Amyotrophic Lateral Sclerosis Benefits in South Dakota

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

• Go online: Apply for SSDI or SSI at ssa.gov. SSA has a special Compassionate Allowances program for ALS, so include all medical records related to your diagnosis.
• Call or visit: If you need help, call the SSA at 1-800-772-1213 or visit your nearest field office. You can also schedule an appointment.

Step 2: Gather Your Documents

• Have your Social Security number, proof of age (birth certificate), medical evidence (doctor’s notes, test results), work history, and financial information ready.
• For SSI, also gather information on your income, resources, and living situation.

Step 3: Apply for South Dakota Medicaid

• If you receive SSI: You are automatically eligible for South Dakota Medicaid[4]. Use the SSA award letter as proof.
• If you work and have a disability: Consider the Medicaid for Workers with Disabilities program through the South Dakota Department of Human Services[4].
• For waiver programs: Contact the Department of Human Services to ask about eligibility for HCBS waivers, such as the Aged and Disabled Waiver.

Step 4: Stay Updated and Report Changes

• Report any changes in your condition, income, or living situation to SSA and South Dakota Medicaid to avoid overpayments and keep your benefits.
• If you have questions about ABLE Accounts or work incentives, use the internal guides for more details.

There are two main federal programs for people with ALS:

• Social Security Disability Insurance (SSDI): Pays monthly benefits if you have enough work credits. ALS is a Compassionate Allowance condition, so claims are processed faster. Benefits start the month after you apply if approved for SSDI[3][5]. Medicare begins after a 24-month waiting period, except for ALS, which gets Medicare immediately[5].
• Supplemental Security Income (SSI): Pays benefits if you have limited income and resources. SSI is often combined with Medicaid for health coverage[3].
• Medicare: Covers hospital, doctor, and other medical services. People with ALS get Medicare the same month their disability benefits begin.
• ABLE Accounts: National ABLE accounts let people with disabilities save money without losing eligibility for SSI and Medicaid.

South Dakota does not have a dedicated state disability program, but people with ALS can get Medicaid, waivers, and work incentive programs:

• Medicaid: South Dakota Medicaid covers doctor visits, hospital care, and other services. SSI recipients get Medicaid automatically[4]. The Medicaid for Workers with Disabilities program lets people with ALS—even if employed—keep Medicaid if they meet income and resource limits[4].
• Home and Community-Based Services (HCBS) Waivers: These waivers help pay for personal care, home-delivered meals, respite, and other services so you can stay at home instead of moving to a nursing facility. Contact the South Dakota Department of Human Services for more information[4].
• Work Incentives: South Dakota participates in federal work incentives, including the Ticket to Work program. It allows you to try working without losing benefits right away. You can have a nine-month Trial Work Period during which you receive full SSDI benefits—even if your earnings are higher than usual[2]. After that, there’s a 36-month Extended Period of Eligibility (EPE) where you get benefits for months you don’t earn above the Substantial Gainful Activity (SGA) limit[2].

Limitations:

• There is no South Dakota ABLE program, but you can open a national ABLE account.
• State Medicaid waivers have limited slots—apply early and ask about waitlists.

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.

• South Dakota Benefits Specialist Network
  Phone: 1-800-224-5336

  Website

  Local help with SD disability benefits
• South Dakota Department of Social Services
  Phone: 877.999.5612

  Website

  Medicaid, waivers, and health programs in SD
• Social Security Administration (SSA)
  Phone: 1-800-772-1213

  TTY: 1-800-325-0778

  Website

  For SSDI, SSI, and Medicare questions

• Does ALS qualify for fast-track Social Security disability approval in South Dakota?

  Yes, ALS is a Compassionate Allowance condition, so Social Security processes applications for both SSDI and SSI faster, often in weeks instead of months.

• How can I get Medicaid in South Dakota if I have ALS?

  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].

• Is there a South Dakota ABLE account program for people with ALS?

  No, but you can open a national ABLE account online to save money without affecting SSI or Medicaid eligibility.

• Can I work while receiving SSDI for ALS in South Dakota?

  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].

• What are the SSDI work credits needed for ALS?

  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.

• How much can I earn in 2025 before losing SSDI benefits?

  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].