If you’re disabled, you’ll need to know what types of Social Security benefits are available, how to apply, and what to show in order to demonstrate that you qualify.
Social Security is a federal program that provides benefits to adults who are retired or unable to work because of a disability. Although it’s a federal program, each state has certain regulations for its own residents. If you’re a disabled North Carolina resident, you should be familiar with North Carolina’s regulations around Social Security disability benefits.
Types of disability compensation
There are 2 types of Social Security disability programs:
- Social Security Disability Insurance (SSDI) provides payments to workers who are disabled and can’t work. In order to qualify, you must’ve worked and paid into the program for at least 5 of the 10 years prior to becoming disabled. Your benefit payment amount is based on how much you earned prior to your disability.
- Supplemental Security Income (SSI) is available to people who can’t work because of a disability and who also are disabled since birth or from an early age and never were able to work. Since they never worked, they didn’t pay into the system. It also includes adults who didn’t work long enough to earn enough work credits to qualify for SSDI, and people over 65 with financial need or who are blind.
Additional disability benefits that might be available
SSDI and SSI include additional benefits, too. Here are 3 such programs:
- Disabled Widows and Widowers Benefits (DWB) (also called “Survivors’ Benefits”) are available to someone who is age 50 or over and who is already receiving Social Security disability benefits after their spouse or ex-spouse dies.If you’ve lost a spouse but are caring for a disabled child who receives Social Security benefits or any child under age 16, you might qualify for benefits even if you’re less than 50 years old.If you were living with your spouse or ex-spouse at the time of their death, you’ll receive a one-time benefit of $255. If you are eligible for your own retirement or disability benefits of ½ or more of your deceased spouse’s monthly benefit, you’re ineligible for DWB.
- Disabled Adult Child Benefits (DAC) and benefits for people who are blind are available if you were disabled before age 22 and if a parent who paid into the Social Security system has retired, become disabled, or died. The child on a parent’s SSI can receive half of their benefit when the parent retires and 75% up on the parent’s death.
- Disability Income Plan of North Carolina (DIP-NC) provides monthly replacement income for short- or long-term disability benefits if you’re still a permanent employee. If you’ve received a determination of disability by the Retirement Systems’ Medical Board, you continue to earn state retirement credits while collecting this disability benefit.
How do I apply for North Carolina disability benefits?
You can apply for benefits through your local Social Security office. Here’s how:
- Use the Social Security locator tool to find your nearest office by ZIP code.
- Apply online (only for SSDI).
- Contact Social Security by phone at 1-800-772-1213 and use its automated service.
When you begin the process of applying for benefits, it’s helpful to have each document and piece of required information. Here’s what you’ll need:
How to apply for SSI: Required information and documents
- Country of birth (if outside the U.S.)
- Permanent resident card number (if you’re not a U.S. citizen)
- Name of current and prior spouse if the marriage was more than 10 years or ended in death
- Spouse’s date of birth
- Beginning and end dates of marriage
- City, state, or country of marriage (if outside the U.S.)
- Names and birthdates of children who were disabled before age 22
- Names and birthdates of children who are under age 18 and currently unmarried
- Names and birthdates of children who are 18 or 19 and full-time students
- Type of U.S. military duty, branch, and dates of service
- Your employer details for the current year and previous 2 years, including information from your Social Security Statement (available at https://www.socialsecurity.gov/myaccount)
- Your employer’s name, employment start and end dates, and total earnings
- If you’re self-employed, you’ll need information from your Social Security Statement, along with the business type and total net income
- Direct deposit information (account type, account number, and bank routing number)
- If you have an international bank account, you’ll need the International Direct Deposit (IDD) bank country, bank name, bank code, currency, account type, account number, and branch or transit number
- Name, address, and phone number of an alternate contact person who Social Security can contact if they need assistance with your claim
- List of your medical conditions
- Names, addresses, and phone numbers of your doctors and other healthcare providers
- Dates of examinations and treatments
- Your patient ID numbers
- Names of medications, the reason for treatment, and prescribers’ names
- Information about other rehabilitative services, public welfare, workers’ compensation, and other records
- Date the condition began to affect your ability to work
- Up to 5 jobs that you had in the 15 years before you became unable to work
- Highest school grade completed, date, special job training, trade school, or vocational school
Tips on applying for disability benefits
It’s crucial that you provide a complete picture to the SSA for why you need benefits. Here are some tips for applying for Social Security disability benefits:
- Tell the SSA all the reasons you can’t work (that is, all of your disabilities, whether physical or mental).
