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SSA-16: Application for Social Security Disability Insurance (SSDI)

SSDI is an insurance program. Therefore, no information about living arrangement or resources is required. Instead, the SSDI application will ask questions about past earnings and entitlement to other benefits. People over 18 years of age who have worked and contributed to the Social Security Trust or others who became disabled before the age of 22 whose parent is deceased or receiving retirement or disability benefits may be eligible.

SSA-16: Application for SSDI

The SSA-16: Application for Social Security Disability Insurance (SSDI) can be completed online. Although SSA will accept paper applications, it strongly prefers the online version. A key advantage to the online application is that it provides a better “record trail” -- no need to worry whether SSA received the form. It also allows SSA staff to quickly verify information submitted and, if it meets insured status/eligibility standards, forward to DDS for a medical decision.

SOAR recommends that case managers use the paper form as a worksheet and then transfer the information to the online application when they are ready to submit the complete application packet. If you have all the information, it should only take about 10 to 15 minutes to complete.

In this article, we'll discuss the SSA-16 paper form to help you prepare to use this with applicants.

View a sample completed SSA-16 paper form here.

Completing the SSA-16

Questions 1-8: Demographic Information

This is a series of questions asking about the applicant’s name, date and place of birth, if a public or religious record of birth was made, and if the applicant previously used other names or Social Security numbers.

SSA may require the applicant to produce a copy of their birth certificate to verify their age. This is not required at the time of application, but may be needed prior to payment. If SSA has seen and recorded the birth certificate on a prior occasion it may not need to be presented again. Check with the local SSA office.

Question 9: When do you believe your conditions became severe enough to keep you from working (even if you have never worked)?

For this question we recommend using the applicant’s last date of work. SSA will examine all of the applicant’s prior employment to determine if any of the previous work attempts were unsuccessful (i.e.: the applicant was unable to sustain work for more than a few weeks or months due to disabling mental or physical health conditions).

  • This question will also come up on the SSA-8000 and SSA-3368. It is important to remain consistent across all forms with the date you provide, or it could delay processing at SSA.
  • For individuals who have never worked, such as youth exiting foster care, SSA’s guidance is to “enter the date when he or she believes the condition(s) became severe enough to keep him or her from working.” Since youth can work before age 18, you can enter dates prior to their 18th birthday if that is relevant.

Questions 10-13: Other Entitlements and Prior Marriages

These questions ask about pensions and annuities the applicant may be eligible for based on work with the railroad industry, employment in a foreign country, or private employer pension plans. Applicants may also be eligible for disability benefits based on their spouse’s earnings record, so SSA asks for details about all prior marriages.

Question 14: Children under the Age of 18

If the applicant’s claim for disability benefits is approved, their children (including adopted children, and stepchildren) or dependent grandchildren (including step-grandchildren) may be eligible for benefits based on the applicant’s earnings record.

SSA will ask for the full name of all children who are now or were in the past 12 months unmarried and:

  • Under age 18
  • Age 18 to 19 and attending elementary or secondary school full-time
  • Disabled (age 18 or over and disability began before age 22)

Questions 15-18: Other Earnings

Since SSDI is an insurance program, SSA will ask questions about past employment and earnings.

  • For question 15a, SSA asks if the applicant had wages or self-employment income covered under Social Security in all years from 1978 through last year. They are looking to see if the applicant held any jobs where Social Security taxes were not deducted or withheld. 

    • Some employers, such as state or federal government agencies, non-profits, and foreign employers, are not required by law to withhold or deduct FICA or OASDI taxes from an individual’s earnings. If this applies, check “no” on question 15a and provide details in 15b.
  • In question 16, SSA is looking for details about employment for the current and past year only. Employment prior to this will be listed on the SSA-3368 (question 6).
  • Questions 17-18 ask about self-employment and earnings in the prior and current year.  Answer these as appropriate.

Question 19: Ability to Work

Pay special attention to how this question is phrased. In 19a, it asks the applicant if they are still “unable to work” because of their conditions. In 19b, it asks about the date they became “able to work.” If the applicant is still unable to work, 19b can be left blank.

Question 20: Workers' Compensation

This question asks: are your illnesses, injuries, or conditions related to your work in any way? In this context, SSA is exploring the applicant’s eligibility for Workers' Compensation (i.e., was their condition caused by an injury at work?).

Note: Members of the military are not eligible for Workers' Compensation from injuries received during military service. Alternatively, they may be eligible for VA disability benefits.

Question 21: Blindness or Low Vision

This question asks if the applicant is blind or has low vision even with glasses or contacts.

Question 22: Intent to File for Other Benefits

SSA needs to know if the applicant intends to file for any other benefits. For SOAR, representatives assist with both SSI and SSDI applications, so the box for Supplemental Security Income should be checked. If the applicant served in the military, check the box for Veterans Administration Benefits and ensure that the applicant is connected with assistance for VA disability benefits. If the applicant is eligible for welfare in the state he or she resides, check that box as appropriate.

Questions 23-26: Payments from Employers and Dependents

These final questions on the SSA-16 ask about any money received from employers after the applicant became unable to work and if the applicant was supporting a child or parent when he or she became unable to work.

Remarks

In the remarks section of the SSA-16, document that this is a SOAR application. It may also be helpful to provide the SOAR representative’s contact information and note that the applicant is experiencing or at-risk for homelessness. If there are any other details related to the questions on this form, also provide that information here.

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    Type:
    SSA Forms
    Date:
    December, 2022

    Other Details