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To be eligible for Social Security Disability Insurance (“SSDI”) benefits, you must have (1) a disabling condition that meets the Social Security Administration’s (“SSA”) definition of a disability and (2) paid a certain amount of Social Security taxes throughout your working career. The amount of disability benefits you can receive will be based on the amount of Social Security taxes you paid before becoming disabled.[1]
Applying for SSDI can be a stressful and complicated. At the Law Offices of Mark T. Hurt, we are experienced in successfully helping disabled clients secure disability income benefits.
Before the Social Security Administration (SSA) calculates your benefit amount, it must first determine whether you meet the eligibility requirements for SSDI. This process involves a thorough review of both your medical condition and your work history. The SSA will evaluate whether your disability is expected to last at least 12 months or result in death, and whether it significantly limits your ability to perform basic work-related activities. They will also check to see if you have earned enough “work credits” through past employment. Typically, workers need 40 credits, 20 of which must have been earned in the last 10 years prior to becoming disabled. However, younger individuals may qualify with fewer credits. This eligibility stage is critical, as no benefit calculation will occur if the SSA determines that an applicant does not meet these foundational requirements.
If you are disabled and would like to learn about SSDI or SSI benefits, call our office to schedule a free consultation. We will evaluate your case and explain the various benefits to which you may be entitled. We are only entitled to a fee if you receive a benefit award.
SSDI benefits are based on the amount of income on which you paid Social Security taxes. Using your Average Indexed Monthly Earnings (“AIME”), also referred to as average earnings, the SSA will calculate your Primary Insurance Amount (“PIA”), which is the amount of benefits you are entitled to receive.
As you can likely imagine, the formula used by the SSA to determine the PIA is complicated, making it difficult for most individuals to compute. In 2020, the average SSDI benefit amount is $1,259 per month, but it can be substantially more if you had a high income before disabled. As a social security benefits lawyer, I can assess your work history and tax payments and provide you with an estimate of the amount of benefits to which you may be entitled.
Once you qualify for SSDI, your benefit amount is determined largely by your work history. Specifically, the earnings on which you paid Social Security taxes. The SSA calculates your Average Indexed Monthly Earnings (AIME) using up to 35 of your highest-earning years. A consistent record of higher earnings will generally lead to a higher AIME and, in turn, a higher monthly benefit.
On the other hand, if you had years of part-time work, low wages, or gaps in employment, those periods can reduce your AIME. This is because the SSA averages your indexed earnings across the number of years in your work record, including lower-earning years unless excluded through specific rules. The SSA then applies a formula to determine your Primary Insurance Amount (PIA), which is progressive—meaning lower-income workers receive a higher percentage of their average income, though higher earners may still receive more in total dollars.
Understanding how your individual earnings history factors into this calculation can help you set realistic expectations and identify opportunities for maximizing your benefits.
To get a clearer picture of your potential SSDI benefits, the SSA provides an online benefit calculator tool. This resource allows users to input their earnings history and anticipated retirement or disability age to generate a benefits estimate. It’s particularly helpful for individuals planning ahead or seeking transparency in the SSDI process. The calculator uses your actual or projected earnings to estimate your PIA—the base number used to determine your monthly payments. While not a substitute for official determination, it offers valuable insight and can help you make informed decisions about when to file for benefits and how much income you may receive. If you’re unsure about how to use the tool, a disability attorney can walk you through the process and help interpret the results.
Generally, it takes three to five months for an SSDI application to be processed; however, if your claim is denied, you may have to appeal and wait longer. Statistically, initial claims have a denial rate of approximately 65%, meaning that, more likely than not, the claims process will take months to over a year to complete.
However, the chance of a wrongful denial can be significantly reduced by seeking the help of an experienced social security benefits lawyer. At our firm, we understand the claims process and the specific types of information required for benefit claim approval, which helps decrease the chance that a claim will be denied due to insufficient documentation.
The following are some additional factors that can delay an SSDI decision:
Because it can take months to process an SSDI application and receive an approval letter, most disability applicants are eligible for back payments of benefits. The number of months of back payments depends on the SSDI application submission date and the date that an individual became disabled as determined by the SSA (known as the “established onset date” or “EOD.”)
In addition to receiving back pay from the application date forward, it is possible to receive up to 12 months of retroactive payments for the year before the application date, if the disabling condition existed at that time. However, benefits are not available for any months before the EOD.
Once an individual is approved for SSDI, there is a five-month waiting period beginning on the EOD.
The maximum back pay benefit amount to which an individual may be eligible is equal to (i) the five month period after disability has been determined, plus (ii) the number of months beginning on the EOD to the date of the disability determination (up to 12 months). So, the maximum number of months of back pay is 17 months total).
Disability payments, such as worker’s compensation, can offset SSDI benefits. However, other disability payments, such as veterans’ benefits or those made by private insurance, do not result in a reduction.
As long as you remain disabled and are unable to work, you will be entitled to SSDI benefits. If your condition improves and you return to work, you must notify the SSA, and your will benefits will likely be reduced or discontinued.
Benefits can be discontinued if the SSA determines:
The SSA conducts periodic case reviews to evaluate if there has been a change in circumstance. Many times, examiners determine that a person is no longer eligible for benefits, even when they are still disabled and unable to work. Under these circumstances, the individual is entitled to challenge the decision.
If your continuing benefits have been wrongfully denied, we would like to help. We can evaluate your claim and help compile evidence to make a strong argument to reverse the determination.
[1] Benefits for People with Disabilities, SSA, https://www.ssa.gov/disability/.
[2] These amounts are accurate as of March, 2020, but are subject to change.
After my husband’s Social Security Disability claim was denied, I contacted Mark Hurt’s law firm. Jessica was extremely helpful and patiently explained every step of the process. We were thrilled to find out that his claim has now been approved. I am so pleased with the results due to Jessica’s efforts. I would highly recommend this firm for any Social Security/Disability issues.”
