Supreme Court Clarifies "Entitle[ment] to" SSI

July 15, 2025
The Supreme Court justices ruled on what it means to be

During June and July, the legal world spends a lot of time reflecting on Supreme Court cases from the past term. It has been six years since the Supreme Court addressed an issue directly concerning Social Security disability claims (we're proud that Rebecca's previous firm, despite its usual high-dollar clientele, represented the claimant in that dispute: Biestek v. Berryhill, 139 S. Ct. 1148 (2019)). 


The Supreme Court did decide one case this year, however, that is at least tangentially related to Supplemental Security Income (SSI) benefits: Advocate Christ Medical Center v. Kennedy, 145 S. Ct. 1262 (2025). We figured that we'd write a short blog post on the case. 


We should clarify that Advocate v. Kennedy shouldn't directly apply to people applying for SSI. It should only matter to hospitals and their reimbursement rates. But, nonetheless, like most lawyers, we like to opine on Supreme Court cases. (Another attorney at our firm, Zachary, interned at the Supreme Court, and he clerked for a judge who joined the lower court decision in the case discussed below.)



The Dispute in Advocate v. Kennedy

Under federal law, hospitals that serve a “disproportionate share” of low-income patients are entitled to extra Medicare payments. To simplify greatly, the hospitals receive additional payment when they treat a sufficient proportion of patients "entitled to" SSI benefits.


SSI is a program that provides monthly cash payments to elderly, blind, or disabled people with limited income and resources. But not everyone enrolled in the SSI program receives a payment every month—some SSI recipients may temporarily have too much money to qualify. We sometimes hear from old clients, for example, who don't receive SSI during months when they receive an inheritance.


The dispute concerned whether someone is considered "entitled to" SSI benefits during months in which they are enrolled in the SSI program but do not receive cash benefits. If those people are "entitled to" SSI during those temporary months when they don't receive benefits, then the hospitals should have received greater reimbursement from the Medicare program.


The Supreme Court’s Decision

In a 7-2 decision written by Justice Barrett, the Court ruled that someone is only "entitled to" SSI during months when they receive cash benefits. The Court relied on a few laws to make this decision.


First, the Court emphasizes that the SSI program is primarily a cash benefit program. 42 U.S.C. §§ 1381–1383generally define the conditions under which someone will qualify for SSI, and those statutes refer to "paid benefits" or benefits "to be paid." In other words, the statute that created SSI fundamentally describes SSI as a program that pays benefits. Therefore, the Court reasons, someone is "entitled to" SSI when they receive SSI cash benefits.


Second, the Court notes that other statutes refer to SSI as a "cash benefit" paid to eligible enrollees, and that eligibility is considered on a monthly basis.


Perhaps importantly, the Court also relied on its decision in Empire Health Foundation v. Becerra, which held that "entitled to" and "eligible for" benefits are effectively synonymous in the context of Medicare calculations. Even if someone is enrolled in the SSI program, therefore, the Court found that they are not entitled (or eligible) for SSI benefits during months when they are precluded from cash benefits. 


Justice Jackson, joined by Justice Sotomayor, dissented. Justice Jackson emphasized that the Medicare statute used SSI entitlement as a proxy to increase reimbursement for hospitals that served poorer populations. Moreover, Justice Jackson notes that SSI enrollment ensures general monthly stability; even if someone has more resources during a particular month, the enrollment ensures general baseline subsistence.


The majority rejects these arguments. First, the Court notes that even if SSI provides ongoing security, it assesses cash benefits on a monthly basis. Second, the Court rejects an argument--more emphasized by the hospitals than by Justice Jackson--that SSI enrollment also provides "entitle[ment] to" other non-cash benefits, including vocational rehabilitation services and Medicaid.


Was the Supreme Court Right?

I don't have a strong opinion about the case. We're Social Security disability lawyers, which includes representing Supplemental Security Income claimants. But Advocate v. Kennedy fundamentally concerns how to interpret a Medicare statute, albeit one that refers to SSI.


