An Overview of Supplemental Security Income

Supplemental Security Income (SSI) is a federally funded government program that pays benefits to people who are 65 or older, disabled or blind, and have limited income. Monthly benefits provide a basic minimum level of income for people based on meeting several requirements. This overview will help you to better understand program requirements, the application process, and other critical information that will better help you to gain approval and start receiving benefits.

Make Sure You Apply for the Right Disability Program

SSI is one of two disability programs administered by Social Security. The other is Social Security Disability Income (SSDI) which also provides benefits for people in need. While there are some similarities between the two programs, many times leading to some degree of confusion, there are also many differences as well. It’s important to understand how the two programs are different so that you can make an informed decision about which program is best suited for your situation. 

The main difference between the two programs is that SSI is based strictly on need, while SSDI pays benefits to people who have paid Social Security taxes through payroll deductions during the course of their working life. To be eligible for SSDI, a person must have a long-term disability or medical condition that will last for at least one year or more, or until they die. SSI offers benefits for people who do not qualify for SSDI (which generally pays more), either because they have not worked and paid into the system to meet eligibility requirements, or they are young and new to the workforce and have not acquired enough work credits to qualify for SSDI benefits. 

The other big difference between SSI and SSDI is the length of waiting time an applicant must go through before they can start receiving benefits. SSDI has a five-month waiting period from the time a person becomes disabled until the time they can start receiving benefits. With SSI, the waiting period is much less. Typically, there is no waiting period, and in some circumstances, people in need can start getting benefits in a little as a few days after they qualify for what is known as a Presumptive Disability.

There are a few other differences between the two programs as well. SSDI recipients must wait two years from the month they became disabled to be eligible for Medicare coverage. SSI recipients can get Medicaid coverage as soon as they are approved for benefits. Also, SSDI payments are based on a maximum family amount, meaning that payments may be made to other dependent family members if there is an excess benefit from the claimant’s fund. SSI is less flexible and will only pay benefits to a program recipient. Under no circumstances are benefits paid to any dependent family members. However, while children cannot collect SSI benefits from a parent’s claim, they can file their own SSI application. 

Payments for both programs are adjusted annually by Social Security, but as previously mentioned, SSI payments are generally much less than SSDI payments. In 2023, the maximum SSI payment for an individual is $914 and $1,371 for an individual with an eligible spouse. You can read our article on SSI payments for more info. SSDI payments vary based on lifetime earnings and work credits. For 2023, the maximum amount a person can receive is $3,627.

Your Rights as an Applicant

Social Security Administration guarantees certain rights for all SSI applicants. They are as follows:

You have the right to apply for SSI. Anyone can apply and there is no charge to do so.

You have the right to receive help from the Social Security Administration (SSA). A representative will complete the application form based on information that is provided to them. SSA will also help applicants get the documents that are needed to provide proof that a person meets SSI eligibility requirements. If those documents are not available, then SSA will pay for an applicant to get a medical exam or test. If it is determined that an exam or test is needed, an applicant must go through that procedure before any final eligibility is determined. 

You have the right to a representative to assist you with your claim and to go to your eligibility appointment with SSA. 

You have the right to a notice in writing of any decision regarding your eligibility or a change in your benefit amount. 

You have the right to examine your case file. You can get a copy as well as reviewing the laws and regulations used in deciding your case by going to SSA.gov.

You have the right to appeal a decision made regarding your case. You can appeal most all decisions regarding eligibility or changes made in your benefit amount. 

Eligibility Requirements for an SSI Claim

There are eight million people who receive SSI benefits every year. To qualify, these people have met a series of SSI eligibility requirements. Here’s a closer look at what those requirements are: 