- Call the SSA to ask for your Disability Determination Services (DDS) caseworker. You can check in to share information about your claim and find out if there’s anything additional that they should know.
- Request a copy of the information you submitted about your medical treatment. This might sound silly because you submitted it, but what this does is allow you to make sure that their file is complete and they have information from each of your medical providers about all of your conditions.
- If your DDS caseworker asks you to go for a medical exam or test, make sure to do it. If you can’t go, you need to let the caseworker know.
- You can have a representative. If you think the application process is confusing, if you’re just not sure you’re doing everything correctly, or if you don’t understand some of the information you can have a personal representative who’s able to work directly with Social Security on your behalf. This doesn’t have to be a lawyer necessarily — it could be a family member or friend who you trust.
- Get a referral for vocational rehabilitation. If you’ve participated in a vocational rehabilitation program that was unsuccessful, it’s evidence that you’re unable to work but have put forth your best effort. You can do this while your SSI/SSDI claim is being processed.
- Make sure the SSA knows where you live. If you’re living somewhere that’s different from their mailing address on file, you need to let them know so they can schedule doctor’s appointments that are nearby.
- If you’re homeless, you might be eligible for special assistance. Social Security will primarily communicate with you through postal mail. If you can’t receive mail or if you have to change your mailing address frequently, they need to know in order to make arrangements. If there’s a local shelter, you might be able to arrange for it to accept your mail.
What if my SSD or SSDI claim is denied?
You have 60 days from the day of your denial to file an appeal.
If you’re denied, call the SSA immediately. You’ll want a Form SSA-561 (Request for Reconsideration) so that you can appeal a medical or non-medical decision.
If your Request for Reconsideration is denied, you’ll have another 60 days to appeal that decision. That appeal will be a Request for Administrative Law Judge Hearing. It could take 16-20 months for your hearing to be scheduled. You should be accompanied by a lawyer if you need a hearing.
How much can you receive in SSDI or SSI benefits?
If approved, you’ll receive a monthly disability check.
If you’re receiving SSDI, the amount is based on your average lifetime earnings covered under Social Security.
If you’re receiving SSI, payment is based on your financial need.
Your payment amounts can be reduced if you’re receiving other benefits such as workers’ compensation, other public disability payments, or a pension based on earnings.
The maximum monthly SSI benefits in 2019 were $771 for an individual, $1,157 for an individual with an eligible spouse, and $386 for another person in the household who cares for the disabled person.
What if I qualify for both SSD and SSI?
There are situations when someone receiving SSI could work and eventually earn an SSD benefit. It’s also possible that an SSI recipient could eventually qualify for DAC benefits. If your SSD payment is higher than the SSI payment, your SSI would probably end.
Occasionally, a disabled person can get “concurrent benefits” from both SSD and SSI programs. Usually, this happens if the person qualifies for SSD but made an amount of money during their work history that makes them eligible for SSI, too. The SSA will automatically evaluate whether you’re eligible for concurrent benefits based on your income and assets.
If you’re receiving both SSI and SSD, you’re eligible for Medicaid and Medicare.
Do you need an attorney to handle your Social Security disability claim?
If this sounds complicated to you, you’re not alone. It is complicated.
What you need most is to ensure that you’re getting the maximum amount of benefits for which you’re qualified. A good lawyer who specializes in Social Security cases will never misrepresent your condition to make your disability seem more than it is, and they won’t misrepresent your financial situation, either. But they will present the facts and present them in a way that’s most favorable to your reaching the maximum benefits.
If you’re in the early stages of applying for Social Security disability benefits, you might be able to gather enough information to do it on your own. But if your claim is denied or if your medical condition is complicated, it’s worth getting a lawyer to help. You can find a lawyer who won’t require payment until your claim is resolved.
Especially if you have multiple benefit sources (like Medicare, Medicaid, or other public assistance) combined with Social Security disability benefits, you should seriously consider meeting with a lawyer to make sure everything “works together” correctly.
We invite you to use the free Enjuris law firm directory to find a lawyer in North Carolina who’s experienced and skilled at handling Social Security disability benefits claims.
See our guide Choosing a personal injury attorney.