Wisconsin offers a range of disability benefits and Medicaid options for people with chronic illnesses like Myalgic Encephalomyelitis. Access Social Security (SSI/SSDI), Medicaid (including waivers), and state-specific programs. This guide covers eligibility, how to apply, ABLE accounts, work incentives, income limits, and where to find help.
To qualify for Social Security Disability Insurance (SSDI), you must have worked long enough in jobs covered by Social Security and have a medical condition preventing substantial work for at least 12 months[7]. For Supplemental Security Income (SSI), financial need is also required. Both programs use the same medical criteria—chronic illnesses like Myalgic Encephalomyelitis are considered if they severely limit daily activities and work capacity for at least a year, even if symptoms fluctuate. The process can be complex; documentation from healthcare providers is critical[7]. In 2025, SSDI benefits will increase due to a 2.5% COLA adjustment[6].
Wisconsin residents with Myalgic Encephalomyelitis may also access state programs. Disability Benefits Specialists (DBS) help people ages 18–59 understand and apply for Social Security, Medicaid, Medicare, and affordable health insurance. These specialists are available through local Aging and Disability Resource Centers (ADRCs)[1]. The Wisconsin Department of Health Services (DHS) administers Medicaid waivers, including Family Care, Partnership, and IRIS, which may support in-home and community-based services for people with disabilities[8]. To use DBS services, you must be a Wisconsin resident aged 18–59 with a disability interfering with daily activities[1]. Eligibility for SSI, SSDI, and Medicaid is determined by both federal rules and state processes, so Professional assistance from DBS or an advocate can be very helpful.
1. Document Your Disability: Gather medical records, doctor’s notes, and treatment history showing the impact of Myalgic Encephalomyelitis on your daily life and ability to work. 2. Apply for SSI/SSDI:
Social Security Disability Insurance (SSDI): For those who have worked and paid into Social Security, SSDI provides monthly payments if you can no longer work due to disability[7]. Supplemental Security Income (SSI): Provides monthly benefits to people with limited income and resources who are disabled, blind, or age 65+, regardless of work history[7]. Medicaid: Joint federal-state program offering health coverage for eligible low-income adults, including those with disabilities[8]. Medicare: Federal health insurance for those who have received SSDI for 24 months (or have certain conditions). ABLE Accounts: Tax-advantaged savings accounts for people with disabilities to save for qualified expenses without affecting eligibility for SSI, Medicaid, or certain housing assistance.
Wisconsin Department of Health Services (DHS) administers several Medicaid programs and waivers for people with disabilities, including chronic illnesses like Myalgic Encephalomyelitis:
Wisconsin residents with Myalgic Encephalomyelitis, like anyone with a significant disability, can open an ABLE account. These accounts allow you to save up to $100,000 without affecting your SSI eligibility. Money in an ABLE account can be used for qualified disability expenses, such as medical care, education, housing, and transportation. For more, see ABLE Accounts.
SSI: Strict income and asset limits apply. In 2025, the federal benefit rate is $943/month for individuals, but actual amounts depend on living situation and other income. SSDI: No asset limit, but earnings from work must not exceed the substantial gainful activity (SGA) level ($20,757/year in 2025 for Wisconsin)[3]. Medicaid: Income limits vary by program; some have no asset limits for eligibility. Wisconsin Disability Retirement: If you apply for retirement disability through the Wisconsin Retirement System, earnings over $20,757/year (2025) may suspend your benefit[3].
If you receive SSI, SSDI, or Medicaid, you must report changes in your income, living situation, or medical condition promptly. Failing to do so may result in overpayments and benefit suspensions. The Social Security Administration and Wisconsin DHS have processes for reporting. For step-by-step help, see Avoiding Overpayments & Reporting Changes.
Disability Benefits Specialists (DBS) are available in every Wisconsin county to help you apply for, appeal, and manage disability benefits. Contact your local Aging and Disability Resource Center (ADRC) for one-on-one assistance—no cost, no income limits—just expert guidance tailored to your needs[1].
SSDI recipients will see a 2.5% cost-of-living increase in 2025. Keep an eye out for your updated benefit notice, available through your mySocialSecurity account. This increase helps keep up with rising living costs[6].
Yes, if your symptoms are severe enough to prevent work for at least 12 months, Myalgic Encephalomyelitis can qualify you for SSI or SSDI, but you must meet all other program rules[7]. Medical documentation is key.
Yes, Wisconsin’s Disability Benefits Specialists offer free help for adults ages 18–59. Contact your local Aging and Disability Resource Center for support[1].
SSI is for people with limited income/resources; SSDI is for those who have worked and paid into Social Security. See [SSI vs SSDI](/guides/ssi-ssdi) for details.
Yes, programs like Family Care, Partnership, and IRIS may provide services for people with disabilities, but eligibility and available services vary[8].
SSI and SSDI have work incentives. You may keep some benefits if you earn under a certain amount. See [SSI & SSDI Work Incentives](/guides/work-incentives) for more.
You can appeal. Wisconsin’s Disability Benefits Specialists can help you understand your options and next steps[1].
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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Report changes in income, living situation, or health to Social Security (for SSI/SSDI) and Wisconsin DHS (for Medicaid). See [Avoiding Overpayments & Reporting Changes](/guides/overpayments-and-reporting) for guidance.
An ABLE account is a savings account for people with disabilities. Money saved does not count against SSI or Medicaid resource limits, up to $100,000. See [ABLE Accounts](/guides/able-accounts).
Initial decisions usually take 3–5 months but can take longer if more information is needed. Some conditions qualify for faster processing, but Myalgic Encephalomyelitis is not on that list[4].
Visit the Wisconsin Department of Health Services website or contact your county social services office to find your local Aging and Disability Resource Center.