• You must be 65 years or older, or you are blind or disabled. Blindness is defined as having 20/200 vision or worse in your better eye with the use of a correcting lens or having a visual field limitation of no greater than a 20-degree angle in your better eye with the use of a correcting lens.
• Children 18 and younger can also qualify if they meet a separate set of eligibility criteria. Parents of children who are blind or disabled are encouraged to apply on behalf of their children.
• You are a U.S. citizen or a legal resident.
• You meet resource requirements. Your primary residence, cars, life insurance policies under $1,500, burial plots and the first $1,500 of burial funds for you and your spouse are exempt, but otherwise your resource limit is $2,000 for an individual or $3,000 for a couple.
• You meet income limitation requirements. If you’re married or a child, part of your spouse or parent’s income may be considered income when determining if you are eligible or not. Income includes all money received from the following sources:
• Wages – including overtime and bonuses
• Earnings from Self-Employment (net)
• Social Security Benefits
• State Disability Payments
• Unemployment Compensation
• Workers’ Compensation
• Federal, State or Local Help Based on Need
• Temporary Help for Needy Families
• Veterans Benefits
• Military Allowance and Pay
• Military Pension
• Refugee Cash Help
• Bureau of Indian Affairs Income
• Disaster Relief
• Office of Personnel Management Benefits
• Private Pension
• Railroad Retirement Benefits
• Foreign Pension
• Black Lung Benefits
• Civil Service Benefits
• Gifts
• Lease/Rental Income
• Lottery/Gambling Winnings/Prizes
• Insurance or Annuity Payments
• Interest or Dividends
• Alimony
• Child Support
• Royalties
• Settlements and Awards, including Court-Ordered Awards
• Proceeds of a Life Insurance Policy
• Inheritance of Cash or Property
• Strike Pay or Other Union Benefits
• Free food or housing
• If someone helps pay for food, utilities, rent, or mortgage

When calculating your income, Social Security does not include:

• First $20 received per month
• First $65 earned from working and 50% earned from working over $65
• Benefits received from Supplemental Nutrition Assistance Program (SNAP)
• Shelter received from private nonprofits
• Home energy assistance
• If you are disabled or blind and working, wages used for things that help you work, such as wheelchair or special transportation are not counted.

Documents you Will Need to Apply for SSI Benefits

To apply for SSI benefits, you will need several pieces of information:

• Social Security card or number. If you currently don’t have one, a number will be assigned to you when you apply for SSI benefits.
• Birth certificate or any other related document that shows your age or date of birth
• Citizenship status. If you are a citizen, you can use a birth certificate, baptism certificate, a naturalization certificate or a U.S. passport. If you are an alien, you will need a current immigration document such as Permanent Resident Card or an I-94 Arrival/Departure Record. If you served in the U.S. military, you may need a copy of your discharge paper which is form DD-214. 
• Living arrangement information. This will include mortgage or lease and landlord’s contact information, the names, dates of birth and Social Security numbers for all household members. You will also need to provide information about costs for rent, food, utilities and other living expenses.
• Your work history. This will include payroll stubs, a tax return for the past year, bank statements and other information that show how much you receive, the source of your income and how often you receive it. 
• Proof of your resources. This includes bank statements, deeds or tax appraisal statements, life insurance policies, stock and bond certificates, titles or registrations for vehicles, boats, campers, etc.
• Medical information. Medical reports to help substantiate your disability. You will also need the names, addresses and phone numbers of all medical professionals who have treated you, as well as the approximate dates you were treated, and the names of any prescription and non-prescription medications that you are currently taking.

How to Apply for SSI Benefits

Once you have gathered your information, you can apply for SSI benefits several different ways:

You can start the application process online by going to Social Security’s Apply Online for Disability Benefits page. To be able to apply online you must meet certain requirements:

• You are between 18 and 65 years old
• You have never been married
• You are not blind
• You are a U.S. citizen living in one of the 50 states, the District of Columbia or the Northern Mariana Islands
• You haven’t applied for or received SSI benefits in the past
• You are applying for SSDI at the same time as your SSI claim.

You can also file a claim by scheduling an appointment at your local Social Security office. Call 1-800-772-1213 or TDD 1-800-325-0078, Monday through Friday, 7 am to 7 pm.

If you think you meet SSI disability requirements, you should contact Social Security and apply immediately. This will be used as your filing date and will allow you to get benefits as soon as possible.

