Social Security Disability Insurance Qualifies You for Medicare

Meet Social Security Disability Insurance Requirements

A medical professional needs to verify that you are disabled before you can qualify for SSDI benefits. Huntstock/DisabilityImages/Getty Images

There are three requirements you must meet before you can be considered for benefits through the Social Security Disability Insurance (SSDI) program.

First, you must have been employed in a job that contributed to Social Security taxes. Any job where you worked "under the table" is not going to count. 

Second, you must have a medical disability, mental or physical, that is expected to last for at least one year. The Social Security Administration will request medical records in addition to supportive documentation from your doctor as proof of disability.

Third, the medical disability must be severe enough to affect your ability to work in your current or past jobs. Ability to work in some capacity based on your age, education and skill level will likely result in a denied claim for SSDI.

If you meet these criteria, you can get ready to apply for SSDI.

Gather Information to Support Your Disability Claim

Applying for benefits from a government program has its many layers. Do not be intimidated. Mazen Rizk/EyeEm/Getty Images

Before you apply for SSDI, you need to gather information. This will help you to accurately complete your application. Here is what you need on hand.

  1. Copies of your medical records relating to the disability
  2. Copies of Worker's Compensation documents, if applicable
  3. List of your medical conditions
  4. List of your medications
  5. List of medical tests relating to the disability with dates of service
  6. List of doctors and other health care professionals who have treated you over the past 12 months with dates of service, office addresses and office phone numbers
  7. Signed medical release form to allow your medical records to be sent to the Social Security Administration
  8. Job history over the past 15 years with description of job duties
  9. Names and birth dates of your spouse(s), past and present
  10. Names and birth dates of minor children
  11. Dates of marriages and divorces
  12. Bank information for your future Social Security checks, if approved for disability
  13. Contact information including name, address and phone number for someone who knows and supports you as a reference

Complete Your SSDI Application

Learn how to apply SSDI benefits. Courtney Keating/E+/Getty Images

Once you gather up your information, you can officially apply for SSDI benefits. This can be done in three ways.

  1. In person. Visit your local Social Security office and fill out an application face to face with a Social Security representative.
  2. On the phone. Complete your application on the phone at 1-800-772-1213. Social Security representatives are available Monday through Friday 7 a.m. to 7 p.m. Eastern Standard Time to assist you.
  3. Online. Applications are available on the Social Security web site. You can save your application as you go and complete it at your convenience.

The application process takes time, averaging one to two hours depending on the complexity of your case. Be sure to set aside enough time to complete your application properly.

Appeal a SSDI Denial

A judge may review your Social Security disability claim. Robert Daly/Caiaimage/Getty Images

It may take the Social Security Administration three to five months to approve or deny your application, shorter if your medical condition is listed on the list of Compassionate Allowance Conditions.

If your application was denied for any reason, you may choose to appeal the decision. In 2010, 23.6 percent of workers applying for SSDI were approved on their initial application, 6.3 percent on reconsideration and 66.8 percent on hearing with an administrative law judge.

There are four levels to the appeals process. If at any level your case is approved, the appeals process stops there.

  1. Reconsideration. In this case, your application will be reviewed a second time by a new set of individuals at the state agency.
  2. Hearing with an administrative law judge. A judge who was not involved in your prior case reviews will examine your case. You may bring witnesses to the hearing to add testimony on your behalf. Hearings are usually in person but can also be conducted on the phone if necessary.
  3. Review by the Social Security Appeals Council. The Appeals Council decides whether or not to hear your case after reviewing results from your hearing. They may review the case themselves or send it back for a hearing with a second administrative law judge.
  4. Federal court review. The last resort is to file a lawsuit with the federal district court.


Annual Statistical Report on the Social Security Disability Insurance Program, 2011 - Outcomes of Applications for Disability Benefits. Social Security Administration. Accessed June 26, 2015.

Become Eligible for Medicare

SSDI and Medicare eligibility
You become eligible for Medicare on your 25th month of SSDI. Morsa Images / DigitalVision / Getty Images

Once you are approved for SSDI, you are on the path to Medicare coverage. As long as your SSDI is not taken away for any reason, you will automatically be enrolled in Medicare Parts A and B on your 25th month of consecutive SSDI benefits. Your premiums will be directly deducted from your SSDI benefit check. You will have to apply for a Medicare Part D plan on your own.

Think carefully before you make any decisions to decline Medicare in lieu of other health coverage, i.e. an Obamacare plan. You cannot have an Obamacare plan at the same time you are on Medicare but if you refuse Medicare Part A, you will lose Social Security benefits of any type, including your SSDI. This could have long-term financial ramifications.

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