What the Social Security Administration does for disability

The Social Security Administration (SSA) is the federal agency that runs the two main disability programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). SSA receives your claim, decides whether your condition meets their medical rules, and if approved, sends you a monthly payment. They also handle the work rules that let you earn money while receiving benefits, manage your Medicare or Medicaid coverage, and answer questions about how much you can work or save.

SSA does not decide whether you are disabled in the everyday sense — whether you struggle with tasks or need help. They decide whether your medical condition is severe enough that you cannot work at a substantial level for at least 12 months. That is a specific legal definition, and it is stricter than most people expect.

The agency has regional offices, hearing offices, and an appeals council. Most of your contact will be by phone, mail, or online through your my Social Security account. You can also visit a local office in person, though many have reduced hours.

Key Takeaways

  • SSA runs SSDI (for workers with a work history) and SSI (for people with low income and resources), and the rules for each are different.
  • SSA's medical decision is based on whether your condition prevents substantial work, not on how much difficulty you face in daily life.
  • You can contact SSA by phone at 1-800-772-1213, through your my Social Security account online, or at your local field office.
  • If SSA denies your claim, you have the right to appeal, and most people who appeal with a lawyer or representative win at the hearing stage.
  • SSA has work incentive programs that let you test your ability to work without losing benefits when ready.

The two programs SSA runs and how they differ

SSDI is for people who have worked and paid Social Security taxes. You need a certain number of work credits (based on your age when you became disabled) and a recent work history. Your payment amount is based on your own earnings record, not on how much money you have now. There is no resource limit — you can have a house, a car, and savings without affecting your SSDI payment.

SSI is for people with low income and resources, regardless of work history. You can have no more than $2,000 in countable resources (the limit is $3,000 if you are married and both receive SSI). Your home and one car do not count. Your payment is smaller than SSDI — it is set by federal law and adjusted yearly — and it varies by state because some states add money to the federal amount.

You can receive both SSDI and SSI at the same time if you meet the rules for each. Some people start with SSI while waiting for an SSDI decision, or switch to SSDI when they become may be able to access. SSA will tell you which program you are on and why.

How SSA decides whether you meet the medical rules

SSA uses a five-step process to evaluate your claim. First, they check whether you are working at a substantial level (in 2024, that means earning more than about $1,550 per month). If you are, they usually deny the claim. If not, they move to step two: whether your condition is severe — meaning it causes more than minimal functional limitation.

Step three is the critical one. SSA compares your condition to their Blue Book, which lists medical conditions that automatically meet the disability standard. The conditions are specific: for example, not "arthritis" but "rheumatoid arthritis with involvement of multiple joints and documented functional loss." If your condition matches exactly, you are approved. If it does not, SSA moves to step four.

In step four, SSA decides whether you can do the work you did before. They look at your job skills, age, education, and what your medical condition allows. If you cannot do your past work, they move to step five: whether you can do any other work that exists in the national economy. This is where most denials happen. SSA may say you cannot do your old job but can do sedentary work, or that you can work part-time, or that your age and education mean you can transition to a different field.

You do not have to prove you cannot work. SSA has to prove you can. But the burden is on you to provide medical evidence — test results, doctor's notes, imaging, mental health records — that supports your claim. Without it, SSA will deny you.

How to contact SSA and what to expect

The main phone number is 1-800-772-1213. Wait times are long, especially early in the week and early in the month. You can also create a my Social Security account at ssa.gov to check the status of your claim, view your earnings record, and message SSA directly. Responses to messages usually come within 5 to 10 business days.

Your local SSA field office handles in-person visits. You can find the address and hours on ssa.gov by entering your zip code. Many offices now require you to call ahead or make an appointment online. Bring your Social Security card, birth certificate, and any medical records or work history documents you have.

If you are deaf or hard of hearing, you can use a video relay service or TTY phone. SSA also has interpreters available for in-person visits if you call ahead. You can bring a representative — a lawyer, advocate, or family member — to any meeting with SSA.

What happens after SSA makes a decision

If SSA approves your claim, you will receive a notice with your payment amount, your start date, and information about Medicare or Medicaid. Your first payment usually arrives within one to two months. You will also receive a notice about your work incentives — the rules that let you work and still receive benefits.

If SSA denies your claim, you have 60 days from the date on the notice to file an appeal. You do not have to accept the denial. Most people who appeal with help from a lawyer or representative win at the hearing stage, where a judge reviews your case and hears new evidence. The hearing usually happens 6 to 18 months after you file the appeal, depending on your local office's backlog.

After you are approved, SSA will ask you to report changes: if you start working, if your medical condition improves, if you move, or if your income or resources change. You must report work within 30 days. Failure to report can result in overpayments that you will have to repay.

Work incentives and how they protect your benefits

SSA has programs designed to let you test your ability to work without losing your entire benefit when ready. The most common is the Trial Work Period, which lets you work and earn any amount for nine months without affecting your SSDI payment. You do not have to tell SSA in advance — you just work and report your earnings when you file your annual report.

After the Trial Work Period ends, you enter the Extended may be able to access Period, which lasts 36 months. During this time, you keep your SSDI payment in any month you earn less than the substantial gainful activity amount (about $1,550 in 2024). Once you earn above that amount for nine months, your benefits stop, but you can restart them within five years if you become unable to work again.

There are also programs like Impairment Related Work Expenses (IRWE), which let you deduct the cost of items or services you need because of your disability — a wheelchair, medication, therapy, transportation — when calculating whether you are earning at a substantial level. This can let you work more hours while staying under the earnings limit.

Medicare and Medicaid after SSA approves you

If you are approved for SSDI, you become covered by Medicare after you have been receiving benefits for 24 months. Medicare is federal health insurance. You pay a premium for Part B (doctor visits) unless your income is very low, and you can buy Part D (prescription drugs) separately. Many SSDI recipients also may have access to for Medicaid, which varies by state.

If you are approved for SSI, you usually become covered by Medicaid when ready in most states. Medicaid is state-run health insurance, and the coverage and rules vary widely. Some states cover more services than others. You will receive a notice telling you which program covers you and what your coverage includes.

You must report changes in your income or resources to SSA, because they can affect your Medicaid coverage. If you start working and your earnings rise, your SSI payment may decrease, but your Medicaid coverage usually continues for a period even if your payment stops.

Frequently Asked Questions

How long does it take SSA to make a decision on my claim?

Initial decisions usually take 3 to 6 months, but it varies by region and how complete your medical records are. If SSA needs more information, they will contact you. If you do not respond within 10 days, they may deny your claim. You can always reapply.

Can I work while my claim is pending?

Yes. Working does not hurt your claim as long as you are not earning at a substantial level (roughly $1,550 per month in 2024). If you are earning above that amount, SSA will likely deny your claim, but you can reapply if you stop working or your earnings drop.

What if SSA says I can do other work but I do not think I can?

You can appeal. At the hearing stage, a judge will review SSA's decision and hear your testimony about why you cannot do the work they say is available. Bring medical evidence and, if possible, a representative who can explain how your condition limits your ability to work.

Do I have to use a lawyer to appeal?

No, but most people who win appeals have representation. Lawyers and non-lawyer representatives charge a fee only if you win, and SSA limits the fee to 25 percent of your back pay. You can find representatives through the National Organization of Social Security Claimants' Representatives (NOSSCR) or local legal aid offices.

What if my condition improves after I am approved?

You must report the improvement to SSA. They may schedule a medical review to see whether you still meet the disability rules. If your condition has improved enough that you can work at a substantial level, your benefits will stop. You can restart them within five years if you become unable to work again.