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Is everyone guaranteed to win SSDI?

Some applicants have the misguided notion that getting Social Security Disability Insurance benefits (SSDI) is a guaranteed right. They have been putting money aside each month through their employee tax contributions and the expectation is that when they become disabled they fill out a few forms and the disability check is sent to them within a few weeks.

Unfortunately, this is not how the SSDI process works, and anyone who does not plan for alternative income, at least in the short run if they are injured and cannot work, may end up in a desperate situation.

Why can’t I have the money that is rightfully mine?

Getting what you consider to be rightfully yours in an interesting question. First, the main thing to realize, whether we are talking about SSDI disability benefits or retirement, is that the amount you have paid into the system is generally a fraction of what you will receive if you are determined disabled. So what people are really expecting to receive is much more than what they are “rightfully” entitled to receive.

Secondly, the assumption that SSDI is something you are entitled to receive is to assume that it is like SSA retirement. SSDI is not an entitlement program, it is an insurance program, and as such you will have to meet specific requirements to prove that you should receive it

I have used this illustration before, but it is good. It is much more like car insurance than retirement benefits. SSDI covers you for a specific time, while you are considered insured. There is a point in time that you will no longer be insured, assuming you stop working and paying your “premiums.”  You are also not guaranteed payment, much like you are not really always guaranteed payment from a car insurance company (without proving specific things about your case).

What are some reasons I would not get approved for SSDI?

There are a variety of reasons you could be denied SSDI benefits.

  1. You are not insured- you could be considered not insured if you stopped working and paying premiums and you have passed your insured date (this is referred to as your date last insured or DLI). You can also be considered not insured if you did not work and pay enough employment taxes to earn sufficient “work credits.”

  2. Youare not disabled – the SSA can also decide that you are not disabled. This can mean that either your condition is not severe enough or it is not going to last 12 continuous months.

  3. You are working – If you are working or making too much money the SSA may consider you automatically NOT disabled.

  4. You are too old- The SSA does not provide SSDI benefits to claimants who are past their full retirement age.

So, you can see as illustrated above, that there are specific requirements which must be met before the SSA will award SSDI benefits. You are not guaranteed or entitled to benefits; you will have to prove that you are disabled, insured, young enough and you cannot perform substantial gainful activity.