SSDI is the lifeline for the many who cannot work because they have a severe medical condition.  It is a federal program, run by SSA, paying financial aid on an eligibility basis for the recipients.  Most times, the queries made between recipients are that if the health turns worse, will the amount of SSDI increase?

No, in most cases your poor health doesn’t increase what you will be receiving from SSDI. In fact, your benefit for SSDI is based off of your history of work not the severity of your condition. Although the SSA might take into account your poor health in other areas, like whether you should be granted additional eligibility or be given permission to enter some other extra programs, this usually does not affect the quantity of money that you would receive on a monthly basis from your benefits.

This blog will break down the critical elements of SSDI payments, factors that can influence the amounts of benefits received, and whether or not your worsening health may result in increasing SSDI.

How Are SSDI Payments Calculated?

To understand why worsening health doesn’t typically lead to an increase in SSDI benefits, one must first understand how these benefits calculate.

SSDI pays based on your lifetime average earnings before you become disabled. The SSA calculates monthly benefit using a formula referred to as the Primary Insurance Amount, or PIA. Your monthly benefit is equal to your covered earnings that is, your wages or self employment income subject to Social Security taxes. The amount of SSDI paid depends on a lot of factors like work history, age, and level of income.

So, what does this mean for you? Bottom line

Your award from SSDI is determined at a point in time based on your earnings record, so deteriorating your medical condition will not change it.

The SSA is not going to change and reassess your payments unless this is an across the board COLA based on deterioration of the underlying condition.

What If My Condition Gets Worse?

Does the quantity of SSDI grow if health worsens?

The bad news is that the SSDI program has no basis to adjust its benefit amount upwards as your disability gets worse after you are qualified. Once you have qualified for SSDI, then your benefit amount is frozen in place unless:

Your sickness becomes so poor that it disqualifies you for SSI or other claims of disability.

For example, here are the ways that the progression of your illness may impact your benefits but not necessarily in the form of an increase in SSDI.

Cost of Living Adjustments (COLA)

If you get so ill that you don’t receive your SSDI and recover somewhat, you probably would find your payments increase probably every year. However, these increases are not based on your current condition but rather tied to COLA offered by SSA as a measure of inflationary cost. This simply means that all those on SSDI have their benefits adjusted because of inflation in any event, irrespective of changes in your condition.

For example, SSDI recipients were awarded an 8.7% COLA increase in 2023 because inflation was already at too high of a level. These increases bring some comfort to the rising prices, but it has nothing to do with how your disability is progressing.

2. Eligibility for Additional Benefits

If your condition has severely worsened, then you would qualify for other programs that could complement this income. They would not complement the SSDI payments per se but could certainly complement with regard to additional financial and medical support. For example

3. Classification into a Compassionate Allowance Condition

If you suddenly turn for the worse and find yourself with a brand new, far worse condition, you may qualify for fast-track approval through the SSA’s CAL. It would seem the purpose of the CAL is to accelerate disability approval rather than increase the award amount once you’ve received an okay.

What If You Can’t Work at All?

If your health declines to the point where you can’t work or engage in any substantial gainful activity (SGA), you should note that your SSDI status is unlikely to change because SSDI already serves individuals who cannot work.

The SSA will periodically check whether a beneficiary continues to meet the definition of disability. That is, if your condition deteriorates, this will probably become one reason why your claim should be approved; but as explained above this will not increase your monthly SSDI. This is just a check so you remain eligible for the program.

Three Common Myths about Increased SSDI When Medical Conditions Change

Many SSDI recipients believe that the amounts paid for their benefits increase in correlation with the worsening of their disease. That is not so; other benefits, like workers’ compensation or private disability insurance, increase the award for a worse injury or illness. Not so with SSDI.

• 1. Earnings-Based Model: The SSDI pays benefits based on the earnings record instead of the level of disability. Ill health does not alter your previous earnings record. Therefore, your benefit amount will not change.

• 2. No Graded System: Unlike private insurance for disability, the SSDI does not have a graded system whereby increments in payments directly relate to the extent of disability.

• 3. Fixed Monthly Payment: In a word, you receive a fixed monthly payment for your SSDI, which only adjusts due to COLA or other nontrade-home changes outside your control, like a change in family status where you get benefits for your dependents.

If the health worsens and the money from SSDI is not enough to live off of, you may have to make the following for extra money.

Types	Description
Apply for Supplemental Security Income (SSI)	SSI may offer some additional support, depending on making less than sufficient income and having resources.
Look for Other Benefits	State and local programs offer many different types of financial assistance for disabled individuals.
Advocate with a Disability Attorney	An attorney who is an expert in Social Security disability will walk you through the process, including all possible assistance available to you.
Consider a Trial Work Period (TWP)	If you can work even marginally, you may qualify for a TWP, whereby you can attempt to work and retain benefits without worrying about losing any of them.

Conclusion

In a nutshell, no, your SSDI does not increase with your deteriorating health. This is because your SSDI benefit is based on your working life-earnings history, and you cannot have a worse earnings history than you currently have, so that will not increase your payments. Exceptions consist of cost-of-living adjustments or qualify for other programs, like SSI, which increase their payment amount. The SSDI program, however, does not have payments that rise based on worsening medical conditions.

If your disability has left you broke, there are other options of aid or possibly a professional you can discuss it with. The SSA cannot raise your SSDI benefits, but there are so many resources available to help navigate the challenges that come with a disabling condition.

So, weak human, the next time you think that your weak health makes bureaucracy seem as pliable as it does, forget it because you cannot bend SSDI, which carves itself in stone, to your will with any amount of wishful thinking. Do not worry, though, since there are still other programs keeping your fragile existence afloat!

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