Five Steps in the SSI Approval Process

For both SSI and SSDI claims, Social Security uses a five-step process to determine if a person’s disability is severe enough to meet the strict standards that will allow them to collect benefits. Depending on your situation, these five steps could take as little as a few weeks or if there are delays or requests for more information or medical tests, the steps could take three to five months. There are exceptions and programs in place that can expedite approval in some cases.

The five steps are: 

1. Your current work status will be reviewed. Claims are only paid for people who are disabled to the point that they cannot work or their ability to work is severely curtailed. Before your medical conditions are even considered, if you are working and earning above the amount allowable to collect benefits, your claim will be rejected. Social Security calls this the Substantial Gainful Activity (SGA) level, and for 2023, that amount is $1,470 per month. If you make less than that amount or you’re not working at all, then Social Security will move to the next step.
2. How severe is your medical disability? To be considered severe and to qualify for benefits, your disability must significantly impact your ability to perform basic work functions such as walking, lifting, standing for long periods of time, or other similar activities over the past 12 months. It is not just the ability to how well you function that matters, it is the effect your impairments have on your ability to actually do work. To be medically evaluated, your case will be turned over to Disability Determination Services (DDS) for review.
3. Is your disability contained in the Blue Book of Impairments? Social Security publishes the Blue Book of Impairments which is an official list of disabilities and conditions that automatically meet the criteria necessary for a person to be considered disabled to the point they can collect benefits. If your impairment is in the Blue Book and you can document your condition with sufficient medical records, your application will move much more quickly through the approval process. 
4. If your disability is not listed in the Blue Book, then DDS must determine if your condition is severe enough to keep you from doing the same kind of work you’ve done in the past. DDS assesses what is known as your “residual functional capacity” which measures how much ability you have to still do the kind of work you’ve done previously despite your disability. If DDS determines that you cannot perform your previous type of work, they will move on to the final step. 
5. Can you do any other type of work? DDS will look at a number of things to see if you can do any other kind of work. They will consider your age, past work experience, education, special skills and other similar criteria to try and reach a conclusion as to whether or not you can make the transition to other kinds of work. If you are not able to do so, then you will move much closer to approval.

How the Blue Book of Impairments Affects Your Claim

After you submit your application, the review process begins. One of the most critical parts of this review is determining whether or not your disability is lists in the Social Security Blue Book of Impairments. If a medical reviewer can match your disability to one of those listed in the Blue Book, your application will move at a much faster pace and your chances for approval are greatly improved. 

The Blue Book lists in great detail all the conditions and disabilities that automatically meet the standards to be considered appropriate to receive SSI benefits. Only the most serious of disabilities and conditions are listed in the Blue Book, many of which are chronic, permanent or fatal. 

It’s important to note that just because you have a condition that is listed in the Blue Book, you do not automatically qualify for SSI benefits. Many people with listed conditions are still rejected for various reasons, some related to the Blue Book, and some for not meeting all the other requirements necessary to receive benefits. 

The Blue Book is divided into Part A and Part B sections. Part A contains all Adult Listings and is broken into the following major categories:

• Musculoskeletal System
• Special Senses and Speech
• Respiratory System
• Cardiovascular System
• Digestive System
• Genitourinary Disorders
• Hematological Disorders
• Skin Disorders
• Endocrine Disorders (including but not limited to)
• Congenital Disorders that Affect Multiple Body Systems
• Neurological
• Mental Disorders
• Cancer
• Immune System Disorders

Part B contains all Childhood Listings. It is broken into the following major categories:

• Low Birth Weight and Failure to Thrive
• Musculoskeletal System
• Special Senses and Speech
• Respiratory System
• Cardiovascular System
• Digestive System
• Genitourinary Disorders
• Hematological Disorders
• Skin Disorders
• Endocrine Disorders
• Congenital Disorders that Affect Multiple Body Systems
• Neurological
• Mental Disorders
• Cancer
• Immune System Disorders

If your condition is not listed in the Blue Book, you may still qualify for what is known as an equal listing. Basically, not every variation of every condition can be listed, and Social Security recognizes that there are also several ways to diagnose the same condition as well. This means that if someone can show that a similar test or condition was used in their diagnosis, Social Security will give it an equal match designation. 

