Information on Eligibility for SSI and Medicaid
Supplemental Security Income (SSI) Eligibility Requirements
WHO IS ELIGIBLE FOR SSI?
Anyone who is:
- aged (age 65 or older); blind; or disabled.
and
- has limited income; and has limited resources; and is a U.S. citizen or national, or in one of certain categories of aliens (in general, an alien who is subject to an active warrant for deportation or removal does not meet the citizenship/alien requirement), is a resident of one of the 50 States, the District of Columbia, or the Northern Mariana Islands; and is not absent from the country for a full calendar month or for 30 consecutive days or more; and is not confined to an institution (such as a hospital or prison) at the government's expense; and applies for any other cash benefits or payments for which he or she may be eligible, (for example, pensions, Social Security benefits); and gives SSA permission to contact any financial institution and request any financial records about you; and files an application; and meets certain other requirements.
WHAT DOES “DISABLED” MEAN FOR A CHILD?
If you are under age 18 we may consider you “disabled” if you have a medically determinable physical or mental impairment, (including an emotional or learning problem) that:
- results in marked and severe functional limitations; and can be expected to result in death; or has lasted or can be expected to last for a continuous period of not less than 12 months.
If you are age 18 or older, the adult definition of disability explained below applies.
WHAT DOES "DISABLED" MEAN FOR AN ADULT?
If you are age 18 or older we may consider you “disabled” if you have a medically determinable physical or mental impairment (including an emotional or learning problem) which:
- results in the inability to do any substantial gainful activity; and can be expected to result in death; or has lasted or can be expected to last for a continuous period of not less than 12 months.
SSA has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that their conditions obviously meet disability standards. The Compassionate Allowances (CAL) initiative allows Social Security to target the most obviously disabled individuals for claims approval based on objective medical information that we can obtain quickly. Fifty medical conditions were initially selected for this initiative. Since that time we have added 150 conditions bringing the total number of conditions to 200. The list may expand over time. A complete list of CAL conditions may be viewed online at: http://www.socialsecurity.gov/compassionateallowances/conditions.htm.
Social Security Disability Insurance (SSDI) Eligibility requirements
To qualify for Social Security disability benefits, you must first have worked in jobs covered by Social Security. Then you must have a medical condition that meets Social Security's definition of disability. In general, we pay monthly cash benefits to people who are unable to work for a year or more because of a disability. Benefits usually continue until you are able to work again on a regular basis. There are also a number of special rules, called "work incentives," that provide continued benefits and health care coverage to help you make the transition back to work.
If you are receiving Social Security disability benefits when you reach full retirement age, your disability benefits automatically convert to retirement benefits, but the amount remains the same.
The definition of disability under Social Security is different than other programs. Social Security pays only for total disability. No benefits are payable for partial disability or for short-term disability.
"Disability" under Social Security is based on your inability to work. We consider you disabled under Social Security rules if: • You cannot do work that you did before; • We decide that you cannot adjust to other work because of your medical condition(s); and • Your disability has lasted or is expected to last for at least one year or to result in death.
This is a strict definition of disability. Social Security program rules assume that working families have access to other resources to provide support during periods of short-term disabilities, including workers' compensation, insurance, savings and investments.