in income and employment status
- Change in other benefits you get
- Change in resources
- Change in citizenship, like renouncing your citizenship
- Change in marital status
To learn more about your reporting responsibilities, read the section “What you must report to us” in What You Need to Know When You Get Social Security Disability Benefits on the SSA website. If you need to tell the SSA about a change, you can use the tool Report Changes to Social Security.
Appealing a Decision about Your Benefits
You can appeal most decisions the SSA makes about your benefits. This includes initial benefit denials and changes to your existing benefits. When you appeal an SSA decision, the SSA will review all of the information you sent it and all parts of your case.
To learn more about the appeals process, read The Appeals Process for Social Security Programs.
Paying Taxes on Your Benefits
Some people have to pay taxes on their Social Security benefits when they have other, substantial income. This other income can come from wages from a job (including self-employment), interest, dividends, and other sources. To learn more about this, read “Income Taxes and Your Social Security Benefit” on the SSA website.
Getting Other Public Benefits
If you get SSDI, you may also qualify for Michigan’s Food Assistance Program (FAP, or Food Stamps). To learn more about Food Stamps, visit Food Stamps (FAP).