Types of Claims

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Obtaining Social Security benefits based on a disability starts with the filing of an application. Some individuals may qualify for SSI or disability insurance benefits (DIB), and in some cases, both programs. Each program provides a medical insurance coverage; with SSI – Medi-Cal coverage is available; with DIB entitlement, coverage under Medicare is available, but only after 24 months of DIB eligibility.

Each program has a common requirement – establishing a medical impairment, or combination of impairments, which result in functional limitations which preclude the ability to perform any work on a sustained basis. Each program (SSI and DIB) also has a second prong of eligibility:

  • SSI: Meeting the (lack of) resources test
  • DIB: Having worked recently and long enough to be fully insured for this benefit (20 quarters of the 40 quarters before the onset of disability.

Eligibility for benefits is linked to the protected filing date. For SSI benefits, entitlement to benefits begins the first day of the month AFTER the application is filed. For DIB, entitlement may begin as early as 12 months BEFORE the filing of an application IF the five month waiting period has been completed (onset at least 17 months before the application is filed)