Social Security Disability Insurance: Benefits & How to Apply

Social Security Disability Insurance (DI) pays monthly benefits to workers who are no longer able to work due to a significant illness or impairment that is expected to last at least a year or to result in death within a year. It is part of the Social Security program that also pays retirement benefits to the vast majority of older Americans.

Benefits are based on the disabled worker’s past earnings and are paid to them and their dependent family members.

To be eligible, a disabled worker must have worked jobs covered by Social Security.

The Social Security and Supplemental Security Income disability programs are the largest of several Federal programs that assist people with disabilities. While these two programs are different in many ways, both are administered by the Social Security Administration and only individuals who have a disability and meet medical criteria may qualify for benefits under either program.

Social Security Disability Insurance pays benefits to you and certain members of your family if you are “insured,” meaning that you worked long enough and paid Social Security taxes.

Supplemental Security Income pays benefits based on financial need.

Workers and employers pay for the DI program with part of their Social Security taxes. Workers and employers each pay a Social Security tax that is 6.2% of workers’ earnings up to a cap of $127,200 in 2017. The cap is adjusted each year to keep pace with average wages. Of the 6.2%, 5.015% goes to pay for Social Security retirement and survivor benefits and 1.185 percent pays for disability insurance.

The combined tax paid by workers and employers for disability insurance is 2.37% of wages, while the combined tax for retirement and survivor benefits is 10.03%, for a total of 12.4%.

Workers earn SSDI benefits through work

Social Security disability insurance protects over 159 million workers. To become eligible for benefits, beneficiaries must meet stringent criteria:

Insured status. Beneficiaries must be both “fully insured,” meaning they have worked for at least one-fourth of their adult lives, and “disability insured,” meaning they have worked in at least five of the last ten years.
Severe impairment. Beneficiaries must suffer from a severe, medically determinable physical or mental impairment that has lasted for five months and is expected to last at least 12 months or result in death.
Inability to perform substantial work. Beneficiaries’ physical or mental impairments must render them unable to do their own past work and unable — considering age, education, and work experience — to do any other kind of substantial work. “Substantial work,” in 2023, means earnings of $1,470 a month ($2,460 for people who are blind), which is about 40% of the median earnings of a full-time worker with a high school diploma but no college.

The large majority of SSDI beneficiaries have extensive work histories; the average beneficiary had 22 years of work experience and earned middle-class wages before becoming disabled. A typical SSDI beneficiary is in late middle age — about 79% are 50 or older, and 44% are 60 or older — and suffers from a severe mental, musculoskeletal, or other debilitating impairment.

Beneficiaries’ labor market prospects are very poor, and their death rates are at least three times as high as the general population’s.

A lifeline for workers facing hardship

Social Security disability insurance beneficiaries receive modest cash benefits, based on their average earnings over their career, after a five-month waiting period. The benefit formula is progressive: higher earners receive a benefit that is larger in dollar terms but represents a smaller fraction of their prior earnings. After 24 months of receiving benefits, SSDI beneficiaries also become eligible for Medicare.

The average monthly SSDI benefit for disabled workers in January 2023 was $1,483 (or roughly $17,800 annually). Benefits replace about half of the disabled workers’ final earnings prior to disability, on average. In a minority of cases, other family members may also be eligible for benefits — most commonly, the minor children of the worker.

SSDI provides a lifeline for workers experiencing great hardship. Without it, nearly half of disabled workers would be experiencing poverty. Even with disability benefits, about 1 in 5 disabled workers are below the poverty line, and many are near the poverty line.

You should apply as soon as you become disabled.

Social Security Disability Insurance 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 we decide 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.

Supplemental Security Income (SSI) disability benefits pay for the first full month after the date you filed your claim, or, if later, the date you become eligible for SSI.

What you need to apply for disability benefits

Processing an application for disability benefits can take on average three to six months. To apply for disability benefits, you’ll need to complete an application for Social Security benefits. You can apply online at www.ssa.gov/applyfordisability.

