SSI Eligibility & Appeals

Knowing your state’s SSI program

• The 2023 minimum monthly base rate is $914.
• Find current and past Federal Benefit Rate amounts on the SSI Federal Payment Amounts web page, published by SSA.
• Check how your state supplements the FBR in this SSA guide (PDF). Look for the topic “SSI payments and state services.”
• Find out if Medicaid is automatic with SSI in your state.

Establishing disability

• Disability is one part of the two-part SSI eligibility test.
• Adults must establish that they cannot work at the substantial gainful level.
• Children under age 18 must establish severe deficits in functional activities at school and at home.
• Both adults and children can establish disability or statutory blindness with medical evidence alone if they meet criteria for a listed impairment. See the Adult Listings or Childhood Listings.

Establishing financial eligibility

• Financial eligibility is one part of the two-part SSI eligibility test.
• Countable income and resources must be within SSI program limits.
• Other income, after subtracting income exclusions, gets subtracted from the SSI base rate (the Federal Benefit Rate plus any optional state supplement).
• SSI requires countable resource of no more than $2,000.
• For children under age 18, part of the parent(s)’ income and resource may be counted to determine SSI eligibility and payment amount.
• At age 18, the SSI program no longer counts any part of the parent(s)’ income and resources.

The medical Continuing Disability Review (CDR)

• The medical CDR is one of two medical reviews all SSI youth may face (the other is the Age-18 Redetermination).
• Most SSI recipients will face a medical CDR every 3 to 5 years.
• The reviewer will look at medical records and other relevant records (including educational records for a child under 18) to determine if there is medical improvement.
• Even if there is medical improvement, SSI will continue unless the improvement means the individual no longer meets the disability criteria.
• If the review results in benefits being terminated, a written notice goes to the recipient explaining their appeal rights.

The Age-18 Redetermination

• One of two medical reviews all SSI youth may face (the other is a medical CDR).
• At age 18, an SSI beneficiary will have a redetermination to determine if they meet the adult standard of disability.
• Unlike the medical CDR which looks for medical improvement, the Age-18 Redetermination is considered a new, initial determination.
• If the review results in benefits being terminated, a written notice goes to the beneficiary explaining their appeal rights.

Appealing an SSI denial or termination

• An appeal is available if a medical CDR or Age-18 Redetermination results in a termination of benefits.
• The SSI applicant or beneficiary will receive a denial or termination notice.
• The notice will explain how to appeal and the time limits for appealing (generally 60 days after getting the notice).
• The notice will explain how to request that SSI continues during the appeal and the time limits for making this request (generally 10 days after getting the notice).
• When the appeal goes to an Administrative Law Judge (ALJ), SSI can continue until the judge issues a written decision.