If your condition is not listed in the Blue Book, you may still qualify medically by obtaining a Medical Vocational Allowance. This takes longer because you need to go through all five sequential steps. A claims examiner will review your medical history and your work history to determine if you can still do your old type of work or another type of work based on your current job skills, age, education and other factors. If you’re not able to do this type of work based on those things, you may be approved for SSI benefits based on a Medical Vocational Allowance. You can also gain a Medical Vocational Allowance if it is proven that you are disabled after going through a residual functional capacity assessment.

How to Speed Up the Approval Process

When you are disabled and financially challenged, every day can seem like an eternity. You want and need benefits as quickly as possible, but in many cases you must go through a comprehensive approval process that can take weeks or months. Even then, about 70% of all applicants are initially rejected.

Before you get too discouraged, understand that there are ways to speed up the approval process and in some instances, there are exceptions and programs that could allow you to start receiving benefits in a matter of days, assuming you qualify.

First, if you don’t meet any of the special circumstances, the best way to receive the shortest approval time is to make every effort to submit your application the right way the first time. It can be lots of work, but putting in the effort up front is still the single best way to get benefits flowing to you as quickly as possible. 

For people with the most serious medical conditions, Social Security has several options that allow for a more streamlined approval process. Decisions can be reached in a matter of days and benefits can follow soon thereafter.

If you have a terminal condition, your claim can be considered through the Terminal Illness Program (TERI). Representatives or medical examiners can submit a claim for the TERI program when they are notified by a doctor or family member that the condition is expected to result in a person’s death, or if they are already in hospice care. TERI cases are processed in less than 30 days the vast majority of time. 

Medical conditions that qualify for the TERI program include Stage IV or inoperable cancer; esophageal, liver, pancreatic, brain, small cell or oat cell lung cancers; mesothelioma; chronic heart of pulmonary failure; being in a coma for more than 30 days; AIDS; ALS; newborns with a congenital or fatal genetic defect; and, patients waiting on certain types of transplant lists. 

Social Security can also expedite SSI claims using a Quick Disability Determination (QDD) process. A computer modeling program analyzes an applicant’s files for factors that show a high probability that they will be determined to meet the standard for disability. When a patient’s file is chosen for the QDD process, a medical consultant does not review the files, and a person could be approved for benefits in about three weeks. If after going through the QDD process, a patients claim is denied, they will be put back into the system and will need to complete all normal approval steps.

When an applicant has a medical condition so serious that it obviously qualifies for benefits, they could be approved is as few as 10 days under the Compassionate Allowance Program. Social Security has a Compassionate Allowance List and if a person’s disability is on that list, they will be put on a fast track for approval. The list includes conditions such as certain types of cancer, muscular dystrophy, ALS, Alzheimer’s disease and others. You can view the full list here. To help with this process, an applicant should try to make sure that Social Security has comprehensive medical records to support the claim. 

For SSI benefits, Social Security can make temporary benefits available for some disabilities through the Presumptive Disability (PD) process. Benefits are available for the first six months while SSA reviews and processes a claim. Presumptive disability payments are not available for SSDI claims. For these types of cases, SSA looks at conditions where it is easy to assume a person has a qualifying disability and they are therefore “presumed” to be disabled. This can include conditions such as cerebral palsy, total blindness or deafness, a spinal cord injury, amputation of two or more limbs, severe mental retardation, ALS, or terminal illness with less than six months or less to live. Other similar serious conditions are also considered, as long as reliably sourced medical information is provided.

If the SSA has not made a PD decision within six months, the presumptive disability payments will stop. If the SSA denies the disability claim, you are not responsible for repaying money received because of the presumptive disability.

Waiting Times, Back Pay and State Supplements

For applications that do not qualify for expedited approval, the length for approval is about three to four months on average, although some can take as long as two years. Part of the reason for the varying lengths has to do with how accurate and complete a person’s medical records are, the amount of backlogged cases, and the ability to coordinate with medical examiners internally at Social Security. 

The saving grace in all of this is that if and when you are approved, you will likely receive back payments dating back to the month you first applied. Back pay is usually paid in a single lump sum. Overall, backpay extends to 12 months before you were approved. Typically you will receive backpay within 60 days after your SSI benefits are approved. 

