Understanding SSDI and SSI

Before you file for disability, it’s important to understand the two main types of disability benefits:

• SSDI: Social Security Disability Insurance is available for individuals who have worked and paid into the Social Security system for a certain number of years. You must have earned work credits based on your employment history.
• SSI: Supplemental Security Income is a need-based program available to individuals who have limited income and resources, regardless of their work history. SSI is for those who haven’t worked enough or at all to qualify for SSDI, or for people who have severe financial need.

Eligibility Requirements for SSDI

To qualify for SSDI, you must meet the following criteria:

• Work History: You must have earned enough work credits to qualify for SSDI. The number of credits required depends on your age at the time of disability. For example, individuals under 24 may need only 6 credits, while those older than 31 typically need at least 20 credits. Each year of work generally earns you 4 credits.
• Disability: You must be able to prove that your broken leg prevents you from doing any substantial gainful activity (SGA). The Social Security Administration (SSA) will consider how the injury impacts your ability to work. If you can’t perform your job or find a different type of work due to the injury, you may qualify for SSDI.
• Duration of Disability: Your broken leg must prevent you from working for at least 12 months or be expected to result in death. This means that for a broken leg to qualify for SSDI, it must be a long-term disability or one that significantly impacts your ability to work for an extended period of time.

Eligibility Requirements for SSI

If you don’t have enough work history to qualify for SSDI, you may still be eligible for SSI if you meet the following requirements:

• Income and Resources: SSI is based on financial need. If your income and resources are below the limit set by the SSA, you may qualify. Generally, individuals with less than $2,000 in resources (or $3,000 for couples) may qualify. Certain resources, like your primary home and car, may not count against this limit.
• Medical Condition: Just like SSDI, you must prove that your broken leg severely limits your ability to work and perform daily activities.

How to Apply for Disability for a Broken Leg

Follow these steps to apply for SSDI or SSI if you have a broken leg:

• Gather Medical Documentation: The most important part of your application is proving that your injury is severe enough to prevent you from working. You will need to collect:
• Doctor’s reports: Statements from your physician detailing the nature of your injury, the treatments you’ve received, and how the broken leg limits your ability to work.
• Hospital records: If you were hospitalized, include records of your treatment and recovery.
• X-rays and MRI results: Imaging reports that show the extent of your injury.
• Physical therapy or rehab records: If you are undergoing rehabilitation, include those records as well.
• Opinion from your healthcare provider: A statement from your doctor describing the long-term limitations of your injury, such as difficulty standing, walking, or using your leg.
• Complete the Application: You can apply for SSDI or SSI online through the Social Security Administration (SSA) website at www.ssa.gov, by phone at 1-800-772-1213, or in person at your local Social Security office. Be sure to:
• Provide accurate details about your injury, including how it prevents you from working.
• Be specific about how the broken leg affects your daily activities, such as walking, standing, or performing job-related tasks.
• Submit Required Documentation: Include all medical records, work history, and income information required by the SSA. This will help speed up the review process.

What Happens After You Apply?

Once you submit your application, the SSA will review your case. This process involves several steps:

• Initial Review: The SSA will look over your application and medical records. For a broken leg, they will evaluate how your condition prevents you from performing your usual work. This can take 3 to 5 months.
• Reconsideration: If your application is denied, you can request reconsideration, where another SSA representative reviews your case. This can take another 3 to 4 months.
• Hearing with an Administrative Law Judge (ALJ): If your reconsideration is denied, you can request a hearing with an ALJ. A hearing allows you to present your case in person. The wait for a hearing can take up to 12 to 18 months, depending on your location.
• Appeals Process: If your hearing is unsuccessful, you can appeal the decision to the Appeals Council and even to federal court if necessary.