Your Complete Guide to North Carolina Disability Benefits

Important: We updated this article in August 2023 to make sure all info below is current and correct. Less than 1 in 20 North Carolinians (4.5%) got federal disability benefits in the past year. However, many more than that likely qualify for these monthly payments. Knowing what to expect and getting expert help filing for these benefits can greatly boost your odds for success. Today, 4 different programs offer monthly benefits to those who qualify for North Carolina disability. Learn which ones to apply for based on your work history and current situation below.

North Carolina Disability Benefits: 4 Ways to Apply

You may qualify for monthly cash benefits from one of four different programs shown below. The Social Security Administration (SSA) manages the first two federal benefits programs. The last one’s a state-run program for public employees, which includes local government workers as well as teachers.

Here are all 4 programs that pay North Carolina disability benefits to those who qualify:

1. Social Security Disability Insurance (SSDI)
2. Supplemental Security Income (SSI)
3. Disability Income Plan of North Carolina (DIP-NC)
4. NCFlex State Disability Insurance Plan

North Carolina disability claimants can qualify for SSDI or SSI, but not both federal benefits at the same time. In addition, both federal programs only pay benefits to those unable to work a minimum of 12 months. North Carolina’s two state programs only pay short and long-term disability benefits to eligible teachers and state employees. Keep reading to learn about each program’s eligibility rules, pay amounts, and when to expect first payments.

Social Security Disability Insurance (SSDI): Who Can Apply, How to Qualify & Pay Amounts

If you work in jobs where you pay Social Security payroll taxes, then you likely have SSDI coverage. That’s because SSDI’s technically a federal disability insurance program designed to protect workers too young to retire. Keep reading to learn more about North Carolina disability benefits through the SSDI program.

1. Who Should Apply for SSDI?

If you answer “yes” to every question below, then you likely qualify for monthly benefits from the SSDI program:

• Have you paid FICA/Social Security taxes while working at least 5 in the last 10 years? Since SSDI is a federal insurance plan, your coverage automatically ends if you stop working for 60 months. That’s why it’s crucial to apply for SSDI within 5 years of becoming too disabled to work. If you haven’t worked recently or enough years to qualify, the SSA automatically denies your claim.
• Are your health problems bad enough to force you take a year off work (or longer)? Your condition must last for at least 12 months or be a terminal illness to qualify for SSDI. In other words, SSDI won’t pay you disability benefits if your symptoms improve any sooner.
• Have you seen a doctor for treatment within the last year? If yes, then great! You’re one step closer to getting SSDI. Otherwise, the SSA must confirm your diagnosis through a Disability Determination Services (DDS) exam. They’re checking that you truly cannot work for at least 12 months, specifically due to your poor health.
• Are you currently at least 18, but younger than 67? SSDI covers working-age Americans who cannot work anymore, specifically for health reasons. Once you turn 67, SSDI benefits automatically convert into regular Social Security retirement. Read this to learn why nobody can draw Social Security and disability benefits simultaneously.

If can’t meet all the SSDI program rules, apply for federal SSI benefits instead.

2. How Long Until Approved SSDI Claims Get Their First Disability Payment?

Six months from your SSDI application date is the soonest you’ll get your first North Carolina disability payment. The SSA typically takes about 3-5 months to review every SSDI application. That’s because federal law requires a five-month mandatory waiting period prior to depositing any SSDI program payments. Unfortunately, many people wait closer 2 years for their first deposit. That’s because they get denied benefits the first time, then finally win after filing an appeal. Having a lawyer file your SSDI application makes you almost 3x more likely to get benefits.

Plus, a lawyer can’t charge you anything until after the SSA approves your SSDI claim. Right now, disability approval rates in North Carolina are just 35% for both federal programs. Most people wait about 472 days from the day they file to receive an award letter in the mail.

If you decide to chance it on your own and apply without a lawyer, you’ll probably get denied. If that happens, you have 60 days to appeal. Reconsideration is the first appeal stage, and it adds another 100 days to your wait, on average. At this stage, the SSDI program approves just 2% of claims. However, you can appeal a second time and plead your case in front of an Administrative Law Judge (ALJ).

Unfortunately, this is where the longest wait times usually come in. If you’re in Raleigh, expect to wait about 18 months, on average, for your court date. Fayetteville had the shortest wait for court dates in 2022, coming in at just 12 months. At the appeals hearing stage, 4 in 5 people have lawyers representing their claims.

3. How Much SSDI Money Can North Carolina Disability Applicants Qualify for Each Month?

In 2023, the SSDI program’s maximum monthly payment is $3,627. However, the amount you receive entirely depends on your monthly paychecks earned while you were working. Nationwide, disabled workers currently receive $1,483 per month in SSDI benefits, on average. The only way to raise your benefit amount is through an annual cost-of-living-adjustment (COLA) increase.

4. Are Payments Made Through the SSDI Program Permanent?

The SSDI program does not pay anyone permanent disability benefits. Once benefits begin, you must confirm you still cannot work at all every 3-7 years. If you don’t fill out and return your SSA paperwork on time, your North Carolina disability payments stop coming. This continues until you turn 67 years old. Once that happens, the SSA automatically converts SSDI into Social Security retirement benefits. Your monthly pay amount won’t change. You also don’t need to file any paperwork to make this happen.