Another possible source of added benefits is from individual states, many of which provide supplemental SSI benefits on top of what Social Security pays. How much extra you may be entitled to depends on your marital status, living situation, age, and other related factors. Typically, state supplements will range from $10 to $200.

Social Security administers state supplemental payments directly in California, Delaware, District of Columbia, Hawaii, Iowa, Michigan, Montana, Nevada, New Jersey, Pennsylvania, Rhode Island, Utah, and Vermont. In these states, you do not need to submit an additional application to receive benefits. All other states administer their own and you’ll need to file a separate application to be considered for added benefits. 

For both state and federal benefits, payment is made once a month through either direct deposit or an electronic debit card. More details on these options are available at GoDirect.gov.

If You Are Approved for SSI benefits, You May Also Receive Medicaid Benefits

In many states, if you are approved for SSI you will also receive Medicaid. Each state sets its own qualifying criteria. In some states, Medicaid coverage is automatic. In other states, you will need to apply and qualify separately. In states where Medicaid eligibility is automatic, there is no waiting period and Medicaid benefits start immediately. In states where Medicaid coverage is not automatic, when you are granted coverage, there is no waiting period either.

States where Medicaid enrollment is automatic include:

Some states use the same eligibility standards as the federal SSI program but want to make their own Medicaid decisions. Known as “SSI criteria states,” you must file a separate application to be enrolled. The SSI criteria states include:

• Alaska
• Idaho
• Kansas
• Nebraska
• Nevada
• Oregon
• Utah

Other states use their own criteria for granting Medicaid. These “209(b) states” may have income limits higher or lower than the federal standard, different asset limits or other requirements that qualify someone as disabled. They include:

• Connecticut
• Hawaii
• Illinois
• Minnesota
• Missouri
• New Hampshire
• North Dakota
• Ohio
• Oklahoma
• Virginia

What to do if Your SSI Claim is Denied

Unfortunately, about 70 percent of all SSI claims are initially rejected, meaning you aren't alone if it happens to you. The good news is that there are several things you can do to appeal a denial. In most circumstances, you shouldn't take a rejection as a final "no." 

If you are rejected, you start by filing a Request for Reconsideration either online or at your local Social Security process. You have 65 days from the date of your initial denial to submit a Reconsideration. When you submit the appropriate forms, the state agency that handles SSI claims will follow the same procedure that was used when you filed your initial application. This will include following the five-step process, looking at your work history, medical records, ability to work and other supporting documents. Reconsiderations are normally decided more quickly than an initial claim because all documentation has already been gathered. Applicants can also submit additional information if they feel it will help bolster their claim. Simply using the same materials as those used in an initial application will probably get you the same result—a denial. 

If your Reconsideration is denied, you can request a hearing in front of an Administrative Law Judge. This will normally take some time to get on the calendar, so be prepared for a delay of possibly several months. The judge will review your files and will treat the hearing like a trial, asking you questions about your case. Medical experts may also be called in to testify as well. You also have the right to be represented by an attorney in a hearing. From a strategic point of view, your best bet is to be honest and open with the judge. They have seen it all and will be able to spot inconsistencies or lies in your testimony. After your hearing, the judge will send a written response either approving or denying your claim.

If you are denied after an Administrative Law Judge hearing, you have one more option which is to file an appeal to the Social Security Appeals Council. The Council will review the judge’s decision and either approve you for benefits, deny your claim or send the case back to the judge for additional review. 

If you need to go through all of these steps, an appeal process can last for as long as two years or more. 

The final level of appeal is to go outside the Social Security system and take your case to Federal court. Very few people take their case this far. Be aware, that doing so can add as much as another year to your appeals process. 

For more information

If you need more information on Supplemental Security Income, the best place to start is by calling Social Security at (800) 772-1213. They will be able to answer basic questions and direct you to resources to better meet your needs. If you’re deaf or hard of hearing, call Social Security’s TTY number at 1-800-325-0778, between 7 a.m. and 7 p.m. on business days. If you prefer, you can also visit the SSA website at www.ssa.gov.