Your application may process faster if you supply the following information:

Your Social Security number.
Your date and place of birth.
Names, addresses, and phone numbers of the doctors,
caseworkers, hospitals, and clinics that took care of you, and the dates of your visits.
Names and dosages of all the medicines you take.
Medical records from your doctors, therapists, hospitals, clinics, and caseworkers 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 returns for the past year.

In addition to the application for disability benefits, you’ll also need to fill out other forms. One form collects information about your medical condition and how it affects your ability to work. Other forms give doctors, hospitals, and other healthcare professionals who have treated you, permission to send information about your medical condition.

How to apply

You can apply for Disability benefits online, or if you are unable to complete the application online, you can apply by calling the toll-free number, 1-800-772-1213, between 8:00 a.m. and 7:00 p.m. Representatives can make an appointment for you to apply.

People who are deaf or hard of hearing may call the toll-free “TTY” number, 1-800-325-0778, between 8:00 a.m. and 7:00 p.m. on Monday through Friday.

The Disability Starter Kit will help you get ready for your disability interview or online application. Kits are available for adults and for children under age 18. The starter kits provide information about the specific documents and the information that we will request from you. They also provide general information about the disability programs and our decision-making process.

Who decides if I have a qualifying disability?

The Social Security Agency will review your application to make sure you meet some
basic requirements for disability benefits. They will also check whether you worked enough years to qualify and evaluate any current work activities.

If you meet these requirements, they will process your application and forward your case to the Disability Determination Services office in your state. This state agency completes the initial disability determination decision for us and considers all of the facts in your case.

Doctors and disability specialists in the state agency may ask your doctors for information about your condition(s). They’ll use the medical evidence from your doctors, hospitals, clinics, or institutions where you’ve been treated, and all other information. They’ll ask your doctors about:

Your medical condition(s).
When your medical condition(s) began.
How your medical condition(s) limit your activities.
Medical test results.
What treatment you’ve received.

The 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 the 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 the needed information, the state agency may ask you to go for a special examination. The SSA prefers to ask your own doctor, but sometimes the exam may have to be done by someone else. The agency will pay for the exam and for some of the related travel costs.

How is the decision made?

The state uses a five-step evaluation process, in a set order, to decide if you have a qualifying disability.

Are you working?
If you’re working and your earnings average more than a certain amount each month, you generally won’t meet the definition of disability. The amount (referred to as “substantial gainful activity”) changes each year. If you’re not working, or your monthly earnings average to the current amount or less, the state agency then looks at your medical condition at step two.

Is your medical condition “severe”?
For you to be considered to have a disability by Social Security’s definition, your medical condition must significantly limit your ability to do basic work activities — such as lifting, standing, walking, sitting, and remembering — 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 agency staff begins step three.

Does your medical condition meet or medically equal a listing?
The SSA’s listing of impairments describes medical conditions that they consider 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 the criteria of a listing, the state agency goes on to step four.

Can you do the work you did before?
At this step, the state agency decides if your medical condition(s) prevents you from performing any of your past work. If it doesn’t, agency staff decide you don’t have a qualifying disability. If it does, the state agency proceeds to step five.

Can you do any other type of work?
If you can’t do the work you did in the past, agency staff look to see if there’s other work you can do despite your medical condition(s). The state considers your age, education, past work experience, and any skills you may have that could be used to do other work. If you can’t do other work, the state agency decides that you have a qualifying disability. If you can do other work, you don’t have a qualifying disability.

In 2016, the disability insurance trust fund received $160 billion, mainly from the 1.185% tax on wages that workers and employers both pay. Total payments from the DI trust fund were $146 billion, mainly for benefits to disabled workers and their families, meaning that income exceeded outgo by $14 billion in 2016. The cumulative assets in the disability insurance trust fund totaled $46 billion at the end of 2016.

Administrative expenses were 1.9% of the outgo from the DI fund, and the remaining portion was paid for benefits.