Medicare and SSDI Benefits

Medicare card on top of a Social Security card

Medicare and SSDI Benefits

Veterans who receive VA disability compensation are also able to collect Social Security disability insurance (SSDI) benefits. However, it is not a guarantee that all disabled veterans qualify for SSDI, as Social Security’s requirements differ from the VA’s.

What Is SSDI?

Social Security disability insurance (SSDI) is a benefits program maintained by the Social Security Administration (SSA). The program receives funding through federal payroll tax and benefits disabled workers.

If I Qualify for VA Disability do I Automatically Qualify for SSDI?

This is a common misconception. Veterans who receive VA disability compensation will not automatically qualify for Social Security disability benefits. This is because of some major differences between how the SSA and the VA determine who qualifies for benefits.

VA Disability Benefits Requirements

To receive VA disability compensation you must have served and have a current disability or illness that impacts your mind or body. In addition to this, your disability must be service connected, meaning

– You became injured or disabled during your time serving

– You had an injury or disability prior to joining the military and your time serving made your condition worse.

– OR, you have a service connected injury that did not become apparent until after your service ended.

If you meet these requirements, the VA will then document and review your injury or illness. Based on the severity of your condition, you will receive a rating of 10%-100%. The rating you receive determines the amount you will earn in disability compensation.

SSDI Benefits Requirements

Social Security has their own requirements an applicant must adhere to in order to qualify for SSDI. To receive Social Security disability benefits you must meet Social Security’s definition of disabled. To do this, you must have proof of a medical condition that the SSA finds disabling. The listing of conditions that Social Security considers to be disabled can be found in their Blue Book. You must also be unable to work due to your condition or working and earning less than $1,350 per month.

In addition to this you must have sufficient work credits. The SSA requires that you have worked at least five out of the last ten years, and paid payroll tax during this time.

See: How long do I need to have worked in order to qualify for SSDI?

How Could I Lose Medicare Coverage?

Once you no longer qualify for SSDI, you could lose your Medicare coverage. The SSA does periodical checks on beneficiaries to see if they are still eligible for disability benefits. Factors that can make a person ineligible for SSDI could be an improvement in their condition, or an increase in earned income. Any change to a person’s situation that does not meet the SSDI qualifying criteria could result in a loss of benefits, and therefore a loss of Medicare coverage. 

See: What are the SSDI qualification requirements?

However, there are some instances where you can begin working again without risking losing your benefits. The SSA offers a trial work period to beneficiaries. This program was created to encourage disabled individuals to return to work.  With the trial work period, you can return to a job and even earn over the SSDI income limit for nine months. At the end of the period, if you are able to maintain an income above the required limit, you will lose your SSDI benefits- But you may be able to keep Medicare coverage. 

Even if you are no longer receiving SSDI, if you have a qualifying disability, you are able to continue to receive Medicare for 93 consecutive months. Once this time ends you are able to keep Medicare, at a cost, or wait until you turn 65 and then begin to receive it again. 

Not Currently Receiving Benefits?

If you are not currently receiving SSDI benefits, or if you need to appeal a denied claim, consider contacting a disability attorney. An attorney will be able to answer any questions you may have about Social Security disability benefits and guide you through the claims process. Studies have shown that those who choose to hire legal representation for their SSDI claims are three times more likely to win benefits than those who do not

Victory Disability is a nationwide law firm. We specialize in helping disabled workers get the benefits that they have earned and deserve. To see if we can assist you, take our free evaluation by clicking here.