What You Need to Know: Social Security and Long-Term Disability Benefits
Long-term disability insurance can be a great safety net. But, what happens if you have long-term disability and you would also be qualified for Social Security disability benefits (SSDI)? Understanding how these benefits work together can help with your planning while you’re healthy and working, and ease the path toward securing payments if you become disabled.
Does Long-Term Disability Insurance Disqualify You for SSDI?
Many people are concerned that long-term disability will make them ineligible for SSDI or reduce the amount of benefits available. Social Security disability is not need-based, which means most other income has no impact on eligibility. The main exception is income earned from work, since that income may demonstrate that you’re still able to participate in substantial gainful activity.
Private long-term disability benefits will not impact SSDI eligibility or the amount of benefits received. However, certain other types of disability benefits may affect SSDI. For example, if you are receiving long-term disability through workers’ compensation, you may still qualify for Social Security disability. However, there is a cap on the combined amount of benefits you may receive. So, your SSDI payments may be reduced.
Supplemental Security Income (SSI) is different. SSI is need-based, and the income cut-off is low. In 2023, it’s just $934/month. So, depending on the amount, long-term disability could disqualify a disabled person from receiving SSI benefits. In fact, many SSDI applicants are disqualified from SSI based on their SSDI income.
Does SSDI Affect Long-Term Disability Benefits?
The short answer is that it depends on your policy. Typically, a long-term disability insurance carrier will require beneficiaries who are qualified for Social Security disability to apply for those benefits. In that case, failing to apply for SSDI could mean losing long-term disability benefits. If you are receiving or have become eligible for private long-term disability benefits, make sure you know whether your policy requires you to apply for SSDI and what the time limit is.
Many policies provide that benefits will be reduced by the amount of SSDI received. For example, if you are receiving $2,000/month in private long-term disability benefits and are approved for $800/month in SSDI, the long-term disability payments may drop to $1,200/month.
Talk to a Disability Benefits Advocate
At Disability Help Group, we know how daunting and confusing coordinating disability benefits can be. We’re here to help make sure you receive all of the benefits you’re entitled to, and get them as quickly as possible. To learn more about how we can help, contact or call us (800) 800-3332.
Tips for Getting Your Disability Benefits Approved Fast
Social Security disability benefits offer an important lifeline to people who are no longer able to work. But, the application and appeals process can be lengthy. The delay in receiving benefits can mean a rough transition for someone who has lost their source of income. While there’s no magic bullet for getting benefits quickly, there are some steps you can take to keep your application for disability benefits moving forward smoothly and speed up approval.
How to Apply for SSDI for the Quickest Response
Speeding up the Social Security disability benefits approval process starts with your application.
That includes:
Applying For Disability Benefits as Soon as You Become Disabled
For nearly all conditions, there’s a five-month waiting period. That means you don’t receive benefits until the sixth month after you become disabled. But, that doesn’t mean you should wait until the sixth month to apply. In 2021, the average processing time for an initial SSDI application was 147 days. That’s nearly five months, so get the ball rolling as soon as you have the necessary information.
Applying Online
The SSA says applying online can reduce the time it takes to receive a determination on your initial Social Security disability application.
Making Sure Your Disability Benefits Application is Complete
Missing information can mean delays or even a denial. The SSA offers a checklist of information you’ll need to apply, along with a worksheet to help you organize your work history and medical conditions. Take advantage of these tools to make sure your application is thorough. (And don’t be confused by the header that says these documents are for interview prep–the questions will be the same whether you apply online or live.)
Provide as Much Medical Information as Possible
SSA can help obtain medical records if necessary. But, the more information you include with the initial application, the more efficient the process.
Keep the SSDI Application Process Moving
Most initial applications are denied. A lot of Social Security disability applicants who are denied in the first round are later approved, so don’t get discouraged. But, don’t drag your feet, either. The sooner you move on to the next step in the process, the sooner you’ll get that next decision. And, there’s a deadline for each additional step. If you miss that, you may have to start from scratch, and that could delay the process by months.
A Social Security Disability Advocate Can Help
At Disability Help Group, we know it’s easy to get bogged down in the SSDI application and appeals process. Our team of caring, experienced advocates is here to help you navigate that process, avoid unnecessary delays, and improve your chances of approval. To learn more, call (800) 800-3332 right now, or fill out the contact form on this site.
How Long Does it Take to Get Social Security Disability Benefits?
