Public Benefits (SSI, SSDI) Fact Sheet

SOCIAL SECURITY

The SSA oversees two disability programs:

  • Social Security Disability Insurance (SSDI, Title 2), and
  • Supplemental Security Income (SSI, Title 16).

Both of the above are long-term disability programs.

How Does SSA Define Disability?

According to Social Security, a disability is an ailment, physical or mental, that prevents you from doing any kind of work for at least one year. Both severe HIV symptomatic and AIDS diagnoses (based on infections) may qualify. SSDI and SSI will review your medical records and supplementary testimony to substantiate your disability. A T-cell count of below 200 is no longer considered a disabling condition.

SOCIAL SECURITY DISABILITY INSURANCE (SSDI)

SSDI is your Social Security retirement fund which you may receive under age 65 if you are disabled. To be eligible:

  • You must meet SSA's definition of total disability.
  • You must also have paid into the Social Security Trust Fund through F.I.C.A. payroll taxes:
    - You must have paid FICA taxes for at least five of the 10 years preceding your disability if you are over 31.
    - Under 31, your pay-in must be for at least half the years between your current age and age 21, i.e. at 29 you must have paid in for at least four years.

Supplemental Security Income (SSI)

Supplemental Security Income (SSI) is a needs-based program for disabled people with little or no income, and assets valued under $2,000 ($3,000 for couple).

To be eligible:

  • You must meet SSA's definition of total disability.
  • You must also have a "financial need" as defined by the SSA.

Financial need is defined by SSA as follows:

  • Your assets must be less than $2,000 (if you are single -- $3,000 for couples).
  • Your monthly "income" must be less than the benefit amount ($980 per month in the year 2009).

One vehicle and one residence are excluded. Assets may include: bank accounts, pensions, IRA's, property, life insurance or burial plans with cash values in excess of $2,000, etc. SSI currently pays $870 (2009 per month for single individuals. Your income must be under the maximum payment. Awards are higher for people without cooking facilities, or the blind. SSI claims cannot be backdated. Processing time is up to three months or longer (see Presumptive Eligibility).

Presumptive Eligibility

SSI can "presume" you are disabled and begin payment immediately if you meet the income and asset requirements and have a doctor's statement testifying to your disability (specifically a "Medical Report on Adult with Allegation of HIV Infection," available from SSA or APLA's Benefits office). SSI can pay up to six months of "presumptive" while they review your medical records and financial eligibility for SSDI, SSI or both. You will receive Medi-Cal automatically with presumptive. If your medical records do not support your doctor's statement, or you fail to complete your application, payment may stop. You will not have to repay the money. District offices can write checks on the day of application; branch offices can get checks quickly. Immediate presumptive payment is at the discretion of the office and the claims representative. If you are in need of immediate assistance, be prepared to present a case of compelling need and ask for (do not demand) "emergency advance" payment. Emergency advances are pro-rated over a month. If you are applying at the end of one month, you might be better off waiting until the start of the next.

During the SSI application process you will be asked about "other income," including assistance from family and friends. If your monthly expenses exceed the payment level, SSI may ask how you meet your bills. Loans are not considered income; gifts are. If someone helps with your support (cash, food, or rent assistance), SSI may consider this "income in kind" and deduct a set amount from your benefit. If you are being loaned money, SSI may ask for signed statements from people loaning you funds. If your assets exceed $2,000, you can "spend down" prior to application to meet the eligibility requirements. After filing, you may be asked to document spend downs. In either case, document spending down with receipts for home repairs, loans paid back, medical bills taken care of, canceled checks, etc.

The Application Process

You can apply for SSDI and SSI by phone and mail or in person. To schedule an appointment at your local office, call 800.772.1213. Or you could apply at the Hollywood office, which is very familiar with HIV claims, by calling 1.866.931.8348 (SSI or SSDI). Applicants for Presumptive SSI at the Hollywood office only should have their Medical Reports faxed to Social Security by their physicians before or on the day they apply. Hollywood's fax is 323.965.3854. If other conditions affect your ability to work, like chronic back pain, file an HIV claim with complications. HIV claims always move faster through the SSA process.