Eligibility and Application

Eligibility

Three groups of people can get Supplemental Security Income (SSI) benefits:

1. People older than 18 but younger than 65, with disabilities and limited income and resources. This article focuses on people between 18 – 65.
2. People who are 65 years old or older, with limited income and resources.
3. Qualifying children and youth under 18 with disabilities. A different definition of disability applies to people under 18. To learn more about SSI for people under 18, read DB101’s section on Benefits for Young People.

You do not have to have worked at all to get SSI benefits.

If you’re between 18 – 65, to qualify for SSI benefits, you need to:

1. Meet certain citizenship and residency requirements;
2. Meet income and resource limits; and
3. Have a disability that prevents you from working.

Medical Disability

To be eligible for SSI benefits, you must show that you have a disability that prevents you from working. Social Security has very specific rules about what is and is not a disability. Social Security uses the same definition of disability for all its programs.

Unable to Work

Your disability must also prevent you from working. Social Security has a standard way of defining work. The term Substantial Gainful Activity (SGA) is used to describe a level of work activity or earnings. In 2024, if you are earning more than $1,550 per month (or $2,590 if you’re blind), Social Security says your earnings are Substantial Gainful Activity.

Note: You may be able to reduce your countable monthly income if you get a wage subsidy, have Impairment Related Work Expenses (IRWEs) or Blind Work Expenses (BWEs). Also, when Social Security figures out if your work activity is SGA, Social Security does more than just look at your earnings. If you are self-employed, for example, Social Security uses up to 3 different tests and analyzes things like hours worked and responsibilities to decide if your work counts as SGA. To find out more information, visit the Social Security Administration’s website.

When Social Security looks at your application, the agency asks a series of questions to figure out if your disability prevents you from working.

Example: Mimi has a severe and life-threatening lung disease. She is still working and earning $1,790 a month working part-time in a flower shop. Social Security decides that her earnings are above $1,550, the current SGA level. Mimi is therefore not disabled according to Social Security because of her earnings.

Example: Floria injured her spine in a fall. She fractured 2 vertebrae and damaged some nerve roots. She is not working now. Social Security finds that her condition is listed on the Listing of Impairments and that it’s severe enough to be disabling. Floria is therefore disabled according to Social Security and may qualify for monthly benefits.

Your disability has to prevent you from earning above the SGA level not just in your old job, but in any job. Social Security looks at your age, education, work experience, and any skills that could be used in other jobs. (If you’re over 55, the rules are less strict.)

Example: Luigi had been working as a longshoreman until he ruptured a disc in his back in a game of touch football. He is not working now, so his actual earnings are below the SGA level. The back injury is long-term and serious, but is not on the Listing of Impairments as an automatically disabling condition.

Luigi wouldn’t be able to do his old job, with all the heavy lifting, but Social Security decides that with his experience, he could be able to work at a desk as a dock dispatcher. Because he would be able to work, Luigi is not disabled according to Social Security.

Resource Requirements

When you apply for SSI benefits, you have to list money and property that you own. If you have money or property that you could sell to support yourself, Social Security wants to make sure that you do that first before you get help.

Example: Billy has $5,000 in a standard savings account (not an ABLE account), set aside for a rainy day. Even though he has no plans to spend this money and doesn’t want to, it does count as a resource. Billy is not eligible for SSI benefits.

Citizenship Requirements

To qualify for SSI benefits, you must be a U.S. citizen or a qualified alien. Some important categories of qualified aliens include people who are:

• Lawfully Admitted for Permanent Residence (LAPR) in the U.S.
• Refugees admitted to the U.S. under Section 207 of the Immigration and Nationality Act (INA)
• People granted asylum under section 208 of the INA

Qualified aliens must also meet certain other conditions to be eligible for SSI benefits. Some groups of immigrants and refugees will only be able to get SSI benefits for 7 years after their date of entry into the U.S. If they think they will continue to need SSI benefits, they need to become U.S. citizens before that time is up. If you are unsure of your immigration status or how it affects SSI, you should contact the Social Security Administration or U.S. Citizenship and Immigration Services (USCIS). See the Social Security Administration's website for more information.