According to the Social Security Administration (SSA), the average processing time for a new Social Security Disability (SSDI) application is three to six months. But, the average processing time varies from state to state. And, that estimate can be a bit misleading. That’s the average time SSA says you should expect to wait for an initial determination. But, a significant percentage of applications are denied at this stage. Working your way through the process of reconsideration and appeals can take much longer.
Fortunately, there are some things you can do to speed up the initial application process and increase your chances of being approved earlier in the process.
Expediting Your SSDI Application
SSA doesn’t offer an expedited process for disability benefits, but you can take steps to make the process as efficient as possible. First, SSA says you can cut your processing time in half if you apply online.
Ensuring that your SSDI application is complete, you’ve provided all necessary documentation, and your medical providers promptly share necessary information can also help move the process forward. A Social Security Disability Benefits Advocate can be your best source of assistance in putting together a clear and complete application to give you the best chance of approval.
What if the Initial SSDI Application is Denied?
If your initial SSDI application is denied, the next step in most states is a request for reconsideration. This step is usually quicker than the initial application, but the success rate is low. The highest rate of approval occurs at the next stage: a hearing before an administrative law judge (ALJ). However, it can take more than a year to get a hearing before an ALJ, and then several months to receive your determination. Those who are denied at this stage may require an additional step, or even two, to complete the process.
In short, a claim for Social Security disability benefits may be approved in just a few months, and you may begin receiving benefits as soon as six months after you become disabled. But, most SSDI application claims are denied in the initial rounds, meaning that many who apply for disability benefits don’t start receiving benefits for two years or more.
A Social Security Disability Advocate Can Help
Your best chance of receiving Social Security disability benefits as quickly as possible is to ensure that you avoid missteps in the process, don’t miss any appeal deadlines, and provide complete documentation to the SSA in a format that is easy to work with.
The process can be daunting. At Disability Help Group, we understand the process, and we understand the stress you’re under and how important it is for you to receive your disability benefits. To learn more about how we can help, call (800) 800-2009 or contact us right now.
Can I get TDIU for PTSD? Yes. TDIU is a special benefit for veterans who cannot support themselves due to service-connected disabilities. It pays the same as a 100% rated disability. For TDIU to apply, your PTSD must first be service-connected. This may seem simple, but several veterans have PTSD because of a traumatic event that happened years after military service. Second, you cannot earn a living because of PTSD.
TDIU for PTSD Requirements
In order to be granted TDIU for PTSD is does not mean the veteran has to be unemployed. VA will grant TDIU to an employed veteran if the employment is considered marginal. VA deems employment marginal if the veteran earns LESS than the federal poverty threshold for one person (in 2018, $12,784.00 per the U.S. Census Bureau).
Rating Percentage
The veteran must meet the percentage requirements. If the veteran has only one service-connected disability, it must be rated 60% or higher. The Schedule of Ratings for PTSD permits only the following ratings: 0%, 10%, 30%, 50%, 70% and 100%.
Services Connected Disabilities
If the veteran is only service-connected for PTSD, it must be rated no lower than 70% to get TDIU. However, if the veteran has more than one service-connected disability, then at least one must be rated 40% or higher. Also, there must be “sufficient additional disability to bring the combined rating” to 70% or higher.
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Disability Help Group Case Studies
Case Study 1: TDIU for PTSD
A 60 year-old veteran was diagnosed with PTSD secondary to his service-connected hypertension. VA previously awarded 10% for his hypertension. In March 2018, the Board of Veterans’ Appeals denied his PTSD claim. After a successful appeal, DHG secured a remand for a new VA medical examination. In November 2019, VA granted service connection for PTSD at 70% effective September 2009. Because the evidence showed that his PTSD prevented him from working, VA also granted entitlement to TDIU. He received a lump sum of $340,000.00, and his monthly payment changed from $133.57 to $3,057.13.
Case Study 2: TDIU for PTSD
A 65 year-old veteran asked VA for a higher rating for his PTSD. At the time, he was service-connected for tension headaches at 50% and PTSD at 50%. His combined rating was 80% and he had not worked since 2012. After a successful appeal, VA granted TDIU back to 2012. As a result, he received a lump sum of $121,000.00, and his monthly payment changed from $1,556.13 to $3,057.13.
Case Study 3: TDIU for PTSD
A 65 year-old veteran had a 50% rating for anxiety with PTSD and a 10% rating for a lumbar spine condition. Shortly after he hired Disability Help Group, it was clear that VA should have granted at least a 70% rating for anxiety with PTSD. After a successful appeal, VA granted a 70% rating for PTSD and then granted TDIU. He received a lump sum of $109,000.00, and his monthly payment changed from $1,062.27 to $3,057.13.
