Social Security Disability Insurance (SSDI) is a program that is designed to provide financial assistance to those who have a disabling condition. But the criteria to qualify for this program can be confusing. For instance, are nursing home residents eligible for SSDI?
SSDI can be thought of as an insurance program that is earned. If the nursing home resident has a work history and meets the requirements that qualify them for SSDI benefits, then they are eligible for SSDI benefits.
Read below to learn more about how nursing home residents can be eligible for SSDI.
Can I Get SSDI While Living in a Nursing Home?
Depending on your situation, you may qualify for and receive benefits under Social Security Disability Insurance even if you are a resident of a nursing home. SSDI is a federal program designed to offer financial assistance to disabled individuals who have contributed through payroll taxes to the Social Security system.
Whether or not you are eligible to receive Social Security Disability Insurance benefits while living in a nursing home depends on several criteria and rules that govern SSDI.
Medical Criteria for SSDI
Disabled individuals must meet strict medical criteria established under the Social Security Act. To be eligible for Social Security Disability Insurance benefits, you need to have a serious medical condition that:
- makes it impossible for you to work or do anything else that would provide you with substantial gain;
- limits your ability to carry out previous job duties;
- prevents you from learning a new job skill; and
- is terminal or will last a year or longer.
Technical Criteria for SSDI
Benefits from Social Security Disability Insurance are earned. You can only receive Social Security benefits if you have worked long enough and recently enough at a job that requires you to pay Social Security taxes. This is how you can earn work credits toward SSDI. Depending on your age, you need to have earned a set amount of credits before you can apply for SSDI.
Your annual salary is used to calculate your work credits. Working and paying Social Security taxes allows a person to collect up to four credits annually, with one credit being awarded for every specific amount of money earned.
The minimum yearly salary required to receive one Social Security credit in 2023 is $1,640, with the highest yearly salary required to earn four credits set at $6,560.
But what is the minimum number of credits required? This will be determined by how old you were when you first experienced symptoms of a disability that meets the criteria. In general, you need 40 credits, 20 of which must have been obtained during the most recent 10 years, beginning with the year that your disability began.
Does SSDI Pay for Assisted Living?
Monthly SSDI benefits typically range from $800 to $1800, depending on the individual’s lifetime earnings average. Other disability payments, such as worker’s compensation or temporary state benefits, can lower the SSDI’s monthly income.
However, the amount of your SSDI compensation will not change if you receive SSI or VA benefits. Individuals receiving SSDI benefits have the same flexibility to spend the money on assisted living as they do with any other Social Security benefit.
How Does Living in a Nursing Home Affect Supplemental Security Income?
Living in a nursing home may reduce or terminate your Supplemental Security Income benefits; however, the type of facility you choose will decide the extent of any reduction or termination. What happens to your benefits, if any, depends on many factors, including how long you stay in a nursing home.
If you move into or out of a nursing home or other medical or skilled nursing facility, you are required by law to notify the Social Security Administration. If you get SSI benefits while living in a medical facility and fail to inform the SSA, you may lose those benefits and be responsible for repaying the SSA.
The majority of SSI recipients have their payments terminated or temporarily suspended when they enter a nursing facility. However, there are a few cases where this is not the case. Your benefits may be unaffected if your time spent in a nursing home is quite brief.
If you are staying in a public nursing facility for a longer amount of time and Medicaid is paying for it, then your SSI benefits may be terminated for the entire duration of your stay at the facility.
However, depending on the state in which you reside, you may be eligible for state disability payments in addition to your SSI, meaning that your monthly benefit may go up rather than decrease while you are a resident of a private nursing home for a lengthy period.
You should contact the Social Security Administration ahead of time to discuss your nursing home stay and benefits. This holds regardless of the ultimate decision that is made regarding your monthly SSI payments—whether they are terminated, paused, decreased, or supplemented with benefits from the state.
If your doctor certifies in writing to the SSA that you’ll be staying at a nursing home for less than 90 days, you won’t lose your SSI benefits because of it. You should also let the SSA know that you’ll need to continue receiving SSI payments after leaving the nursing home so that you can afford to live in your permanent home.
Temporary Institutionalization Benefits for SSI
The Social Security Administration refers to the benefits you are eligible for if you plan to stay in a nursing home for less than 90 days as “temporary institutionalization benefits.”
You may be eligible for temporary institutionalization benefits from the Social Security Administration if you and your doctor timely report your stay at a public hospital or Medicaid-certified nursing facility.
If, however, your stay exceeds 90 days, you must inform the Social Security Administration of your new plans or risk having your benefits terminated.
In conclusion, if you are currently residing in a nursing home, you may still qualify for Social Security Disability Insurance.
