By Michael Shemtoub, trial attorney, Beverly Law. Updated November 2026.
Spinal cord or back injury after an accident?
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Listing 11.08, spinal cord disorders
The listing can be met in three ways (SSA Blue Book):
- A: complete loss of function, meaning a complete lack of motor, sensory and autonomic function of the affected parts of the body, lasting three consecutive months.
- B: disorganization of motor function in two extremities, causing an extreme limitation in standing up from a seat, balancing while standing or walking, or using the arms, lasting three months.
- C: a marked limitation in physical functioning plus a marked limitation in one area of mental functioning, both lasting three months.
Timing matters. SSA says it generally needs evidence from at least three months after symptoms began. When the records show a total cord transection causing loss of motor and sensory function below the injury, SSA will not wait three months to decide (SSA Blue Book, 11.00M4). The medical terms behind these categories are explained in what qualifies as a spinal cord injury.
The general disability test
Outside the listing, SSA asks whether you cannot work at the substantial gainful activity level because of your condition, and whether the condition is expected to last at least 12 consecutive months or result in death (SSA). In 2026, the substantial gainful activity amount is $1,690 a month for people who are not blind (SSA SGA). Claims that do not meet the listing are decided this way, using the person’s work history, restrictions and medical record.
SSDI or SSI
These are two separate programs with different rules.
| SSDI | SSI | |
|---|---|---|
| Who it is for | People with enough work history; the amount is based on that history (SSA) | People with a disability who have little or no income or resources (SSA) |
| Work credits | Generally 40 credits, 20 earned in the last 10 years; younger workers may need fewer (SSA) | Not required |
| Waiting period | Five months; benefits generally start in the sixth full month of disability (SSA) | No five-month wait |
| Asset limit | None listed by SSA | $2,000 for an individual, $3,000 for a couple (SSA) |
| 2026 federal amount | Based on your earnings record | $994 a month for an individual (Red Book) |
Medicare follows SSDI, after a wait. Part A begins automatically after a person has received disability benefits for 24 months (CMS). Add the five-month SSDI waiting period, and the gap between injury and Medicare can run well over two years.
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How an injury settlement affects SSI
SSI counts what you own and what you receive, so a settlement can end or reduce it. Under SSA’s rules, an award or settlement is unearned income. The part spent on medical, legal or other essential expenses connected with the accident, such as attorney fees or medical costs, can be subtracted. The rest counts as income in the month it arrives, and whatever is left becomes a resource the next month (POMS SI 00830.515). With a $2,000 resource limit, a settlement can end SSI eligibility unless it is planned for.
Medicare has its own claim. If Medicare paid for crash-related care, those conditional payments must be repaid when the beneficiary receives a settlement or judgment (CMS). Private health plans and hospitals may assert liens as well; see medical liens after a car accident.
Special needs trusts and ABLE accounts
Two tools can keep settlement money from counting against SSI. The first is a trust under Section 1917(d)(4)(A) of the Social Security Act, often called a special needs trust, or a pooled trust under Section 1917(d)(4)(C) (SSA Spotlight on Trusts). SSA’s 2026 guidance explains that these trusts are exceptions to the general rule that a trust counts as a resource. How the trust spends money still matters. Payments for shelter can reduce the SSI check by no more than $351.33 a month in 2026, food is no longer counted as of September 30, 2024, and payments for other items such as medical care do not reduce SSI (SSA).
The second is an ABLE account. Starting January 1, 2026, the disability must have begun before age 46. SSA disregards the first $100,000 in the account for SSI, and Medicaid continues even if the balance goes higher, as long as the person otherwise stays eligible for SSI (SSA Spotlight on ABLE). A trust or ABLE account should be set up with advice from a lawyer who handles benefits planning before the settlement money is paid.
Medicaid differs by state
| State | What the state agency says |
|---|---|
| California | Medi-Cal began counting assets on January 1, 2026, for people with a disability: $130,000 for one person plus $65,000 for each extra household member through June 30, 2027, then $21,000 for one person (DHCS) |
| Texas | People found eligible for SSI are automatically eligible for Medicaid (Texas HHS) |
| Washington | SSI-related Apple Health uses a $2,000 resource limit for one person and $3,000 for a married couple (WAC 182-512-0010) |
What this means for your case
Apply for benefits early, and give your injury lawyer copies of every Social Security notice. The settlement and the benefits have to be planned together, because the way money is paid out (directly to you, into a trust, or into an ABLE account) can decide whether SSI and Medicaid survive. Texas cases are handled by the firm’s Texas-licensed attorneys, Joyce Ondich and John Efstathiou. For how damages are measured, see what a spinal cord injury case is worth, and for tax questions, is a settlement taxable. The same benefit rules apply to head injuries, covered in disability benefits for a brain injury.
Common questions
Do I have to wait three months to apply?
No. You can apply right away. SSA generally wants evidence from at least three months after the injury before it decides, unless the records show a total cord transection.
Does a settlement stop my SSDI?
SSDI is tied to your work record, and SSA does not list an asset limit for it. SSI is the program that counts settlement money as income and resources.
Can I work part time and keep benefits?
Possibly. SSA has work incentives, including a trial work period. In 2026, a month counts toward that trial period when earnings exceed $1,210 (Red Book).
Will Medicare pay right away?
Usually not. Medicare Part A starts after 24 months of disability benefits, and SSDI itself has a five-month waiting period.
What if my settlement goes straight into a special needs trust?
SSA’s settlement rules say awards paid directly into a qualifying special needs or pooled trust may not count as income. The trust has to meet SSA’s requirements, so it should be drafted before the money is paid. Beverly Law offers a free case review in English or Spanish at (310) 552-6959. You owe no fees or costs unless we win. Find related answers in our injury law FAQs.
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Related pages
Sources
- SSA, Disability Evaluation Under Social Security (Blue Book), 11.00 Neurological Disorders, Adult (listing 11.08) (ssa.gov)
- SSA, How you qualify for disability benefits (ssa.gov)
- SSA, Disability (ssa.gov)
- SSA, Substantial Gainful Activity amounts (ssa.gov)
- SSA, The Red Book, What's New in 2026 (ssa.gov)
- SSA, Supplemental Security Income (SSI) (ssa.gov)
- SSA, Understanding SSI, SSI Resources (ssa.gov)
- SSA POMS SI 00830.515, Awards and Settlements (secure.ssa.gov)
- SSA, Spotlight on Trusts, 2026 Edition (ssa.gov)
- SSA, Spotlight on ABLE Accounts, 2026 Edition (ssa.gov)
- CMS, Original Medicare (Part A and B) Eligibility and Enrollment (cms.gov)
- CMS, Non-Group Health Plan Recovery (Medicare conditional payments) (cms.gov)
- California DHCS, Medi-Cal Asset Limit FAQ (dhcs.ca.gov)
- Texas HHS, Medicaid for the Elderly and People with Disabilities Handbook, A-2100 Supplemental Security Income (hhs.texas.gov)
- WAC 182-512-0010, SSI standards (Washington Apple Health) (app.leg.wa.gov)
Important: This page is general information, not legal or medical advice, and reading it does not create an attorney-client relationship. Every case is different; talk to a lawyer about yours. Texas cases are handled by the firm’s Texas-licensed attorneys, Joyce Ondich and John Efstathiou. Last reviewed: November 7, 2026.