While most of this article refers to PTSD, it also applies to other mental disorders. For example, many of our clients have won TDIU based on their service-connected schizophrenia.
What is VA Permanent and Total Disability? The Department of Veterans Affairs (VA) offers 2 disability benefit programs: 1) Compensation; and 2) Pension. Both disability programs provide monthly payments to disabled veterans. There is a major difference in the programs.
VA Pension Total and Permanent
VA Pension is a needs-based program similar to Social Security’s Supplemental Security Income (SSI). Similarly to SSI, to be eligible for pension benefits, a veteran must have wartime service, low income, and a Permanent and Total disability. The Permanent and Total disability does not need to be “connected” to the period of military service. Disabled veterans aged 65 years or older can receive Permanent and Total disability for pension. For further information on Permanent and Total disability you can read our blog, How Can I Get TDIU.
VA Compensation Total and Permanent
VA Compensation is not based on need, income or age. It pays a veteran for disabilities incurred in or aggravated during their active duty service. The monthly payment depend on how much the veteran’s ability to work is impacted.
Eligibility for VA Permanent and Total Disability
A veteran can be eligible for both Pension and Compensation. Generally, Compensation will pay more money per month than Pension. Many veterans seek Permanent & Total disability for Compensation purposes instead of Pension because it pays more money.
Can You Receive Total Disability without Permanent Disability?
VA will award Permanent and Total disability to veterans whose disabilities are rated 100% with a very low likelihood of improvement. Although the terms “Permanent” and “Total” are often discussed together, it is possible to have a permanent disability that is not totally disabling. For example, a veteran may have a PTSD permanent disability at 70%. The PTSD is not “Total” because it is less than 100%.
It is possible to have a total disability that is not permanent. For example, the same veteran’s PTSD may be temporary at 100% during hospitalization for a suicide attempt. To learn more about TDIU and PTSD you can read our posts, Can I get TDIU from PTSD? or VA Permanent and Total Disability for PTSD.
General Rule
Generally, VA will award a Permanent & Total designation
if the following criteria are met:
The veteran has a disability rated at 100%, and
Medical evidence shows that this disability is
not likely to improve during the veteran’s lifetime.
Medical Evidence
Your treating doctor can provide the best medical evidence to prove entitlement to Permanent and Total Disability. Ask your doctor whether your 100% disability is likely to improve during your lifetime. If the answer is no. Ask your doctor to put this opinion in writing. VA will most likely defer to your doctor’s opinion and award Permanent and Total disability.
Exception to the Rule
As with most rules, there are exceptions. Regardless of the percentage, VA will deem certain disabilities Permanent & Total. Examples include the loss or loss of use of both hands, both feet, or sight in both eyes. In addition, VA would probably award Special Monthly Compensation.
Case Studies
The following DHG clients received a Permanent & Total disability rating.
PTSD Permanent and Total Disability
A 50 year-old Gulf War combat veteran filed a claim for PTSD in 2009. In 2010, he was denied despite the Combat Action Ribbon noted on his DD Form 214. After significant development, we won the case on appeal. The medical evidence proved that he met the criteria for a 100% rating. His symptoms included unprovoked irritability with periods of violence, impaired impulse control, audio hallucinations, and panic attacks. They were so severe that he could not hold a job. In addition, his doctor wrote that his symptoms would only get worse throughout his lifetime. VA awarded a Permanent and Total disability for PTSD. You can also work and get TDIU, if you are working you may want to read our post, Can I Work and Get TDIU?
Schizoaffective Disorder
A 57 year-old Air Force veteran lost his wife to a deadly car accident. This happened 3 months into his active duty service. He was never the same after that accident. He was diagnosed with schizoaffective disorder, depressive type. Unfortunately, he turned to drugs and alcohol to self-medicate his symptoms. He was homeless for many years. When he filed a compensation claim, VA branded him a drug addict. At the local VA hospital, he met another veteran who referred him to us. We developed medical evidence, a lay statement from the veteran, and legal arguments. Our represtative also submitted a medical opinion from a private psychiatrist, who recommended a total and permanent rating based on the medical evidence. Shortly afterwards, VA awarded a Permanent and Total disability rating for schizoaffective disorder
Call for a Free Case Review
When VA awards a Permanent and Total disability rating your rating is protected for the rest of your life. Are you eligible for Permanent & Total disability.
