Chronic Pain Benefits in South Dakota: 2025 Guide

To qualify for federal disability benefits with chronic pain, you must meet the Social Security Administration’s (SSA) definition of disability. This means your condition must prevent you from doing substantial work, is expected to last at least one year or result in death, and meets SSA’s medical criteria for severity. For SSDI, you must have paid enough Social Security taxes and earned enough work credits (usually 40, with 20 in the last 10 years). For SSI, you must have limited income and resources. Both programs use the Substantial Gainful Activity (SGA) limit to determine if you can work and still receive benefits. In 2025, SGA is $1,620/month for non-blind individuals and $2,700/month for blind individuals [1].

If you are approved, SSDI has a 5-month waiting period before payments start, and most people must wait 24 months for Medicare. SSI payments start as soon as you are approved, and you may qualify for Medicaid [3].

In South Dakota, people with chronic pain may qualify for additional state programs. The South Dakota Medicaid for Workers with Disabilities program helps those who are employed but have a significant disability. This program allows you to keep Medicaid coverage even if your income is above the usual SSI limits, as long as you meet the state’s threshold. In 2025, the threshold for continued Medicaid under 1619(b) is $53,022 per year [2].

South Dakota also offers Home and Community-Based Services (HCBS) waivers for people with disabilities who need long-term care. These waivers can help pay for services like personal care, home modifications, and respite care. Eligibility for waivers depends on your income, resources, and level of need. You can learn more about Medicaid waivers and apply through the South Dakota Department of Social Services [5].

• Gather medical records and work history.
• Review SGA limits and work incentives.
• Apply online at SSA.gov or visit a local SSA office.
• If you work, ask about PASS and 1619(b) Medicaid.
• For Medicaid, apply through the South Dakota Department of Social Services.

• Step 1: Collect all medical records that show your chronic pain diagnosis, treatment, and how it limits your ability to work. Include doctor’s notes, test results, and medication lists.
• Step 2: Review the Substantial Gainful Activity (SGA) limits for 2025. If you are working, make sure your earnings are below $1,620/month (non-blind) or $2,700/month (blind) to qualify for SSDI/SSI [1].
• Step 3: Apply for SSDI or SSI online at SSA.gov, by phone, or in person at a local SSA office. You will need to provide personal information, work history, and medical evidence.
• Step 4: If you are approved for SSI, you may automatically qualify for Medicaid in South Dakota. If you are approved for SSDI, you may qualify for Medicare after 24 months.
• Step 5: If you work, ask about work incentives like the Plan for Achieving Self-Support (PASS) and 1619(b) Medicaid. These programs help you keep benefits while working [2].
• Step 6: For Medicaid waivers and other state programs, apply through the South Dakota Department of Social Services. You may need to provide additional documentation and meet income/resource limits [5].

• Social Security Disability Insurance (SSDI): Monthly payments for people who paid enough Social Security taxes and have a qualifying disability. Payments start after a 5-month waiting period. Most people get Medicare after 24 months.
• Supplemental Security Income (SSI): Monthly payments for people with limited income and resources who are disabled, blind, or age 65+. Payments start as soon as you are approved. You may qualify for Medicaid.
• Work Incentives: Programs like PASS, 1619(b) Medicaid, and Expedited Reinstatement help you keep benefits while working or trying to return to work [2].

• South Dakota Medicaid for Workers with Disabilities: Allows people with disabilities to keep Medicaid coverage even if their income is above the usual SSI limits, as long as they meet the state’s threshold. In 2025, the threshold is $53,022 per year [2].
• Home and Community-Based Services (HCBS) Waivers: These waivers help pay for long-term care services like personal care, home modifications, and respite care. Eligibility depends on income, resources, and level of need. Apply through the South Dakota Department of Social Services [5].
• ABLE Accounts: South Dakota offers ABLE accounts, which let people with disabilities save money for disability-related expenses without losing benefits. Learn more about ABLE accounts and how to open one [4].

South Dakota offers ABLE accounts, which allow people with disabilities to save up to $18,000 per year (2025) for disability-related expenses without losing SSI, Medicaid, or other benefits. Funds in an ABLE account can be used for things like medical care, education, housing, and transportation. To open an account, visit the South Dakota ABLE website or call the ABLE program office [4].

• SSDI: No strict income limit, but you must not earn more than the SGA limit ($1,620/month non-blind, $2,700/month blind in 2025) [1].
• SSI: Income and resource limits apply. In 2025, the federal SSI limit is $943/month for an individual and $1,415/month for a couple. Some income is excluded, like the first $20 of unearned income and the first $65 of earned income [2].
• Medicaid for Workers with Disabilities: In 2025, the threshold for continued Medicaid under 1619(b) is $53,022 per year [2].

If your income or resources change, you must report it to SSA and the South Dakota Department of Social Services. Failing to report changes can result in overpayments and penalties. If you receive an overpayment, you may be able to request a waiver or set up a repayment plan. Learn more about avoiding overpayments and reporting changes [3].

• South Dakota Department of Social Services
  Phone: 1-800-592-5468

  Website

  For Medicaid, HCBS waivers, and state disability programs.
• Social Security Administration
  Phone: 1-800-772-1213

  TTY: 1-800-325-0778

  Website

  For SSDI, SSI, and federal disability benefits.
• South Dakota Benefits Specialist Network
  Phone: 1-800-224-5336

  Website

  For state-specific disability benefit questions.

• Can chronic pain qualify for SSDI or SSI in South Dakota?

  Yes, chronic pain can qualify for SSDI or SSI if it meets SSA’s medical criteria for disability. You must show that your pain prevents you from doing substantial work and is expected to last at least one year or result in death. Medical records and doctor’s notes are required.

• What is the SGA limit for chronic pain in 2025?

  In 2025, the SGA limit is $1,620 per month for non-blind individuals and $2,700 per month for blind individuals. If you earn more than this, you may not qualify for SSDI or SSI.

• Can I work and still get disability benefits in South Dakota?

  Yes, you can work and keep disability benefits if your earnings are below the SGA limit. South Dakota also offers work incentives like PASS and 1619(b) Medicaid to help you keep benefits while working.

• How do I apply for Medicaid for Workers with Disabilities in South Dakota?

  To apply for Medicaid for Workers with Disabilities, contact the South Dakota Department of Social Services. You will need to provide proof of disability, income, and resources. The program allows you to keep Medicaid coverage even if your income is above the usual SSI limits.

• What are HCBS waivers and how do I get one in South Dakota?

  HCBS waivers help pay for long-term care services like personal care, home modifications, and respite care. To get a waiver, apply through the South Dakota Department of Social Services. Eligibility depends on income, resources, and level of need.

• Can I save money in an ABLE account if I have chronic pain?