In Depth:  Supplemental Security Income (SSI)

Title XVI: SSI

  • SSI is a needs-based program that pays monthly benefits to disabled people who cannot engage in substantial gainful activity due to a serious illness or impairment that is expected to last at least a year or to result in death.
  • Substantial gainful activity (SGA) involves the performance of significant physical or mental activities, or a combination of both. Work activity performed on a part-time basis may also be considered SGA. Earnings averaging over $1,090/month (for 2015) demonstrate SGA.  A higher SGA is applied for blind workers ($1,820).
  • Benefits are based on financial need, not work history or earned credits.
  • The monthly maximum Federal benefit amount is $733 for an eligible individual and $1,100 for an eligible individual with an eligible spouse.
  • There will be no cost of living adjustment increase in Federal benefits in 2016.
  • SSI recipients will be eligible for their first payment on the first of the month after they apply for disability. Because SSA takes at least a few months to grant disability benefits (sometimes years for those in the appeal process), recipients will likely receive several month’s payments in SSI back payments.
  • In most states, individuals awarded Supplemental Security Income (SSI) become eligible for Medicaid.

Case Highlight

Client was a 47 year old high school graduate with a long-standing history of alcohol abuse.  Client claimed disability as a result of cirrhosis, diabetes, and kidney disease.  SSA denied her claim citing alcohol abuse as a contributing factor to her impairments.  It was our burden to prove that Client would still have these impairments despite abstaining from alcohol use.  Client started a recovery program and was able to demonstrate sobriety.  I worked closely with a ClaimAid Patient Advocate to provide medical records that demonstrated Client’s condition was not improving despite sobriety.  Client was approved benefits and now has the medical coverage she needs for a liver transplant.