As a general gut-check, the Supreme Court reaches a sensible conclusion: We would more normally say that someone is "entitled to" SSI during months when they are actually receiving SSI benefits. After reading the decision, frankly, I think that this case turns more on the statutory text than the majority or dissent acknowledge: If we are asking whether someone is "entitled to" SSI, we are probably asking whether the word entitled means something more like "eligibility to receive the SSI benefits" or "enrollment in the SSI program." While the opinions both cite precedents about what entitlement entails, I think there is probably more to assess there. The hospitals make a compelling argument, for example, that someone is "entitled to" SSI when they receive other non-cash benefits (such as Medicaid) through their SSI enrollment. 


How the Supreme Court's Decision Matters for Social Security Disability Applicants

We still want to emphasize a takeaway for Social Security disability applicants: It generally makes sense to apply for both SSDI and SSI.


Advocate v. Kennedy addresses people enrolled in SSI who do not receive any SSI payments. Some people are approved for both SSDI and SSI, and they don't receive any SSI payments because their SSDI payments are sufficiently high to make them ineligible for SSI. But even people who do not receive any SSI payments could still benefit from SSI enrollment through other non-cash benefits. 


Disclaimer: The information provided in this blog is for general informational purposes only and does not constitute legal advice. Reading this blog does not create an attorney-client relationship. For advice specific to your situation, please contact Donoff & Lutz, LLC directly to speak with an attorney.

