Myalgic Encephalomyelitis Benefits in New York

• To get Social Security Disability Insurance (SSDI), you must have worked in jobs covered by Social Security and have enough work credits. You must also have a medical condition that meets Social Security's definition of disability and is expected to last at least 12 months or result in death. Myalgic Encephalomyelitis is listed as a condition that can qualify for disability benefits if it meets the criteria in Social Security's Blue Book or is equally severe.
• Supplemental Security Income (SSI) is for people with limited income and resources who are disabled, blind, or age 65 or older. You do not need work credits for SSI. Your disability must meet Social Security's definition, and your income and resources must be below certain limits. Myalgic Encephalomyelitis can qualify for SSI if it meets the medical criteria and financial requirements.
• Both SSDI and SSI require you to provide medical evidence, such as doctor's reports and test results, to prove your disability. The Social Security Administration (SSA) will review your application and decide if you qualify.

Source: SSA Disability Qualifications (2024-11-06)

• New York State does not have a state-run short-term disability insurance program like California. Instead, most disability benefits come from federal programs (SSDI and SSI) and state Medicaid.
• To qualify for Medicaid in New York, you must meet income and resource limits and be a resident of the state. Medicaid covers medical care for people with disabilities, including those with Myalgic Encephalomyelitis.
• New York offers Medicaid waivers, such as the Home and Community-Based Services (HCBS) waiver, which can help people with disabilities live in the community instead of institutions. These waivers have specific eligibility requirements, such as needing a certain level of care.
• New York also has the ABLE account program, which allows people with disabilities to save money without losing eligibility for means-tested benefits like SSI and Medicaid.
• To get state benefits, you must apply through the New York State Department of Social Services or local county offices. You will need to provide proof of disability, income, and residency.

Source: New York State Department of Social Services (2024-11-06)

• Gather your medical records and proof of income.
• Decide if you want to apply for SSDI, SSI, or both.
• Fill out the application online at the Social Security website or visit your local Social Security office.
• Submit your application and wait for a decision.
• If denied, you can appeal the decision.

Source: SSA How to Apply (2024-11-06)

• Step 1: Collect all necessary documents, including medical records, proof of income, and proof of residency.
• Step 2: Decide which benefits you want to apply for (SSDI, SSI, Medicaid, or Medicaid waivers).
• Step 3: Fill out the application for each program. For SSDI and SSI, you can apply online at the Social Security website, by phone, or in person at a local Social Security office. For Medicaid and Medicaid waivers, you can apply online at the New York State Department of Social Services website or in person at a local county office.
• Step 4: Submit your application and all required documents. Make sure to keep copies of everything you send.
• Step 5: Wait for a decision. The Social Security Administration or New York State Department of Social Services will review your application and may ask for more information.
• Step 6: If your application is denied, you can appeal the decision. You have 60 days to file an appeal.
• Step 7: If approved, you will start receiving benefits. You must report any changes in your income or living situation to avoid overpayments.

Source: SSA How to Apply (2024-11-06) Source: New York State Department of Social Services (2024-11-06)

• Social Security Disability Insurance (SSDI): Provides monthly payments to people who are disabled and have worked in jobs covered by Social Security. Payments are based on your work history and earnings.
• Supplemental Security Income (SSI): Provides monthly payments to people with disabilities who have limited income and resources. Payments are based on financial need.
• Medicare: Available to people who receive SSDI after a 24-month waiting period. Covers medical care.
• Medicaid: Available to people with disabilities who meet income and resource limits. Covers medical care and long-term services.

Source: SSA Disability Programs (2024-11-06)

• Medicaid: New York State Medicaid covers medical care for people with disabilities, including those with Myalgic Encephalomyelitis. It also covers long-term care services.
• Medicaid Waivers (HCBS): These waivers allow people with disabilities to receive care in the community instead of institutions. Examples include the Home and Community-Based Services (HCBS) waiver and the Traumatic Brain Injury (TBI) waiver.
• ABLE Accounts: New York's ABLE account program allows people with disabilities to save money without losing eligibility for means-tested benefits like SSI and Medicaid.
• Other Programs: New York offers vocational rehabilitation services, transportation assistance, and other support programs for people with disabilities.

Source: New York State Department of Social Services (2024-11-06) Source: New York State Medicaid (2024-11-06)

• New York's ABLE account program allows people with disabilities to save money without losing eligibility for means-tested benefits like SSI and Medicaid. You can save up to $16,000 per year in an ABLE account, and the total balance can be up to $100,000 without affecting SSI eligibility. ABLE accounts can be used for qualified disability expenses, such as housing, education, and transportation.

Source: New York ABLE (2024-11-06)

• For SSI, the federal income limit in 2025 is $967 per month for an individual and $1,450 for a couple. New York State adds a small supplement to these amounts.
• For Medicaid, the income limit in 2025 is $1,133 per month for an individual and $1,512 for a couple. These limits can be higher for people with disabilities who need long-term care.
• For SSDI, there is no income limit, but you must not be able to do substantial gainful activity (SGA). In 2025, SGA is defined as earning more than $1,620 per month ($2,700 if legally blind).

Source: SSA SSI Limits (2024-11-06) Source: New York State Medicaid (2024-11-06)

• If you get more benefits than you are entitled to, you must report it and pay it back. This is called an overpayment. To avoid overpayments, report any changes in your income, living situation, or medical condition to the Social Security Administration or New York State Department of Social Services.
• You can report changes online, by phone, or in person. If you do not report changes, you may have to pay back the overpayment and could face penalties.

Source: SSA Overpayments (2024-11-06) Source: New York State Department of Social Services (2024-11-06)

• Social Security Administration
  Phone: 1-800-772-1213

  TTY: 1-800-325-0778

  Hours: 8:00 AM - 7:00 PM, Monday - Friday

  Website

  For questions about SSDI, SSI, and other federal benefits.
• New York State Department of Social Services
  Phone: 1-800-342-3009

  Hours: 8:00 AM - 5:00 PM, Monday - Friday

  Website

  For questions about Medicaid, Medicaid waivers, and other state benefits.

• What is Myalgic Encephalomyelitis?

  Myalgic Encephalomyelitis (ME) is a chronic illness that causes severe fatigue, pain, and other symptoms. It can make it hard to do daily activities and work. ME is recognized as a disabling condition by Social Security.

• How do I know if I qualify for disability benefits in New York?

  To qualify for SSDI, you need enough work credits and a qualifying disability. For SSI, you need limited income and resources. For Medicaid, you need to meet income and resource limits and be a resident of New York.

• What documents do I need to apply for disability benefits?

  You need medical records, proof of income, proof of residency, and proof of disability. You may also need work history and tax records. Make sure to keep copies of everything you submit.

• How long does it take to get a decision on my application?

  It can take 3 to 6 months to get a decision on your SSDI or SSI application. Medicaid applications are usually processed faster, but it can take longer if more information is needed.

• Can I work while getting disability benefits?

  Yes, you can work while getting disability benefits, but there are limits on how much you can earn. If you earn more than the SGA limit, you may lose your benefits. There are work incentives to help you keep your benefits while you work.

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

  An ABLE account is a savings account for people with disabilities. You can save money without losing eligibility for means-tested benefits like SSI and Medicaid. The money can be used for qualified disability expenses.