Supplemental Security Income (SSI): Who Can Apply, How to Qualify & Pay Amounts

Anyone who hasn’t worked in the right jobs or enough years to get SSDI can probably qualify for SSI instead. The federal SSI program is needs-based, and makes payments to eligible blind and disabled applicants younger than 65. (SSI also pays monthly benefits to those aged 65 and up whose income and assets fall below the program’s strict limits.) Below, we’ll explain how the SSI program rules work, payment amounts, and more.

1. SSI Applicants Younger Than 65 Must Be Blind or Disabled to Qualify

Only blind or disabled SSI applicants who cannot work may qualify for North Carolina disability before their 65th birthday. If you’re already 65 years old when you apply, you can pass the SSI medical screening based on age alone. Otherwise, the SSI program requires a DDS medical exam that must confirm you’re unable to work for health reasons.

2. SSI Claimants Also Need Very Low Income and Few Resources to Qualify

You’ll have to list all monthly income and assets on your SSI claim for North Carolina disability benefits. SSI program rules state that any money you get each month counts as income, even if you aren’t working. That includes things like alimony or child support payments, interest from a savings account, lottery winnings, TANF, SNAP, etc. In addition, you can’t have more than $2,000 in your bank account when you apply. “Countable assets” include any resources you own now and can easily sell for cash. Examples include your jewelry, property, 401k or IRA accounts, stocks or bonds.

Things that never count towards your $2,000 asset limit include:

• Your house (if you own it) and the lot it sits on
• A vehicle (car, truck, motorcycle, boat) you use for daily travel
• Wedding ring, furniture, clothing or other daily living items (appliances, bedding, towels)

Basically, you won’t qualify for SSI if you own too much stuff or receive too much money every month. Married couples must have less than $3,000 in resources and $1,470 in combined monthly income to qualify for SSI.

3. The Maximum Monthly SSI Payment Is $914 per Person, $1,371 per Couple

Whenever there’s an annual COLA increase, SSI program payments get a raise. However, you also must pass routine status reviews every 3-7 years to keep those monthly payments. As long as your symptoms stay the same or get worse, you’ll keep your North Carolina disability benefits. Once you turn 65, the SSI program stops requiring these disability status check-ins going forward. You still need to meet the SSI income limits, of course. But as long as you do that, you’ll keep getting SSI for life.

How Teachers & State Employees May Qualify for Disability Income Plan of North Carolina (DIP-NC) Benefits

Eligible employees participating in the Teachers’ and State Employees’ Retirement System (TSERS) or Optional Retirement Program (ORP) may qualify for DIP-NC benefits. Working at least 30 hours per week for 9+ months each calendar year makes you an eligible employee. However, you cannot apply for DIP-NC benefits until you’ve been a TSERS or ORP member for one full year. Here’s what you need to know:

1. The DIP-NC program enforces a 60-day mandatory waiting period before you can draw STD benefits. You can use any available sick, personal or bonus leave days during this 60-day wait.
2. DIP-NC’s STD benefits last up to 365 days once your 60-day waiting period ends. If your medical condition lasts longer, apply for extended short-term disability benefits. Extended STD benefits are payable for 12 more months at the same rate, if approved.
3. Short-term North Carolina disability benefits are 50% of your monthly paycheck after taxes. Your first six months of STD payments are still subject to FICA (Social Security) taxes. DIP-NC program rules say you cannot receive more than $3,000/month in initial or extended STD payments.
4. Only TSERS or ORP employees with five years of membership service are eligible for LTD benefits. Fully vested employees may qualify for long-term disability once their STD benefits end.
5. LTD benefits are 65% of your monthly work wages and are payable for up to 36 months. The max monthly payment from the DIP-NC program is $3,900.
6. If you cannot work at all for health reasons before you turn 67, apply for Social Security disability. Some TSERS or ORP members may qualify for up to $3,627 per month in reduced benefits after their 36-month LTD period.

For more information, read the DIP-NC Member Handbook.

How Eligible Employees Can Qualify for North Carolina’s NCFlex Disability Insurance Plan Benefits

NCFlex provides both short-term and long-term North Carolina disability benefits to employees who qualify. This NCFlex coverage isn’t required, so be sure to enroll as soon as you can!

Important: The NCFlex plan does not cover any employees working in the University of North Carolina system. If health problems force you to stop working, you must apply for benefits through your DIP-NC plan instead.

For everyone else, here’s what you need to know:

• Only full-time, active employees of a state agency, select community college, or charter school can enroll in NCFlex’s disability plan. You must work at least 30 hours per week to count as a full-time employee under the NCFlex plan’s rules.
• Short-term disability benefits through the NCFlex plan begin once your mandatory 14-day waiting period passes. NCFlex’s STD benefits last until the 60th day after you stop working.
• You can receive up to $150 per day, or up to $750 a week in STD benefits. NCFlex pays STD benefits each week. If you also receive workers’ comp or Social Security benefits, they won’t reduce your STD payment amount.
• The NCFlex plan’s long-term North Carolina disability payments start on day 61. If your health makes you unable to work ever again, LTD payments can last until you turn 67.
• LTD payments equal 66 2/3% of your monthly paycheck amount while working. The maximum amount you can receive in monthly LTD payments is $12,500 per month.

For more information on the NCFlex plan’s North Carolina disability benefits, read this booklet.

How to Get Free Expert Claim Help at Home

A North Carolina disability lawyer filing your claim make you nearly 3x as likely to get benefits. They also work on contingency, so you’ll pay the lawyer $0 unless they help you win benefits. And if you do win, then you’ll only pay one small fee.

Want a claims expert to call you for free help? Click the button below to start your free online benefits quiz now and see if you may qualify:

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