By Rebecca Fate April 19, 2026
No one plans disability. If the time comes, you may not know what programs apply to your situation, what medical conditions qualify, how much in benefits each program provides, and how long the process takes. The first thing to know is that Ohio does not have its own state-run disability cash benefits program for most workers. Instead, most Ohio residents who cannot work because of a medical condition most commonly look to federal disability benefits, such as Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), or to more specific disability programs applicable to certain situations. What disability programs are available in Ohio? Ohio does not operate a separate state disability insurance program like some states do. Ohio residents can still apply for federal disability-related benefits, if they have the required work history, income, or military service. The most common disability benefit programs available to Ohioans include: Social Security Disability Insurance (SSDI) Social Security Disability Insurance (SSDI) is a federal program for people who can no longer work because of a serious medical condition and who have paid enough into the Social Security program through their employment taxes. In many cases, eligibility depends on whether you have earned enough work credits through recent employment. To qualify for SSDI, you must become disabled prior to your “date last insured,” the last date that you have protection against disability. Your monthly SSDI benefit is generally based on your earnings history and how much you paid into Social Security over time. SSDI benefits increase annually to adjust for the cost of living. Supplemental Security Income (SSI) Supplemental Security Income (SSI) is also a federal disability program, but unlike SSDI, it is based on financial need rather than work history. If you have not worked enough, or recently enough, to qualify for SSDI, you may still qualify for SSI if you have limited income and limited assets. SSI usually pays less than SSDI, but it can still provide important monthly support for disabled adults with very few resources. Ohio’s School Employees Retirement System (SERS) Ohio’s School Employees Retirement System (SERS) disability program provides monthly benefits to eligible non-teaching public school employees who become permanently physically or mentally disabled for their SERS-covered job. To qualify, a member generally must have become disabled after joining SERS, apply within two years after contributing service stops, and not be receiving a SERS service retirement benefit or disability benefits from another Ohio retirement system; benefit amounts under the current plan are generally the greater of 45% of final average salary or service credit × 2.2% of final average salary. Ohio’s State Teachers Retirement System (STRS Ohio) Ohio’s State Teachers Retirement System (STRS Ohio) disability program provides monthly benefits to eligible teachers and other STRS members who have a physical or mental condition that prevents them from performing the duties of their most recent STRS-covered job. STRS Ohio does not provide short-term or partial disability benefits; generally, the condition must be expected to last at least 12 months. Private short-term or long-term disability insurance If you or your employer purchased short-term disability insurance or long-term disability insurance before you became disabled, you may be able to file a claim under that policy. These benefits are usually paid through a private insurance company and are based on the terms of the policy. Veterans’ disability benefits VA disability compensation is a monthly, tax-free benefit for veterans who were injured or became ill during military service, or whose service made an existing condition worse. Eligibility can include both physical and mental health conditions, and the amount paid generally depends on the veteran’s disability rating and dependents. Workers’ compensation Ohio workers’ compensation disability benefits provide wage replacement and related benefits when an employee is injured or develops an occupational disease because of work. Depending on the claim, benefits may be temporary total disability while the worker cannot work, permanent partial disability for lasting impairment, or permanent total disability when the worker cannot return to sustained employment. What conditions qualify for Social Security disability in Ohio? To qualify for Social Security disability, you must meet both medical and non-medical eligibility requirements. Perhaps most notably, a medical condition must prevent you from working for at least 12 months (or be expected to last 12 months) or result in death. You generally cannot receive benefits if your condition is expected to improve within 12 months. The key issue is not just whether you have been diagnosed with a condition. The real question is whether your condition limits your ability to perform substantial work on a sustained basis. It is misleading—and sometimes plain wrong—to say that certain conditions are the reason for disability in some percentage of cases. Because the Social Security Administration asks about your functional capacities, a disability claim turns on the limitations caused by all medical conditions. We have won cases, for example, based on the collective effects from lower back problems and depression. Still, we can identify some conditions that we very commonly see in successful disability claims: mental health disorders, such as depression, anxiety, bipolar disorder, or schizophrenia intellectual disability and related developmental disorders musculoskeletal disorders, such as arthritis and degenerative disc disease nervous system disorders, such as epilepsy, strokes, and Alzheimer’s circulatory system disorders, such as coronary or peripheral artery disease respiratory disorders, such as chronic obstructive pulmonary disease (COPD) severe injuries, such as car accidents or workplace injuries This is not a comprehensive list. Since our family first started helping with disability claims in the late 1970s, we have seen just about every condition. It all turns on how your condition limits your ability to work. Do you automatically qualify for SSDI/SSI based on your diagnosis? No! This is a common misconception based on Social Security’s “Listings” or “Blue Book” conditions. While some diagnoses appear in Social Security’s listings, that does not mean a diagnosis alone automatically qualifies you for benefits. The “Listings” only result in disability if the claimant has certain measures indicating that the condition is particularly significant, and most people unfortunately do not meet those stringent requirements. In most cases, Social Security looks at how severe your condition is, how long it has lasted or is expected to last, what treatment you have received, and—most importantly—how your symptoms limit your ability to work. Even if your condition is listed, you still usually need medical evidence showing that you meet the specific requirements. SSDI qualifications in Ohio To qualify for SSDI in Ohio, like elsewhere in the United States, you generally must: have a medical condition that prevents you from working for at least 12 months or is expected to result in death be under full retirement age when applying for disability benefits have enough recent work history and work credits for your age SSI qualifications in Ohio To qualify for SSI in Ohio, like elsewhere in the United States, you generally must: meet Social Security’s disability standard have very limited income have very limited assets or resources Because SSI is a needs-based program, Social Security looks closely at your bank accounts, available resources, household finances, and other income sources when deciding eligibility. How to apply for Social Security disability in Ohio You can apply for disability benefits in Ohio either on your own or with help from a representative or lawyer. In most cases, you will need to submit an application along with additional information about your medical treatment, work history, daily limitations, and financial circumstances if you are applying for SSI. There are generally four main ways to apply for disability benefits: online through the Social Security Administration website ; through a phone call with Social Security; through paper applications, using the Social Security Administration forms ; or in person at your local Social Security office . Before applying, it helps to gather: medical records names and contact information for doctors and specialists work history education records bank account and financial information medications and treatment history dates of treatment and hospitalizations When completing the forms, it is important to be truthful, specific, consistent, and realistic about your limitations. Social Security may also ask for more information or request that you attend a consultative examination. Who handles disability claims in Ohio? In Ohio, the medical review of SSDI and SSI claims is handled by the Division of Disability Determination (DDD) within Opportunities for Ohioans with Disabilities (OOD) , working under agreement with—and funded by—the Social Security Administration. That means disability claims in Ohio usually move through both a federal application system, processed at a local office, and an Ohio-based medical determination through an office in Columbus. How long does it take to get disability benefits in Ohio? The disability process in Ohio can be slow, especially if your case moves beyond the initial application stage. The Social Security Administration estimates that an initial disability decision generally takes 6 to 8 months. But initial disability processing times vary by state. The Social Security Administration Office of the Inspector General (OIG) published a July 2025 report that indicates Ohio, on average, processes initial disability claims in 136.8 days. Just based on our experience, we might estimate that claims are currently processing a little slower than when the OIG issued its July 2025 report. The Social Security Administration has dealt with hiring freezes over the past few years , and our local offices have estimated lower staffing than within any manager’s memory. Moreover, the Social Security Administration has reallocated resources to improve phone call processing . While phone call times have improved, we understand that staff hours have been allocated away from disability claim processing. Many claims unfortunately have to proceed to the hearing level . After requesting a hearing, most people have to wait between 7 and 10 months for a hearing. At the time of publication, four Ohio-based hearing offices (Akron, Cincinnati, Cleveland, Toledo) have an average wait of seven months; the Columbus office takes an average of eight months; and the Dayton office takes an average of nine months. We might note that the Dayton, Ohio hearing office is one of the most efficient hearing offices in the country, with the Administrative Law Judges publishing more than two decisions per day ; in our opinion, the Dayton, Ohio hearing office is simply understaffed. How much do disability benefits pay in Ohio? The amount you receive depends on the program. SSDI payment amounts Your SSDI payment is based on your work history and past earnings. People with higher lifetime earnings usually receive larger monthly SSDI benefits than people with lower earnings histories. In 2026, the average monthly SSDI benefit is $1,630 per month, with a maximum benefit of $4,152 per month. SSI payment amounts In 2026, the federal benefit rate for SSI benefits is $994 per month for an individual, or $1,491 per month for a couple. In many cases, the Social Security Administration reduces monthly benefits due to an SSI recipient’s income or living situation. Ohio does not supplement the federal benefit rate with additional monetary benefits. What happens after you apply? Many disability applicants are denied at the initial stage. If that happens, the next steps may include: reconsideration (another review by the Division of Disability Determination (DDD) within Opportunities for Ohioans with Disabilities (OOD) ) a hearing before an administrative law judge further appeal to the Appeals Council and federal court. Because the process can take a long time, many people end up spending many months or even years moving through the system before receiving a final decision. Do you need a disability lawyer in Ohio? You are not required to hire a lawyer to apply for SSDI or SSI in Ohio. Many people apply on their own. Based on the statistics, however, claimants with attorneys seem to do much better: according to Government Accountability Office statistics, attorney-represented claimants are almost three times more likely to win at a hearing , and according to a National Bureau of Economic Research paper, attorney-represented claimants are approved 316 days faster . And, hopefully, a good attorney will make sure you are much more comfortable—and