SSA manages two programs that provide benefits based on disability or blindness, the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program.

Social Security Disability Insurance Program

SSDI provides benefits to disabled or blind individuals who are "insured" by workers' contributions to the Social Security trust fund. These contributions are based on your earnings (or those of your spouse or parents) as required by the Federal Insurance Contributions Act (FICA). Title II of the Social Security Act authorizes SSDI benefits.

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Supplemental Security Income Program

The SSI program makes cash assistance payments to aged, blind, and disabled individuals (including children under age 18) who have limited income and resources. The Federal Government funds SSI from general tax revenues. Most states pay a supplemental benefit to individuals in addition to their Federal benefits. Some of these states have made arrangements with us to combine their supplemental payment with our Federal payment into one monthly check to you. Other states manage their own programs and make their payments separately. Title XVI of the Social Security Act authorizes SSI benefits.

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Concurrent Entitlement

We use the term “concurrent” to describe individuals who are eligible for disability benefits under both the SSDI and SSI programs. To show how an individual’s concurrent benefits would be affected by returning to work, we have provided an example of a “concurrent” beneficiary situation in our chapter, EXAMPLE OF CONCURRENT BENEFITS WITH EMPLOYMENT SUPPORTS.

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Comparison of the SSDI and SSI Disability Programs

The SSDI and SSI programs share many concepts and terms, however, there are also many, very important differences in the rules affecting eligibility and benefit payments. The following table summarizes differences between the SSDI and SSI programs. These differences are important as many individuals may apply or be eligible for benefits under both programs.

Comparison of the SSDI and SSI Disability Programs

	SSDI	SSI
Source of payments	Disability trust fund	General tax revenues
Minimum Initial Qualification Requirements	Must meet SSA’s disability criteria Must be “insured” due to contributions made to FICA based on your own payroll earnings, or those of your spouse or your parents	Must meet SSA’s disability criteria Must have limited income and resources
Health Insurance Coverage Provided	Medicare. Consists of hospital insurance (Part A) and supplementary medical insurance (Part B). Voluntary prescription drug benefits (Part D) are also included. Title XVIII of the Social Security Act authorizes Medicare.	Medicaid. Medicaid is a jointly funded, Federal-State health insurance program for low-income and needy individuals. It covers certain children, some or all of the aged, blind, and/or disabled in a State who are eligible to receive Federally assisted income maintenance payments. Title XIX of the Social Security Act authorizes Medicaid. The law gives the States options regarding eligibility under Medicaid.
How do we figure your monthly payment amount?	We base your SSDI monthly payment amount on the worker's lifetime average earnings covered by Social Security. We may reduce the amount if you receive Workers' Compensation payments (including Black Lung payments) and/or public disability benefits, for example, certain State and civil service disability benefits. Other income or resources do not affect the payment amount. The monthly payment amount is adjusted each year to account for cost-of-living changes.	To figure your payment amount, we start with the Federal Benefit Rate (FBR). In 2008, the FBR is $637 for a qualified individual and $956 for a qualified couple. We add your state supplement, if any, to the FBR and then subtract your countable income. We do not count all the income that you have. The income amount left after we make all the allowable deductions is "countable income." The sections on SSI employment supports explain some of the ways that we can exclude income. The FBR is adjusted each year to account for cost-of-living changes.
Is a State Supplemental Payment provided?	There is no State Supplemental payment with the SSDI program.	Most states pay some individuals who receive SSI an additional amount that is called a “state supplement.” The amounts and qualifications for these state supplements vary from state to state.

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How Do We Define Disability?

The inability to engage in any substantial gainful activity (SGA) because of a medically determinable physical or mental impairment(s):

That can be expected to result in death, or

That has lasted or that we can expect to last for a continuous period of not less than 12 months.

Note: There is a separate definition of disability for children (under age 18) who are applying for the SSI program. A disabled child also qualifies for the SSI employment supports described later in this book.

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What is Substantial Gainful Activity (SGA)?

The term “substantial gainful activity” is used to describe a level of work activity and earnings.

Work is “substantial” if it involves doing significant physical or mental activities, or a combination of both. For work activity to be substantial, it does not need to be performed on a full-time basis. Work activity performed on a part-time basis may also be substantial gainful activity.

“Gainful” work activity is:

Work performed for pay or profit; or

Work of a nature generally performed for pay or profit; or

Work intended for profit, whether or not a profit is realized.

If you are receiving SSDI benefits based on disability, SGA is used as a factor to decide if your disability continues after you return to work and complete your trial work period (TWP). If you are receiving SSI benefits based on disability, SGA is only used as a factor to determine initial eligibility for SSI benefits. Once you are receiving SSI benefits, different standards are applied. For details on how we calculate SSI benefits, see our chapter, GUIDE TO EMPLOYMENT SUPPORTS.

SGA does not apply to individuals who are blind in the SSI program. Your eligibility continues until you medically recover or your eligibility stops because of a non-disability related reason.

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How do we evaluate your work activity for SGA purposes?

We generally use earnings guidelines to evaluate whether your work activity is SGA, and whether we may consider you disabled under the law.

The amount of monthly earnings considered as SGA depends on the nature of a person’s disability. The Social Security Act specifies a higher SGA amount for statutorily blind individuals. If your impairment is anything other than blindness, earnings averaging over $940 a month (for the year 2008) generally demonstrate SGA. If you are blind, earnings averaging over $1570 a month (for the year 2008) generally demonstrate SGA.

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What if you are Self-Employed?

If you are self-employed and your disability is not blindness, the way we evaluate your work activity for SGA purposes will depend on whether the work activity being evaluated occurs before or after you have received SSDI benefits for 24 months and the purpose of the evaluation. We will apply either the Three Tests or the Countable Income test to determine if your work activity is SGA, depending on when you work.

The Three Tests:
We apply the three tests to evaluate your work activity when you initially apply for SSDI and prior to you receiving SSDI benefits for 24 months. We will also use the three tests to evaluate your work activity during the reentitlement period to determine whether benefits can be reinstated after we have already determined your disability has ended due to SGA work activity. Your self employed work activity is SGA if:

you render significant services to the business, and you had over the SGA level ($940 in 2008) average monthly income; or

your work is comparable to the work of individuals without disability in your community engaged in the same or similar businesses; or

your average monthly work is worth the SGA level earnings in terms of its effects on the business, or when compared to what you would have to pay an employee to do the work.

The Countable Income Test:
We will apply the countable income test if you have been entitled to and received SSDI benefits for at least 24 months. We will only use the countable income test to determinate whether you have engaged in SGA, and if your disability has ended as a result of that SGA.

We will compare your countable earnings to the SGA earnings guidelines. If your monthly countable income averages more than $940 (for 2008) we will determine that you have engaged in SGA unless there is evidence you are not rendering significant services in the month. If your monthly countable income averages less than $940 (for 2008) we will not consider you to have engaged in SGA.

If you are self-employed and your disability is blindness, we decide SGA based solely on your earnings. This evaluation criterion is used to determine whether you have engaged in SGA and whether payments can be reinstated during the extended period of eligibility.

If you are self-employed, your disability is blindness, and you are age 55 or older, special rules apply. If your earnings demonstrate SGA but your work requires a lower level of skill and ability than the work you did before age 55, or when you became blind, whichever is later, we will suspend, not terminate, your benefits. Your eligibility for SSDI benefit continues indefinitely and we pay your benefits for any months earnings fall below SGA.


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