Traumatic Brain Injury Benefits in Pennsylvania (2025)

To qualify for federal disability benefits with Traumatic Brain Injury, you must have a medical condition expected to last at least one year or result in death that prevents "substantial gainful activity" (SGA). For SSDI, you need enough work credits from jobs covered by Social Security. For SSI, you must have limited income and resources, and no work history is required. Both programs require your disability to meet Social Security's strict medical criteria[1][2][7]. SSI has income and asset limits ($943/month and $2,000 for an individual in 2025), while SSDI does not[1]. If you get both, it's called "concurrent benefits."

Pennsylvania’s Bureau of Disability Determination (BDD) reviews medical eligibility for SSI and SSDI claims on behalf of the federal government[2]. For state Medicaid (Medical Assistance), you may qualify based on disability, income, and resources. Pennsylvania also offers Medical Assistance for Workers with Disabilities (MAWD) for employed people with disabilities—you must be 16–64, working, meet Social Security disability standards, and have income below 250% of the federal poverty level. MAWD allows higher income and resource limits than regular Medicaid[4][5]. Always check with your local County Assistance Office for the latest rules and to see if you qualify for additional state waivers or services.

Start your application for SSI or SSDI online at ssa.gov, by phone at 1-800-772-1213, or at your local Social Security office. For Pennsylvania Medicaid, apply online at COMPASS, by phone, mail, or in person at your County Assistance Office. Gather medical records, proof of income, and ID before you apply. If you’re working, MAWD may help you keep healthcare coverage[4][5].

Apply for SSI/SSDI

1. Gather documents: Medical records, work history, proof of income, and ID.
2. Apply online at ssa.gov, by phone, or in person.
3. Pennsylvania’s BDD will review your medical eligibility—respond quickly to any requests for info[2].
4. Wait for a decision, which can take several months. Appeal if denied.

Apply for Pennsylvania Medicaid (Medical Assistance)

1. Choose your path: Apply online at COMPASS, by phone, by mail, or in person at your County Assistance Office[5].
2. Prove disability: Show you get SSDI/SSI, or provide medical evidence.
3. Prove income and resources: Paystubs, bank statements, etc.
4. If working, ask about MAWD (Medical Assistance for Workers with Disabilities), which has higher income limits and requires proof of employment and disability[4][5].
5. Complete your application and follow up if you don’t hear back.

After Approval

• Report changes in work, income, or living situation to avoid overpayments.
• Explore work incentives if you want to try working while keeping benefits.
• Consider an ABLE account to save for disability expenses without losing eligibility for benefits[6].

SSDI (Social Security Disability Insurance): Monthly cash benefit based on your work history and Social Security contributions. No income or asset limits for eligibility, but you must have enough work credits. Family members may also qualify for benefits. Medicare starts after a 24-month waiting period[1][2][7].

SSI (Supplemental Security Income): Monthly cash benefit for people with limited income and resources, regardless of work history. Strict income and asset limits apply. SSI recipients in PA automatically qualify for Medicaid[1].

ABLE Accounts: Save up to $17,000 per year in a tax-advantaged account for disability-related expenses without affecting SSI or Medicaid eligibility. Eligibility is expanding in 2026[6].

Medical Assistance (Medicaid): Pennsylvania’s Medicaid program covers doctor visits, hospital stays, prescriptions, mental health, and more. SSI recipients qualify automatically. Others must meet income and resource limits[1].

Medical Assistance for Workers with Disabilities (MAWD): For people ages 16–64 who are employed, have a disability, and meet income/resource rules. MAWD allows much higher income (up to 250% of the federal poverty level) and resource ($10,000) limits than regular Medicaid. You pay a monthly premium of 5% of your countable income[4][5].

Home and Community-Based Services (HCBS) Waivers: Pennsylvania offers several Medicaid waivers that provide additional supports for people with disabilities living at home, including services not typically covered by Medicaid. Ask your County Assistance Office or a benefits counselor for details.

No separate state disability cash benefit exists—cash help comes from SSI, SSDI, or other federal programs.

ABLE accounts let Pennsylvanians with disabilities (onset before age 26, expanding to age 46 in 2026) save up to $17,000 per year for disability expenses without losing SSI or Medicaid. Withdrawals for qualified expenses are tax-free. ABLE accounts are a smart way to build financial independence while keeping benefits[6]. See our ABLE Accounts guide.

SSI: $943/month (individual), $1,415/month (couple), and $2,000 in resources (individual), $3,000 (couple) in 2025[1]. SSDI: No income or asset limits, but earnings during a trial work period may affect benefits[1]. MAWD: Up to 250% of federal poverty level for income, $10,000 in resources (excluding home and one car)[4][5]. Always report income changes promptly.

Report all changes in work, income, living situation, or medical condition to Social Security and your County Assistance Office. Failing to report can lead to overpayments, which you may have to pay back. Use our Avoiding Overpayments & Reporting Changes guide for step-by-step help.

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

  TTY: 1-800-325-0778

  Hours: Monday–Friday, 8 a.m. to 7 p.m.

  Website

  Apply for SSI/SSDI, check status, report changes
• PA Department of Human Services (Medicaid/MAWD)
  Phone: 1-877-395-8930

  TTY: 1-866-235-4378

  Hours: Monday–Friday, call center hours vary

  Website

  Apply for Medical Assistance/MAWD, check status, report changes
• PA Bureau of Disability Determination
  Phone: 717-787-5276

  Hours: Monday–Friday, 8 a.m. to 5 p.m.

  Website

  Handles medical eligibility reviews for SSI/SSDI

• Does Pennsylvania have a state disability program?

  No. Pennsylvania does not offer a state disability cash benefit. Financial help comes from federal SSI or SSDI. However, Pennsylvania does provide Medical Assistance (Medicaid), including special programs like MAWD for working people with disabilities[1][4].

• Can I work and still get disability benefits in Pennsylvania?

  Yes, with limits. SSDI allows a trial work period (up to $1,550/month in 2025). SSI reduces benefits as your income rises. MAWD lets you work, earn more, and keep Medicaid if you meet income and disability rules[1][4].

• I get SSI. Do I qualify for Medicaid?

  Yes. In Pennsylvania, SSI recipients automatically qualify for Medicaid (Medical Assistance), with no waiting period[1].

• How do I apply for Pennsylvania Medicaid with a brain injury?

  Apply online at COMPASS, by phone, mail, or in person at your County Assistance Office. You’ll need proof of income, resources, and disability. If you’re working, ask about MAWD[4][5].

• What are ABLE accounts, and who qualifies?

  ABLE accounts are tax-advantaged savings accounts for people with disabilities (onset before age 26, expanding to age 46 in 2026). You can save without losing SSI or Medicaid. Withdrawals for disability expenses are tax-free[6].

• What happens if my income changes?

  Always report changes to Social Security and your County Assistance Office. Not reporting can lead to overpayments and benefit cuts. See [Avoiding Overpayments & Reporting Changes](/guides/overpayments-and-reporting).