Published on: August 14, 2023
In the United States, there are two primary federal programs that provide disability benefits to eligible individuals: Title 2 and Title 16 disability. These programs are administered by the Social Security Administration (SSA) and offer financial support to people who are unable to work due to a disability. While both programs share the common goal of assisting disabled individuals, they differ significantly in their eligibility criteria, funding sources, and the scope of benefits they provide.
Title 2 is referred to more commonly as Social Security Disability Insurance (SSDI or SSD) and Title 16 is called Supplemental Security Income (SSI).
Understanding all the individual features, eligibility requirements, and payment formulas of each of these programs can be challenging for people who don’t work with them every day. At Disability Experts of Florida, our entire staff is highly trained and has years of experience working with the different rules and regulations that apply to the Social Security Administration’s different disability benefits programs. If you need help determining if you are eligible for disability benefits or you want help filing a successful claim, contact us at disabilityexpertsfl.com or call 1 (855) 777-0455.
Title 2 Disability - Social Security Disability Insurance
Title 2 disability, also known as Social Security Disability Insurance (SSDI), is funded through the Social Security Trust Fund, which is primarily financed by payroll taxes paid by employees, employers, and self-employed individuals. To be eligible for SSDI benefits, a person must have a qualifying work history, meaning they must have paid a sufficient amount of Social Security taxes through their employment.
1). Eligibility Criteria:
To qualify for SSDI, you must have a disability that prevents them from engaging in substantial gainful activity (SGA) for at least 12 months or be expected to last for at least 12 months. Additionally, the individual must have earned enough work credits based on their age at the time of disability onset. Work credits are earned by paying Social Security taxes while employed.
2). Benefit Amount:
The monthly benefit amount for SSDI is based on the individual's average lifetime earnings covered by Social Security. Generally, the more a person has earned and paid into the system, the higher their benefit amount will be. However, there is a cap on how much any one individual can collect in disability benefits each month. In 2023, the top benefit amount any claimant can receive is S3,627.
The amount if each claimant’s monthly SSDI benefit is determined by indexing and averaging the 35 highest earning years in their working life. That Average Indexed Monthly Earnings (AIME) figure is run through a formula that produces your individual monthly benefit amount. The formula counts 90% of the first $1,115 of your AIME, 32% of the AIME amount above $1,115 and under $6,721, and 15% of any amount of your AIME over $6,721. The resulting dollar amount is rounded down to the next lowest $0.10 which will be your Primary Insurance Amount (PIA). This is your monthly SSDI benefit amount.
3). Medicare Eligibility:
Medicare is not included as a disability benefit under the SSDI program until the recipient of the benefits has waited two years. This is a major point of controversy and the subject of a campaign to eliminate the two-year Medicare waiting period. The purpose of the waiting period is to ensure that only long-term disabilities will be covered and to preserve the financial resources of the program. But the long waiting period may be a heavy burden for many SSDI recipients to endure. Other programs may be available, however, including Medicaid and other state-sponsored healthcare assistance programs.
Title 16 Disability - Supplemental Security Income (SSI):
Title 16 disability, also known as Supplemental Security Income (SSI), is funded through general tax revenues and not from Social Security payroll taxes. SSI is designed to provide financial assistance only to disabled individuals with limited income and resources, regardless of their work history.
- Eligibility Criteria: To qualify for SSI, an individual must have a qualifying disability, be at least 65 years old, or meet specific income and resource limitations. The income and resource thresholds vary from state to state but are generally lower than those of other assistance programs.
- Benefit Amount: The monthly SSI benefit is set by the federal government and may be supplemented by some states. Florida does provide supplements to SSI benefits for people living in community care programs (family care homes), assisted living facilities, or in Medicaid homes (facilities where Medicaid pays for more than 50% of the cost). The benefit amount is subject to change based on other sources of income and living arrangements.
- Medicaid Eligibility: SSI recipients automatically qualify for Medicaid, which provides crucial healthcare coverage for low-income individuals. In fact, Medicaid is extended to everyone who files an SSI claim. Medicaid benefits will continue if the SSI claim is approved. If the SSI claim is not approved, then Medicaid coverage will end, but the claimant does not need to reimburse Medicaid for any payment made on the claimant’s behalf while the claim was pending.
Differences in Scope
The primary distinction between Title 2 and Title 16 disability lies in their scope. SSDI is focused on providing benefits to disabled individuals who have a work history and paid Social Security taxes, whereas SSI aims to assist disabled individuals with limited income and resources, regardless of their work history.
Understanding the differences between these programs is essential for individuals seeking disability benefits, as the eligibility criteria, benefit amounts, and funding sources vary significantly.
Disability Experts of Florida are at your service if you need any information or you want to learn more about your eligibility for disability benefits. Or, if a family member may be eligible for disability benefits, we are eager to help you get them the financial support they need.