If you have chronic pain in South Dakota, you may qualify for federal disability programs like SSDI and SSI, as well as state-specific Medicaid and work incentives. This guide explains eligibility, how to apply, and what benefits are available in 2025.
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].
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].
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 offers work incentives like PASS and 1619(b) Medicaid to help you keep benefits while working. Ask your caseworker about these programs.
If you work and have a significant disability, you may qualify for Medicaid for Workers with Disabilities. The 2025 threshold is $53,022 per year.
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.
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.
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.
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.
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.
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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Yes, you can save money in an ABLE account if you have chronic pain and meet the eligibility criteria. ABLE accounts let you save up to $18,000 per year (2025) for disability-related expenses without losing SSI, Medicaid, or other benefits.
If your income changes, you must report it to SSA and the South Dakota Department of Social Services. Failing to report changes can result in overpayments and penalties. You may be able to request a waiver or set up a repayment plan.
The time to get disability benefits varies. SSDI has a 5-month waiting period before payments start. SSI payments start as soon as you are approved. The application process can take several months, depending on the complexity of your case.
If you are approved for SSDI, you may qualify for Medicare after 24 months. If you are approved for SSI, you may automatically qualify for Medicaid. If you work, you may qualify for Medicaid for Workers with Disabilities.
In 2025, the threshold for continued Medicaid under 1619(b) is $53,022 per year. If your earnings are below this amount, you can keep Medicaid coverage even if your SSI cash payment stops.