have to do much less work—during the disability claims process. Frequently asked questions about disability in Ohio How do I qualify for disability in Ohio? To qualify for disability benefits, you generally need a medical condition that prevents you from working for at least 12 months or is expected to result in death. You must also meet the technical rules for the program you are applying for, such as work-credit requirements for SSDI or income and asset limits for SSI. What conditions qualify for disability in Ohio? Many physical and mental conditions can qualify if they are severe enough to prevent substantial work for the required length of time. Common categories include mental disorders, musculoskeletal conditions, nervous system disorders, circulatory problems, and severe injuries. How long does it take to get approved for disability in Ohio? Approval times vary. SSA currently says an initial disability decision generally takes 6 to 8 months, and Ohio hearing-office wait times vary by office, with recent estimates ranging from about six months in Toledo to ten months in Dayton. How much does disability pay in Ohio? There is no single disability payment amount that applies to everyone. SSDI depends on your earnings history. SSI depends on financial need and other countable income. Does Ohio have a state disability program? In most cases, no. Ohio residents usually look to federal disability programs such as SSDI and SSI, along with private disability insurance or veterans benefits when applicable. Disclaimer: The information provided in this blog is for general informational purposes only and does not constitute legal advice. Reading this blog does not create an attorney-client relationship. For advice specific to your situation, please contact speak directly with a Social Security disability lawyer .
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Each year, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) recipients rely on cost-of-living adjustments (COLAs) to offset inflation. These adjustments significantly affect household budgets, but most people do not understand how the COLA is calculated. Contrary to popular belief, COLAs are not discretionary increases or political decisions. They are determined by a legally required formula and applied automatically by the Social Security Administration (SSA). What Is a Social Security COLA? A cost-of-living adjustment is an automatic increase intended to preserve the purchasing power of Social Security benefits when consumer prices rise. COLAs apply uniformly across Social Security programs, including: SSDI SSI Retirement benefits Survivors benefits There is no separate COLA calculation for disability benefits. SSDI beneficiaries receive the same percentage increase as retirees. See 42 U.S.C. § 415(i) . The Inflation Index Used: CPI-W The Social Security COLAs are based on the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W), published monthly by the U.S. Bureau of Labor Statistics (BLS) . The CPI-W measures changes in prices for a market basket that includes: Food and beverages Housing Transportation Energy (gasoline and utilities) Medical care Apparel and other consumer goods Federal law requires the SSA to use CPI-W—not an index tailored to retirees or people with disabilities. See 42 U.S.C. § 415(i)(1)(B) . How the COLA Is Calculated COLAs are determined using a three-month comparison, not annual inflation totals: The SSA calculates the average CPI-W for July, August, and September of the current year. That average is compared to the highest prior average for those same months in any previous year. If the current average exceeds the prior peak, the percentage increase becomes the COLA. If not, no COLA is paid. Benefits are never reduced due to inflation. They either increase or remain unchanged. The SSA explains this process in detail here . Why COLAs Often Feel Inadequate Many disability beneficiaries feel that COLAs do not fully offset rising expenses, perhaps because people receiving disability benefits may see their costs rising more quickly than other people: Medicare premium and medical costs—disproportionately borne by people with disabilities—often rise faster than overall inflation The CPI-W reflects spending patterns of working households, not disabled or retired populations, who may spend on different products COLAs are based on national averages and do not account for regional cost differences At most, COLAs should be viewed as inflation protection , not income growth. When COLAs Take Effect COLAs are typically announced in October, but take effect later: SSDI and retirement benefits reflect the COLA in January payments SSI benefits reflect the COLA in December payments, usually issued in late November This timing difference often causes confusion but does not change the adjustment amount. Can Congress Change the COLA Formula? Yes. Congress may amend the COLA formula through legislation. Proposals have included: Switching to CPI-E, which tracks older Americans’ spending Adopting “chained CPI,” which generally produces smaller increases Absent legislative change, the SSA must continue using CPI-W. Know How Your Benefits Will Change Social Security disability COLAs are automatic, formula-driven adjustments mandated by federal law. While they play a critical role in protecting benefits against inflation, they are limited by the structure of the CPI-W and may not fully account for the unique expenses faced by people with disabilities. Understanding how COLAs are calculated—and how they affect SSI and SSDI differently—allows beneficiaries to better plan and avoid surprises. Disclaimer: The information provided in this blog is for general informational purposes only and does not constitute legal advice. Reading this blog does not create an attorney-client relationship. For advice specific to your situation, please contact Donoff & Lutz, LLC directly to speak with an attorney.
By Zachary Lutz November 19, 2025
