Chronic Pain Benefits in Virginia: 2025 Guide

To get Social Security Disability Insurance (SSDI), you need enough work credits (usually 40, with 20 in the last 10 years) and a medical condition that stops you from working for at least 12 months [5]. For Supplemental Security Income (SSI), you must have limited income and resources, and your condition must be severe enough to limit your ability to work for at least 12 months [5].

The Social Security Administration (SSA) uses a five-step process to decide if your chronic pain qualifies:

• Are you working above the Substantial Gainful Activity (SGA) limit? ($1,550/month in 2025 for non-blind people) [1].
• Is your condition severe enough to limit your ability to work?
• Does your condition match a listing in the SSA’s Blue Book?
• Can you do your past work?
• Can you do any other work?

If your chronic pain is severe and lasts at least 12 months, you may qualify for SSDI or SSI [1].

In Virginia, SSI payments are the federal amount only: $943/month for individuals and $1,415/month for couples in 2025 [1]. Virginia does not add extra money to SSI.

Virginia Medicaid offers waivers for people with developmental disabilities, but these are not for chronic pain. If you have chronic pain and need home or community supports, you may qualify for other Medicaid programs or waivers if you also have a developmental disability [2].

Virginia’s Disability Determination Services (DDS) follows the same federal rules as other states. Your chronic pain must be severe enough to stop you from working for at least 12 months [1].

If you are approved for SSDI or SSI, you may also qualify for Medicaid or Medicare, depending on your income and other factors [1].

• Gather medical records and work history.
• Check if you meet federal work credit rules for SSDI.
• Apply online at SSA.gov or call 1-800-772-1213.
• If denied, you can appeal within 60 days.
• Report any changes in income or health to avoid overpayments [1].

• Step 1: Get your medical records. You need proof of your chronic pain, including doctor visits, tests, and treatment history.
• Step 2: Check your work credits. You need 40 credits (about 10 years of work), with 20 in the last 10 years, for SSDI [5].
• Step 3: Apply online at SSA.gov, by phone, or in person at a Social Security office.
• Step 4: Virginia’s DDS will review your application. They may ask for more medical info or send you to a consultative exam.
• Step 5: If denied, you can appeal. The first step is a reconsideration, then a hearing if needed.
• Step 6: If approved, you will get monthly payments and may qualify for Medicaid or Medicare.
• Step 7: Report any changes in income, work, or health to avoid overpayments [1].

• SSDI: Monthly payments if you have enough work credits and a qualifying disability.
• SSI: Monthly payments if you have low income and resources, and a qualifying disability.
• Medicare: Health coverage after 24 months of SSDI.
• Medicaid: Health coverage for low-income people with disabilities.
• ABLE Accounts: Tax-advantaged savings for people with disabilities [5].

• Virginia Medicaid Waivers: For people with developmental disabilities, not chronic pain. If you have both, you may qualify for home and community supports [2].
• Virginia Community Services Boards (CSBs): Can help with mental health, substance use, and some disability services.
• Virginia Department of Behavioral Health and Developmental Services (DBHDS): Administers Medicaid waivers and can help with applications [2].
• Virginia Disability Determination Services (DDS): Reviews SSDI and SSI applications for Virginia residents [1].

ABLE accounts let people with disabilities save money without losing SSI or Medicaid. You can use the funds for disability-related expenses. Virginia has its own ABLE program. Learn more at the official ABLE site [internal_links].

• SSI: $943/month for individuals, $1,415/month for couples in 2025 [1].
• SSDI: No strict income limit, but you cannot earn more than the SGA limit ($1,550/month in 2025) and still get benefits [1].
• Medicaid: Income limits vary by program and family size. Check with your local CSB or Medicaid office.

You must report changes in income, work, or health to avoid overpayments. If you get too much money, you may have to pay it back. Learn more about reporting changes and avoiding overpayments [internal_links].

• Virginia Department of Behavioral Health and Developmental Services
  Phone: (804) 786-3921

  TTY: (804) 371-8977

  Email: [email protected]

  Website

  For Medicaid waiver questions

• Can chronic pain qualify for disability in Virginia?

  Yes, if your chronic pain is severe and stops you from working for at least 12 months, you may qualify for SSDI or SSI. You must meet federal medical and work credit rules [1].

• How much does SSI pay in Virginia?

  In 2025, SSI pays $943/month for individuals and $1,415/month for couples. Virginia does not add extra money to SSI [1].

• What is the SGA limit for SSDI in 2025?

  The SGA limit is $1,550/month for non-blind people in 2025. If you earn more, you may not qualify for SSDI unless you qualify for work incentives [1].

• Do Virginia Medicaid waivers cover chronic pain?

  No, Virginia Medicaid waivers are for people with developmental disabilities. If you have chronic pain and a developmental disability, you may qualify for home and community supports [2].

• How do I apply for SSDI or SSI in Virginia?

  You can apply online at SSA.gov, by phone, or in person. You will need medical records and work history. Virginia’s DDS will review your application [1].

• What happens if my application is denied?

  If denied, you can appeal within 60 days. The first step is a reconsideration, then a hearing if needed. You can get help from a disability advocate or attorney [1].

• Can I work while getting SSDI or SSI?

  Yes, but you cannot earn more than the SGA limit ($1,550/month in 2025) and still get SSDI. SSI has strict income limits. Learn about work incentives [internal_links].