Application

You can apply for Supplemental Security Income (SSI):

• Online (which starts the application process immediately)
• By calling Social Security at 1-800-772-1213 or 1-800-325-0778 (TTY) to make an appointment to apply either:
  • Over the phone, or
  • In person at your local Social Security office.

The initial application process will take some time, sometimes up to four months. If you need urgent help, call your county social services agency right away. If you’re eligible, they can get you health coverage and CalFresh (formerly Food Stamps). Depending on your need and circumstances, they may also be able to help you with emergency cash assistance and/or housing.

While waiting to hear from Social Security, you can also apply for CalWORKs, Medi-Cal, and other benefits. You can apply online at BenefitsCal or at your county social services agency.

Application Questions

When you apply for SSI, you’ll need to give Social Security:

1. Basic facts (name, date of birth, etc.)

2. Documentation of your medical condition

3. Documentation of your income

4. Documentation of your assets

Social Security will also ask you to sign up to get your check through direct deposit into your bank account.

Don’t delay your application just to round up the documents you need; Social Security can help you. Social Security provides an online Adult Disability Starter Kit, which explains what you need to know before you apply, and includes a checklist and worksheet to guide you through the process.

It’s important to apply right away if you think you’ll need SSI. Even though it will take a while for Social Security to process your application, your benefits will be paid retroactively to your application date.

Decision

If you've supplied all the documentation needed, Social Security usually takes 3 to 6 months to look over your application and decide if you should get SSI benefits. Once they decide, they send you an award letter or a denial letter.

After you get your award letter, your SSI benefits go into your bank account automatically each month. If you don’t have a bank account, you can have your SSI benefits put onto a Direct Express debit card that you can use to pay for things.

Award letters can be hard to read. If you have questions about your new benefit, you can call Social Security at 1-800-772-1213 or 1-800-325-0778 (TTY). More information is available on Social Security’s website.

Denial and Appeal

Some applicants get a denial letter, telling them that their claim for SSI benefits has been turned down.

The most common reasons for SSI to deny claims are:

• Medical: This is the most frequent reason for denied claims. Often Social Security doesn’t have enough medical documentation of your health condition, or Social Security doesn’t believe your medical condition is bad enough to keep you from working.
• Resources: Social Security believes that you have more resources than the allowed limit of $2,000 ($3,000 for a couple)
• SGA: Social Security believes that you are earning more than the Substantial Gainful Activity limit of $1,550.

Note: When you apply for SSI benefits, Social Security must first check to see if you’re eligible for Social Security Disability Insurance (SSDI). If you get a denial letter from SSDI, it does not mean you’ve been turned down for SSI benefits. Check the letterhead on the denial letter. An actual SSI denial letter will say Supplemental Security Income at the top.

You don’t have to accept Social Security’s decision. If you feel that the decision is unfair or incorrect, you have the right to file an appeal.

There are 4 levels to the appeal process. If you are not satisfied with the result at each level, you can appeal to the next. The 4 levels are:

1. Reconsideration: In a reconsideration, somebody inside Social Security who wasn’t involved in the first decision looks at your application again from scratch. You can supply more information if you want. This is a paper appeal and means that you don’t have to go in front of a judge. You should supply Social Security with any new information you have about your case.
2. Hearing: If the reconsideration is denied, you can ask for a hearing before an Administrative Law Judge. You can bring witnesses to help make your case. You should consider having an attorney or representative help you with the hearing.
3. Appeals Council: Social Security’s Appeals Council will review your case if you appeal the decision of the Administrative Law Judge. The Council can accept the decision of the judge, decide the case for itself, or send it back to an Administrative Law Judge for an additional hearing.
4. Federal Court: If the Appeals Council decides against you, you can file a lawsuit in federal court.

For any level beyond the reconsideration, it would be a good idea to have a lawyer working for you.