South Dakotans with Amyotrophic Lateral Sclerosis (ALS) may qualify for Social Security disability (SSDI/SSI), Medicaid, Medicare, and work incentives. State-specific waivers help with daily living and medical care. This guide covers eligibility, how to apply, and money-saving programs in SD.
The Social Security Administration (SSA) operates two main disability programs for people with Amyotrophic Lateral Sclerosis (ALS)—Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). SSDI is for people who have paid enough Social Security taxes and have a medical condition expected to last at least one year or result in death, like ALS[3][5]. You generally need at least 40 work credits, with 20 earned in the last 10 years ending with the year your disability starts[5]. SSI is for people with limited income and resources, regardless of work history[3]. SSA uses a fast-track program (Compassionate Allowances) for ALS, speeding up applications for both programs. To qualify, you must not be able to do your previous work, and your ALS must make adjusting to other work impossible[3][5].
South Dakota does not have a standalone state disability program, but residents with ALS can apply for Medicaid and may be eligible for Home and Community-Based Services (HCBS) waivers through the South Dakota Department of Human Services[4]. The Medicaid for Workers with Disabilities program is for those who are employed and have a significant disability, potentially allowing people with ALS to keep working and still get Medicaid[4]. SSI recipients automatically qualify for South Dakota Medicaid[4]. For SSDI, after a 24-month waiting period, you’ll qualify for Medicare—but those with ALS get Medicare the same month their disability benefits begin. There is no state ABLE program in South Dakota, but you can use a national ABLE account to save money without affecting SSI and Medicaid rules.
If you have ALS and live in South Dakota, start by applying for SSI (if you have low income/resources) or SSDI (if you have enough work credits). Apply online at ssa.gov, by phone, or in person at a local Social Security office. Contact the South Dakota Department of Human Services to ask about Medicaid and waivers for long-term care, in-home supports, and other needs[4]. For help understanding your options, call the South Dakota Benefits Specialist Network at 1-800-224-5336.
Step 1: Complete Your SSI or SSDI Application
Step 2: Gather Your Documents
Step 3: Apply for South Dakota Medicaid
Step 4: Stay Updated and Report Changes
There are two main federal programs for people with ALS:
South Dakota does not have a dedicated state disability program, but people with ALS can get Medicaid, waivers, and work incentive programs:
Limitations:
There is no South Dakota ABLE program, but anyone with a qualifying disability (including ALS) diagnosed before age 26 can open a national ABLE account. An ABLE account lets you save up to $18,000 per year (2025) without counting against SSI and Medicaid asset limits. Funds can be used for disability-related expenses.
For 2025, the federal Substantial Gainful Activity (SGA) limit is $1,620/month for non-blind individuals and $2,700/month for blind individuals[2]. Earning above these limits could affect SSDI benefits. For SSI, countable income is capped at $914/month for an individual (2025), and total savings/resources cannot exceed $2,000 (individual) or $3,000 (couple). SSI recipients get Medicaid automatically in South Dakota[3]. The Medicaid for Workers with Disabilities program has higher income, but you must have a significant disability.
Report changes in work, income, resources, or living arrangements to the SSA and South Dakota Medicaid as soon as possible. Failing to report changes can result in overpayments, which you may have to pay back. Use the SSA’s online tools and notify both agencies for important updates. See our guide on Avoiding Overpayments & Reporting Changes for details.
Social Security nearly always approves ALS claims through the Compassionate Allowances program, meaning you get a decision in weeks, not months.
Only national ABLE accounts are available for South Dakotans with ALS. Consider opening an account through a national provider if you want to save without losing benefit eligibility.
You must tell SSA and South Dakota Medicaid about changes in your health, work, income, or living situation. This helps you avoid overpayments and keep your benefits running.
Yes, ALS is a Compassionate Allowance condition, so Social Security processes applications for both SSDI and SSI faster, often in weeks instead of months.
If you receive SSI, you are automatically eligible for South Dakota Medicaid[4]. If you work and have ALS, check if you qualify for the Medicaid for Workers with Disabilities program[4].
No, but you can open a national ABLE account online to save money without affecting SSI or Medicaid eligibility.
Yes. You can use a nine-month Trial Work Period where you keep full SSDI even with high earnings. After that, you can keep Medicare and work incentives for several more years if you keep earning under SGA[2].
You generally need 40 work credits, at least 20 earned in the last 10 years before your disability starts[5]. If you stop working because of ALS, you may still have enough recent credits to qualify.
In 2025, earning more than $1,620/month (non-blind) could risk losing SSDI benefits. This is called the SGA limit. There are special rules for trial work periods[2].
This guide is for informational purposes only and is not legal or financial advice. Always consult with a qualified professional for personalized guidance.
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The main waiver is the Aged and Disabled (HCBS) Waiver, which helps pay for in-home supports and services. Contact the South Dakota Department of Human Services for details and waitlist info[4].
ALS is Medicare fast-tracked—you get Medicare the same month your SSDI cash benefits begin, with no 24-month wait[5].
Apply for the Medicaid for Workers with Disabilities program. It has higher income limits and lets you keep Medicaid coverage as long as you meet program rules[4].
Appeal immediately. ALS is nearly always medically allowed, but sometimes paperwork or technical issues can delay approval. Call your local SSA office or a disability advocate for help.