If you’re applying for Social Security disability benefits, the Social Security Administration (SSA) will encourage you to track your application through its online portal: “my Social Security.” With due respect for the good people at SSA, we very strongly encourage you to ignore the my Social Security portal (or, at least, to use it only for limited purposes). The Portal is Mostly a Prediction: An Analogy to the Domino’s Pizza Tracker Once upon a time, I went to a party where we ordered Domino’s pizza (still my wife’s favorite). As a bit of tongue-in-cheek fun, we put the famed Domino’s pizza tracker on the TV and cheered every step of the way. Everyone knows, of course, that the Domino’s pizza chef isn’t typing in status updates on every pie. The pizza maker doesn’t have time to update everyone whether they’re tossing the dough, spreading the sauce, adding cheese, watching the oven . . . if you’ve ever worked food service, you know that just isn’t possible. Instead, Domino’s just approximates how long each step takes, and presumably provides actual updates at some steps. For example, when the pizza chef hits “complete” on an order ticket, Domino’s probably has its kitchen system connected to the pizza tracker and can say that they’re waiting for the delivery driver to pick up your order. Although Domino’s is mostly estimating the pizza-making process, Domino’s does an excellent job. It’s an efficient, predictable (and tasty) pizza shop. Indeed, government technologists have explicitly admired the Domino’s pizza tracker! The my Social Security portal also just estimates how far a claim has proceeded through the disability review process (SSA representatives told us as much), but unlike the Domino’s pizza tracker, SSA does a bad job of estimating how long its process takes. And you can’t much fault the agency: due to funding deficiencies, it still has deeply outdated computer systems, and it’s hard to estimate disability claim processing times when claims take wildly different amounts of time to review. Why You Shouldn’t Rely on the my Social Security Portal If it’s not enough that you learn that the portal is simply an estimate of your claim's processing status, please consider some discrete reasons that you should ignore the portal: 1. The my Social Security portal is often wrong and can cause emotional distress. About once every other week, I speak to someone that saw something demonstrably wrong in the my Social Security portal. Many errors are minor. But it is incredibly disheartening to tell someone that they haven’t actually been approved for benefits, or that their benefits are less than the portal says. A few times, our clients have had anxiety attacks after the portal (wrongly) told them that their claim was denied. We’re not the only ones that have seen these problems, and notable computer errors have misled millions of recipients. 2. Even when correct, the portal might induce you to make mistakes. I have always worried that a claimant will see their claim was “approved” in the portal and subsequently ignore future SSA communications. The “approval” can be misleading, such as cases where a claim has been medically approved but still requires other steps before the benefits are paid. Or, in another example, we have had a client who saw their claim was “approved” on the portal, but who did not realize (because the portal did not tell them) that this approval was based on a significantly amended onset date. The claimant need to appeal the approval if they wanted to pursue all of their potential benefits. 3. The portal doesn ’ t include all the necessary information—if you overly rely upon the portal, you risk not communicating with SSA. The SSA says the portal will show your filing date, servicing office, scheduled hearing (if any), etc. The SSA only says it will show about that much. So many steps in a disability application are not reflected in any meaningful way online, possibly including some documents that require response. You cannot assume the portal will always alert you. If you miss a request because you believed “the portal is doing everything,” your claim could be delayed or even denied. 4. You might tolerate unjust delays because the portal suggests that everything is okay. The portal might tell you that your claim is “filed” or “in review,” but that doesn’t mean everything is hunky-dory. Since many claims face delays, missing evidence, or appeals, the portal status provides very little actionable insight. Relying on a superficially unchanged status could lull you into thinking nothing is required on your part, when in fact you may need to do something. It’s hard to know what to do, sometimes, but if you have a good attorney, they should handle things so you don't have to worry too much. What you should do instead Keep detailed records of your application: dates filed, copies of everything submitted, notes of calls with SSA or DDS, names of people you talk to, etc. Call your local SSA field office or the relevant DDS office (or your attorney) if you haven’t heard anything meaningful for more than a couple months. Respond promptly to SSA and DDS requests for information. Keep Social Security (and your attorney, if you have one) updated on your contact information, especially your phone number and mailing address. When Should You Check the Portal? It might feel reassuring to check the portal. But the portal often lags, omits, or misrepresents disability claim processing. As explained above, if you watch the portal too closely, you risk delays, errors, and emotional distress. That said, there are limited reasons to use the portal. Most notably, it can quickly provide your earnings history, which SSA is often slow to release otherwise. In general, check the portal if you’re looking for something specific—but don’t rely on it for vital claim information. What You Can Check Instead While you mostly will receive updates from the Social Security Administration through paper notices, there’s another way to follow claims: through Appointed Representative Services, authorized Social Security disability representatives have access to the Appeals and Appointed Representative Processing Services (AARPS) portal and the Electronic Records Express (ERE). The AARPS and ERE portals aren’t perfect, or complete, but they provide more reliable information than the my Social Security portal. Unfortunately, only appointed representatives—attorneys, for the most part—have access to these portals. So you will need to check with your attorney for updates that might show on these portals. Still, by far the most complete way to monitor steps in your claim: Watch your mailbox and read the letters that the Social Security Administration mails to you. Disclaimer: The information provided in this blog is for general informational purposes only and does not constitute legal advice. Reading this blog does not create an attorney-client relationship. For advice specific to your situation, please contact Donoff & Lutz, LLC directly to speak with an attorney.
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