Note: The answers below are simplified. Disability Benefits Guidance, LLC will make sure you fully understand the answers to these complex questions and which factors will affect your claim.

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What’s the difference between SSI and SSDI and how do I know which to apply for?

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Supplemental Security Income (SSI) is a public needs-based benefit for children or adults who meet Social Security’s child or adult definition of disability and individuals 65 or older who are low-income. This program has strict income and resource limits. This program does not require any work history. The amount you receive is the Federal Benefit Rate (FBR) in effect at the time minus any earned or unearned income you have in a given month.  The 2025 FBR is $967 for an individual. If approved for SSI you will qualify for Medicaid health insurance but must apply for it in certain states such as Virginia.

 

Social Security Disability Insurance (SSDI) is a work-based benefit that you “earn” by working and paying taxes. This benefit depends on having enough work credits from wages or self-employment income. There are special rules that govern how recently you must have obtained these credits and special calculations that determine the actual payment amount. If approved for SSDI you will automatically qualify for Medicare health insurance after a 24-month wait period.

 

An SSDI benefit can rule out an SSI benefit but some people can qualify for both. I will make sure you apply for everything for which you may qualify.

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Why are disability claims usually denied by the Social Security Administration (SSA)?

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There are many reasons for this. One is that if you are continuing to work (even part time) you are contradicting what you need to prove which is that you can’t work due to your disability. Additional proof may be needed to clarify your work limits. Another is that your condition has not yet lasted 12 months or is expected to improve enough to work within 12 months. Or, your medical evidence does not show that you meet one of the conditions that is considered automatically disabling. Or, your medical and work evidence may have inconsistencies or be inadequate to prove your claim. Or, you may prove you can’t do your past work but it appears you can do other simpler work. There could be others reasons such as having excess resources when applying for SSI or not enough credits when applying for SSDI. We will identify and address all issues that may apply to your claim.

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Can you help me if my claim has already been denied?

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Yes. My service is designed to assist before you apply, while you apply and if you are denied. The first appeal is called a Request for Reconsideration and I can help determine why you were denied and what you can do immediately to improve your claim. If you are denied a second time the appeal is called a Request for Hearing by an Administrative Law Judge. This stage requires representation which I do not provide, however, I can help you understand what more can be done to improve your case as you seek representation. I will also help you understand how representation works, why it is necessary and the best way to find a competent attorney or non-attorney to represent you.

  

I can also provide guidance when approaching early retirement and how to navigate the decision to collect early and/or file for disability.

 

I can also provide guidance regarding the review process for adults which occurs periodically once approved or youth turning 18 which is called the age 18 re-determination.

 

Why does it take so long?

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Currently, Social Security is experiencing huge delays in deciding claims due to staff shortages and the high volume of applications. The system is also designed to approve the most disabled applicants first using strict criteria which results in less obvious claims being denied and requiring appeals. The appeal process itself is laborious and time consuming as most cases need appeals and the wait times are lengthy. My service will prioritize finding ways to speed up the process, avoid delays on your end and help you develop compelling evidence that will lead to approval at the earliest stage possible.

  

How did you develop your knowledge and how many people have you helped?

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From 1997 to 2013 I operated Disability Benefits Assistance, Inc. representing over 200 applicants in their disability claims mainly at the “hearing” level. I maintained a 97% approval rate. To prepare for this service I took an intensive course on Social Security’s rules and regulations that govern the decision and then developed my expertise case by case. From 2013 to 2024 I served as the Social Security advocacy subject matter expert at the disAbility Law Center of Virginia. There I provided guidance to over 2000 individuals navigating various stages of a disability claim or review, conducted intensive consultations including summary letters to enable ongoing self-advocacy and conducted trainings throughout Virginia for case managers, parents and individuals navigating this system.

 

Can I have more than one session if needed?

 

Yes, however, my service is designed to be affordable so the one consultation may be enough to educate you about the process, analyze your case, and explain how to prove your case going forward. Our time together during that session will be very productive due to the information you provide me in advance. You may decide to request my case summary and game plan as a reference guide.

     

Some people may also want additional assistance completing applications or appeal forms, having periodic check-ins or if an issue develops during the process. I also assume that some people will reach out once benefits are approved to better understand what to expect, how to manage their benefits, and to discuss their option to return to work at some point.

 

When do I get an attorney or non-attorney involved?

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Representatives usually do not take cases until the Request for Hearing stage. A lot can be done do avoid a hearing or if one is needed to ensure that any case weaknesses are already addressed so a representative will be eager to take on your case. 

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Are you able to help at key transitions such as turning 18 or approaching retirement?

  

Absolutely. 

 

I can provide important guidance to prepare for and navigate the SSI age-18 re-determination or when applying for the first time as a young adult or knowing when to obtain the Disabled Adult Child benefit. I can also provide guidance when approaching early retirement and how to navigate the decision to collect early and/or file for disability. In fact, getting guidance before a transition or when nearing a review is a good time to obtain this service.