Benefits Counseling

Basic SSI & SSDI Information

The Social Security Administration has two major programs that provide benefits to people who are disabled or blind.

SSDI
Social Security Disability Insurance (SSDI) provides benefits to disabled or blind individuals who are “insured” by making contributions to the Social Security trust fund. These contributions are the Federal Insurance Contributions Act (FICA) Social Security tax paid on their earnings or those of their spouse or parents.

To be eligible for SSDI, the worker must have worked and paid Social Security taxes for enough years to be covered under Social Security insurance. Some of those taxes must have been paid in recent years, and you must:

• Be the worker, the worker's widow/widower or the worker's disabled adult child
• File an application
• Meet Social Security's definition of medically disabled
• Not be working or working but not performing substantial gainful activity (SGA)

SSI
The Supplemental Security Income (SSI) Program makes cash assistance payments to aged, blind and disabled people (including children under age 18) who have limited income and resources. Most states pay benefits to individuals to supplement their federal benefits.

To be eligible for SSI based on a medical condition:

• You must have limited income and resources
• You must be considered medically disabled or blind
• You must be a U.S. citizen or meet the requirements for non-citizens
• You must be a resident of the 50 states, District of Columbia or Northern Mariana Islands
• You must file an application
• You must file for all other benefits for which you are eligible
• If your impairment is other than blindness, when you apply you must not be working or working but not performing SGA. Once you are receiving SSI benefits, this requirement no longer applies. Your eligibility will continue until you medically recover or do not meet a financial requirement.

SSDI & SSI
In both SSDI & SSI, the Social Security Administration (SSA) defines disability as the inability to engage in any SGA because of a medically determinable physical or mental impairment that has lasted or is expected to last at least 12 months or is expected to result in death.

SSA evaluates the work activity of persons claiming or receiving disability benefits under SSDI, and/or claiming benefits because of a disability under SSI. Under both programs, earnings guidelines are used to evaluate work activity to decide whether the work is SGA, and whether you meet the definition of disability under the law. This is the first step in determining whether someone meets SSA's definition of disability.

If your impairment is other than blindness, earnings averaging over $800 a month (for the year 2003) generally demonstrates SGA. If you are blind, earnings averaging over $1,330 a month (for the year 2003) generally demonstrates SGA. These amounts are adjusted each year.

Payment Amounts
SSDI
SSA bases SSDI payment amounts on the worker's lifetime average earnings covered by Social Security. The payment amount is adjusted each year to account for cost-of-living changes. Workers' Compensation payments and/or public disability benefits may reduce the payment amount. Other income or resources do not affect the benefits amount.

SSI
SSA bases SSI payment amounts on the amount of countable income, living arrangement and the state in which you live. The basic monthly payment is called the Federal Benefit Rate (FBR). The FBRs for the year 2003 are $552 per month for an individual and $829 per month for an eligible couple. The FBRs are adjusted each year to account for cost-of-living changes. The state of Wisconsin pays an additional amount called a “state supplement.”

The SSI payment amount is figured by starting with the FBR and then subtracting your countable income. All income is not counted. The income amount left after all allowable deductions is “countable income.”

New Benefits Amount for 2003

Each year the SSA adjusts benefit amounts. For the year 2003, beneficiaries will receive a 1.4 percent Cost-Of-Living Adjustment (COLA).

SSI

State SSI supplement amounts are not adjusted yearly and will not change.

SSDI

Social Security Disability (SSDI) payments will also increase by 1.4 percent in January. When an SSDI beneficiary chooses to go to work, they have an SGA and TWP threshold to consider. These amounts will also increase in January.

Medicare Premium Amounts

Part A: (Hospital Insurance) Premium

• Most people do not pay a monthly Part A premium because they or a spouse have 40 or more quarters of Medicare covered employment.
• $316 per month (Note: This premium is paid only by individuals who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters of Medicare-covered employment).
• The Part A premium is $174 for those individuals having 30-39 quarters of Medicare-covered employment.

Part B: (Medical Insurance) Premium

• $58.70 per month.

For more information please contact your local Social Security office or call Independent Living Resources at (608)787-1111 or toll free at (888)474-5745.