To be eligible for Title II, individuals must have insured status as former workers, or be eligible on the insured status of a specific relative like a parent or spouse. To establish insured status for benefits, individuals need 20 quarters of coverage (payment of Social Security taxes-FICA) in the 10 years before their disability started (those disabled before the age of 31 need less work to qualify)

To be eligible for SSDI benefits an individual must:

SSDAC (or DAC - Social Security for the Disabled Adult Child)

Adults with disabilities who have not paid FICA (Social Security) taxes long enough to have insured status, may receive Title II benefits based upon their parent’s insured status.

To be eligible for SSDAC benefits an individual must be:

• 18 years of age or older;
• Disabled before turning 22 years old;
• A child of an insured worker who is either disabled, retired, or deceased; and
• Earnings must never have exceeded the SGA level.

For Example:
Bob, Jr. is 25 and became disabled when he was 5 years old. His father, Bob, Sr., is retiring after working and paying FICA taxes for 40 years. Bob, Jr. is eligible for SSDAC as soon as his father retires and will be eligible for Medicare once he completes the 24 month eligibility waiting period.

SSA Title II beneficiaries are also eligible for Medicare. Medicare coverage begins 24-months (2 years) after eligibility for SSDI/DAC. The Title II program is not based upon financial need. The dollar amount of benefits is based on a person’s work record and the age benefits begin. Currently, no provision is made for reducing the Title II benefits as the recipient’s earnings increase. The person receiving Title II will receive either the whole check or none at all.

People with disabilities must complete a five-month waiting period from the month of disability onset before Title II cash benefits begin.

Substantial Gainful Activity (SGA)

If a person is earning income in excess of $940\month in 2008 ($1,570 if blind in 2008), that person is considered to be earning at the Substantial Gainful Activity (SGA) level. However, if the worker’s productivity is equal to that of non-disabled workers in comparable positions, he/she may be determined to be earning at the SGA level even if gross earnings are less than $940/month. After the Trial Work Period, if SSA determines that a person is earning at the SGA level, he/she will receive full benefit checks for an additional three months, and then his/her cash benefit will stop unless sufficient Social Security Work Incentives apply that can reduce how SSA looks at the earnings. Remember, for the 36 months that follow the TWP, disability status is protected and SSDI checks will be due for any month earnings are below SGA.

For Example:
After working for many years, Catherine became disabled but is now back working, earning $840 a month. SSA has determined that she is working at the SGA level. Her monthly SSDI checks will stop in 3 months. Social Security Work Incentives may allow her to keep her SSDI benefits.

Social Security Work Incentives During SGA Determination

A Title II recipient may use Work Incentives to reduce the amount of gross earnings that SSA counts to determine if the person is earning at the SGA level. This may allow Title II recipients to maintain benefit checks and Medicare. This strategy encourages self-sufficiency and provides financial security until sufficient supports (addressing physical well-being and financial adequacy) are established. An IRWE (Impairment Related Work Expense) and subsidy, both of which must be approved by SSA, are two of the Work Incentives that make a difference when SSA evaluates earnings for SGA. Definitions and discussion of these Work Incentives will follow.

For Example:
Dave receives SSDI and is working, earning $890 a month. He has an IRWE to pay for $400 in personal attendant care. This reduces his Countable Earned Income to $490/month and keeps him below the SGA level. He is still eligible for SSDI monthly benefits.

Trial Work Period (TWP)

SSDI/DAC recipients are entitled to a nine-month Trial Work Period (TWP), which provides opportunities to test work skills while maintaining full benefit checks regardless of earned income. The TWP begins the first month that a person is entitled to Title II benefits or files an application for disability benefits. Only months when wages exceed $670 in 2008 (or 80 hours of work for self-employed people) count as Trial Work Period months. The TWP ends after a person has performed nine months (not necessarily consecutive) of trial work within a rolling period of 60 consecutive months. Sheltered workshop earnings equal to or in excess of $670 a month in 2008 count as TWP months. A list of TWP amounts since 1976 is on page 36 of this booklet.

Extended Period of Eligibility (EPE)

At the conclusion of the Trial Work Period, a person will enter a 36-month Extended Period of Eligibility (EPE). During this period, a person’s Social Security disability status is protected, even if he/she grosses over $940/month in 2008 and isn’t due an SSDI check. However, during the EPE people may work and receive SSDI/DAC benefits for each month that gross earnings are below $940. The EPE ends in the first month that a person earns SGA following the 36-month EPE period.


For Example:
Ellen receives SSDI and wants to return to work, but her disability may prevent her from working a regular schedule. Her Trial Work Period allows her to earn over $670 (2008) a month in those months she is able to, for up to nine months in the 60 months beginning when she started her TWP, and still receive her SSDI monthly benefits. Once she has used her 9 month TWP, she can continue to receive SSDI checks if she doesn’t earn $940 or more per month. If she earns over $940/month, she isn’t due her SSDI check, but Social Security still considers her “disabled” during her EPE.

Medicare Coverage

Medicare is the health insurance for Title II beneficiaries. Medicare coverage starts 24 months after SSDI/DAC eligibility is established and cash benefits begin. Medicare has two parts:

Hospital Insurance (Part A)

Part A pays for inpatient hospital care and certain follow-up care. Part A is automatic for the person receiving SSDI/DAC benefits following the 24-month waiting period, and there is no cost to the person for the insurance, but there are some co-payments, deductibles, and limits on coverage.

Medical Insurance (Part B)

Part B pays for some doctors’ services and a variety of other medical services and supplies not covered by Part A. Medicare Part B is voluntary and is financed partly by low monthly premiums paid by recipients. Those who choose Medicare Part B coverage will have the premium deducted from their monthly benefit check. In 2008 the cost is $96.40/month.

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