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When you’re approved for Social Security Disability Insurance (SSDI), your monthly benefit is based on your average lifetime earnings before your disability began. It’s not tied to how severe your condition is—and that means your benefit amount typically doesn’t increase if your health gets worse.
Here’s what you should know if you’re experiencing a decline in your health while receiving SSDI benefits:
1. Your Monthly Benefit Is Set
Your SSDI payment is calculated based on your past earnings and is set at the time you’re approved. Even if your condition worsens, that figure generally remains the same. The only common increases come from cost-of-living adjustments (COLAs), which are applied annually to help benefits keep pace with inflation.
2. You Might Qualify for Other Benefits
If your health takes a serious turn and you face financial hardship, you may be eligible for additional support, including:
- Supplemental Security Income (SSI): Available to individuals with limited income and resources.
- Medicaid or Other State-Based Aid: Especially if your worsening condition leads to higher medical costs or reduced access to care.
- Assistance Programs for Housing, Food, or Caregiving: Availability and eligibility criteria vary program to program.
3. Worsening Health May Affect Your Case Reviews
The Social Security Administration (SSA) periodically reviews disability cases to determine if recipients still meet the criteria for benefits. If your health has declined, that may reduce the likelihood of your benefits being discontinued. However, SSA does not increase your payment just because your condition has become more severe.
How Often Social Security Reviews Disability Cases
SSA schedules Continuing Disability Reviews at different intervals based on how likely your condition is to improve:
- Medical Improvement Expected: every 6–18 months
- Medical Improvement Possible: every 3 years
- Medical Improvement Not Expected: every 5–7 years
If your health has worsened, you’re often placed in the “not expected” category, meaning reviews occur less frequently.
How to Prove Your Health Has Worsened
If you’re preparing for a review or appeal, strong medical documentation makes a major difference. Include:
- Recent test results and imaging showing progression,
- Specialist or doctor notes describing worsening function,
- Hospital or surgery reports,
- Medication lists showing increased dosages, and
- Doctor statements explaining your current limitations.
Keep records in date order, newest first, to help reviewers see your decline clearly.
4. Dependents May Affect the Total Benefit
If your family situation changes—for example, if you become responsible for a child or dependent—you may be able to claim additional benefits on their behalf. While this doesn’t raise your individual check, it can increase the total your household receives.
Dependents, Family Maximum, and Adding a Dependent
Qualifying family members may receive auxiliary (dependent) benefits based on your SSDI record, including:
- A spouse age 62+ or caring for your child under 16,
- Unmarried children under 18 (or up to 19 if still in high school), and
- Adult disabled children whose disability began before age 22.
The total amount your family can receive can’t exceed the family maximum, usually 150–180% of your primary benefit. If new dependents are added, everyone’s portion may be adjusted to stay within this limit.
How to Add a New Dependent
To add a dependent, provide SSA with:
- Proof of relationship (birth or marriage certificate),
- The dependent’s Social Security number, and
- Any dependency documents SSA requests.
Report new dependents by phone, in person, or online via My Social Security. Once approved, your household’s monthly total may rise, though your individual check stays the same.
Have Questions About SSDI?
If you’re unsure how your changing health might affect your Social Security Disability benefits, or if you’re having trouble with your claim, it’s okay to ask for help. The Ortiz Law Firm helps people nationwide with Social Security Disability claims and appeals. Contact us today to learn more about how we can support your case.