For a FREE CASE REVIEW, Call 800-800-3332 or click here.
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How Can I Increase My VA Disability Rating? When discussing VA Disability rates, one must distinguish between the Compensation and Pension rates. Both involve monthly payments from VA, but they have very different requirements. Pension is a needs-based program similar to Supplemental Security Income (SSI). VA will grant pension benefits to veterans with wartime service, low income, and total and permanent disability. The total and permanent disability does not need to be “connected” to their military service.
Maximum VA Pension
VA Pension rates are based on income. The maximum pension rate is an annual amount set by Congress. A veteran’s pension is determined by how much income his family generates.
VA Compensation Rating
VA Compensation is NOT based on need or income. It pays a veteran for disabilities incurred in or aggravated during their active duty service. A veteran may not receive both pension and compensation at the same time. Compensation is generally paid at a much higher rate, most veterans opt for compensation. The following will focus on disability compensation rates.
Increase VA Disability Rating, Schedule of Ratings
Congress directed VA to, “adopt and apply a schedule of ratings of reductions in earning capacity from specific injuries or combination of injuries.” In other words, a veteran’s disability rating must reflect how much that disability impairs the veteran’s ability to work. VA law also requires that the Schedule of Ratings “provide 10 grades of disability and no more.” Under the schedule, VA assigns disability ratings of: 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, and 100%. The higher the disability rating, the higher the monthly compensation VA will pay to the veteran.
Why VA Ratings Differ
Some medical conditions are more disabling than others. How does VA figure out the right disability rating? The Schedule of Ratings breaks down disabilities into different categories based on the affected part of the body. Each category contains groups of medical problems. Each group contains a list of disabilities, and each disability has its own diagnostic code. Every diagnostic code specifies the symptoms required for various ratings. For example, many veterans suffer from a hearing loss disability known as tinnitus. In-service exposure to loud noise – such as on the deck of an aircraft carrier – is a common cause of tinnitus. Under the Disease of the Ear category, tinnitus has the 6260 diagnostic code. Under code 6260, the maximum disability rating is 10%. The rating is the same whether tinnitus affects one or both ears.
VA Diagnostic Codes and Ratings
Understand the VA diagnostic codes to increase your VA disability rating. Not every diagnostic code is as simple as 6260. For example, the 9411 code applies to post-traumatic stress disorder (PTSD). Depending on the symptoms, a veteran may receive either 0%, 10%, 30%, 50%, 70% or 100%. A 100% rating for PTSD reflects total impairment of occupational and social skills. Symptoms in the 100% range include persistent suicide attempts. However, a veteran with very mild PTSD controlled by medication will probably receive 10%. VA is bound by the diagnostic code criteria. If your service-connected disability satisfies the criteria for a higher rating, then VA must grant that rating.
Disability Help Group VA Team
We have helped thousands of veterans win higher VA disability ratings. One veteran in particular came to us with a 50% rating for his PTSD. During development, we discovered that he had more than 10 psychiatric hospitalizations within the past 5 years. He was involuntarily hospitalized under the Baker Act. He required 300 mg of Lithium twice daily to simply maintain a baseline of suicidal ideations. After several years of our advocacy, VA agreed to assign a 100% rating all the way back to his first hospitalization. Thanks to our work, VA paid him a lump-sum of over $200,000.00.
Increase Your VA Disability to 100%
The maximum VA rating permitted by law is 100%. If you have one disability at 70% and another disability at 50% ? Does that mean you really have a 120% overall rating? No. To avoid exceeding the 100% cap, VA uses a Combined Ratings table. A rating is not added to another rating to determine the VA rating. The VA uses the Combined Ratings table to determine the rating VA first considers the most disabling condition – that is, the one with the highest rating – then less disabling conditions in order of severity. This method captures the residual efficiency of a veteran with more than one service-connected condition. The formula will never result in a rating higher than 100%.
Combined VA Rating
If the combined value ends in a number from 5 through 9, VA rounds up to the next highest multiple of 10. When the combined value ends in 1 through 4, VA rounds down to the lower multiple of 10. If the combined value ends in 0, then rounding is unnecessary. For example, a veteran with 70% and 50% rating has a combined value of 85%. An 85% value rounds up to a 90% combined rating. A veteran with a combined value of 84%, rounds down to 80%. A veteran with two separate disabilities rated at 10% each has a combined value of 19%, which rounds up to a 20% combined rating.
