Ehlers-Danlos Syndrome Benefits in Idaho

To qualify for Social Security Disability Insurance (SSDI), you must have a disability that prevents you from working for at least 12 months and meet work credit requirements. For Supplemental Security Income (SSI), you must have limited income and resources, and your disability must meet Social Security’s definition. Ehlers-Danlos Syndrome (EDS) can qualify if it causes severe, ongoing limitations in daily activities and work. The Social Security Administration (SSA) reviews medical evidence, including doctor reports and test results, to decide if your condition meets their criteria for disability.

• Must have a medically documented disability that is expected to last at least 12 months or result in death.
• Must be unable to do substantial gainful activity (SGA). In 2025, SGA is $1,620/month for most people, or $2,700 if blind.
• Must meet non-disability requirements (work credits for SSDI, income/resource limits for SSI).

[Source: SSA.gov, 2025](https://www.ssa.gov/benefits/disability/qualify.html, accessed 2025-11-05)

In Idaho, eligibility for disability benefits depends on both federal rules and state-specific programs. For Medicaid, you must be financially eligible and meet the level of care for people with developmental disabilities (DD). EDS may qualify if it is chronic, appeared before age 22, and causes significant functional limitations in at least three major life activities (like self-care, learning, mobility, or independent living). Idaho’s Medicaid DD program requires a diagnosis of intellectual disability, cerebral palsy, epilepsy, autism, or another condition with similar treatment needs. If EDS causes severe, lifelong limitations, you may qualify for Medicaid waivers and support services.

• Must be determined financially eligible for Medicaid.
• Must meet ICF/IID level of care (chronic, onset before age 22, significant functional limitations).
• Must need a combination of special, interdisciplinary, or generic care.

[Source: Idaho Health and Welfare, 2025](https://healthandwelfare.idaho.gov/services-programs/medicaid-health/apply-adult-developmental-disabilities-programs, accessed 2025-11-05)

• Gather medical records and proof of income.
• Apply for SSDI or SSI online at SSA.gov or at a local Social Security office.
• If applying for Medicaid, complete a Medicaid application and then a DD program assessment.
• Report any changes in income or health to avoid overpayments.
• Consider applying for an ABLE account for extra savings.

• Step 1: Collect all medical records, including doctor reports, test results, and treatment history for Ehlers-Danlos Syndrome.
• Step 2: Apply for SSDI or SSI online at SSA.gov, by phone, or in person at a Social Security office. You will need to provide personal information, work history, and medical evidence.
• Step 3: If approved for SSDI or SSI, you may automatically qualify for Medicaid. If not, apply for Medicaid through Idaho Health and Welfare. Complete the Medicaid application and be determined financially eligible.
• Step 4: If you need Medicaid waiver services, complete an application and assessment for the Adult with Developmental Disabilities (DD) program. This will determine if you meet the ICF/IID level of care.
• Step 5: Report any changes in income, work, or health to Social Security and Idaho Health and Welfare to avoid overpayments.
• Step 6: Consider opening an ABLE account to save for disability-related expenses without losing benefits.

[Source: SSA.gov, 2025](https://www.ssa.gov/benefits/disability/qualify.html, accessed 2025-11-05) [Source: Idaho Health and Welfare, 2025](https://healthandwelfare.idaho.gov/services-programs/medicaid-health/apply-adult-developmental-disabilities-programs, accessed 2025-11-05)

• Social Security Disability Insurance (SSDI): Provides monthly payments and Medicare to people with a qualifying disability and work history.
• Supplemental Security Income (SSI): Provides monthly payments and Medicaid to people with a qualifying disability and limited income/resources.
• Medicare: Health insurance for people with SSDI after a 24-month waiting period.
• Medicaid: Health coverage for people with SSI or low income.
• ABLE Accounts: Tax-advantaged savings accounts for disability-related expenses.

[Source: SSA.gov, 2025](https://www.ssa.gov/benefits/disability/qualify.html, accessed 2025-11-05)

• Idaho Medicaid: Provides health coverage and support services for people with disabilities, including developmental disabilities waivers.
• Adult with Developmental Disabilities (DD) Program: Offers case management, home and community-based services, and support for people with chronic disabilities like EDS if they meet ICF/IID criteria.
• Idaho Disability Determinations Service (DDS): Reviews medical evidence for SSDI and SSI claims in Idaho.
• Medicaid Waivers (HCBS): Waivers for home and community-based services for people with disabilities.
• ABLE Accounts: Idaho offers ABLE accounts for residents with disabilities.

[Source: Idaho Health and Welfare, 2025](https://healthandwelfare.idaho.gov/services-programs/medicaid-health/apply-adult-developal-disabilities-programs, accessed 2025-11-05) [Source: Idaho DDS, 2025](https://www.labor.idaho.gov/disability-determination/, accessed 2025-11-05)

ABLE accounts let people with disabilities save money for disability-related expenses without losing SSI or Medicaid benefits. Idaho residents can open an ABLE account through the state’s ABLE program. Contributions are tax-free, and funds can be used for housing, education, transportation, and other qualified expenses. There are annual and lifetime contribution limits.

[Source: Idaho ABLE, 2025](https://ipulidaho.org/health/financing-and-eligibilty/ssdissi/, accessed 2025-11-05)

• SSDI: No strict income limit, but you cannot earn more than the SGA limit ($1,620/month in 2025, or $2,700 if blind).
• SSI: Income and resource limits apply. In 2025, the federal SSI payment is $943/month for an individual, but state supplements may apply.
• Medicaid: Income and resource limits vary by program. For Medicaid DD, you must meet financial eligibility and ICF/IID criteria.

[Source: SSA.gov, 2025](https://www.ssa.gov/benefits/disability/qualify.html, accessed 2025-11-05)

You must report changes in income, work, or health to Social Security and Idaho Health and Welfare. Failure to report can result in overpayments and penalties. Overpayments must be repaid, but you can request a waiver if you are not at fault. Keep records of all changes and communications.

[Source: SSA.gov, 2025](https://www.ssa.gov/benefits/disability/qualify.html, accessed 2025-11-05)

• Idaho Disability Determinations Service
  Phone: 208-334-3233

  Website

  For help with SSDI and SSI medical reviews.
• Idaho Health and Welfare
  Phone: 208-334-3100

  Website

  For Medicaid and DD program questions.

• Can Ehlers-Danlos Syndrome qualify for SSDI or SSI in Idaho?

  Yes, if EDS causes severe, ongoing limitations that prevent you from working for at least 12 months. You must meet federal disability criteria and, for SSI, income/resource limits. Medical evidence is required.

• What is the SGA limit for SSDI in Idaho in 2025?

  The SGA limit for SSDI in 2025 is $1,620 per month for most people, or $2,700 if you are blind. Earning above this limit may affect your benefits.

• How do I apply for Medicaid with Ehlers-Danlos Syndrome in Idaho?

  First, apply for Medicaid and be determined financially eligible. Then, complete an application and assessment for the Adult with Developmental Disabilities program to see if you meet ICF/IID criteria.

• What is the ICF/IID level of care for Idaho Medicaid?

  ICF/IID is a level of care for people with chronic disabilities that appeared before age 22 and cause significant functional limitations in at least three major life activities.

• Can I work while receiving SSDI or SSI in Idaho?

  Yes, but you cannot earn more than the SGA limit. SSDI and SSI have work incentives to help you try working without losing benefits.

• What is an ABLE account and how can it help me?

  An ABLE account lets you save money for disability-related expenses without losing SSI or Medicaid benefits. Idaho offers ABLE accounts for residents with disabilities.