Disability Reimbursement: Who Is Eligible and Why
Approval of Social Security disability benefits can be a slow process. Unfortunately, due to the volume of applications and the need to investigate each eligible claim, it can take months for the board to send out approval letters, and even longer before you actually begin to receive payments. The Social Security Administration (SSA) acknowledges that this delay is not your fault and believes that this lapse in time should not impact your benefits. Therefore, it has created a policy that allows certain claimants to be reimbursed for the time lost between the claim’s approval date and the payment start date. This is known as back pay.
Understanding Back Pay
If your claim satisfies the disability requirements and the SSA agrees that your claim warrants approval, you’ll most likely be entitled to disability back pay. Back pay is essentially a reimbursement of benefits that you should have received during the application process and as far back as 12 months before filing. Claimants who suffer severe and long term conditions may also be eligible for retroactive back pay starting from the original diagnosis of their conditions, as long as they satisfy the SSA qualifications.
Although the majority of applicants are eligible for back pay, there are exceptions, including the following:
- Claimants who were able to work and secure an income during the delayed period. Since they were able to provide for their families in the interim, and the benefits were not needed, there’s no need to reimburse payments. Therefore, these applicants will not qualify for back pay.
- Claimants whose conditions began within five months of the approval date. The SSA requires a standard five-month window to conduct investigations and benefit calculations before payment is due. This means that all benefit payments for the first five months after approval will be eliminated. This period doesn’t really affect many claimants as the majority of applicants have been living with their conditions for years and therefore require years of back pay—five months is just a drop in the bucket. However, for those who have been injured recently, this window may prevent them from receiving back pay.
Back Pay Approval Qualifications
Back pay depends on the following factors of your claim:
- Disability onset date. When did your disability first become apparent? When did it become debilitating enough to affect your ability to work? Did it begin more than five months ago? If yes, your onset date will be the starting point for your retroactive back pay.
- Application file date. When did you file your claim? This date will determine when your back pay will end and the five-month blackout date begins.
- Approval date. Does the time it took for the disability board to approve the claim fall within the blackout month? How much time is left? This will determine when the back pay block will resume.
- Additional delay times. If your claim must go to an administrative hearing it may prolong approval past the blackout period. If this occurs, your back pay cycle will resume and will be substantially larger than the back pay of a claimant who was approved during the initial investigation.
Receiving Your Back Pay
Depending on the amount that the SSA determines your back pay is worth, it may take several months and several installments for you to receive the full reimbursement. Furthermore, portions of this amount may simply be added to your monthly benefits, so it’s important to keep accurate and organized records to ensure your back pay is actually being paid.
For more information on disability benefits, back pay, or eligibility, feel free to contact our office directly to schedule a complimentary review of your claim. John L. Keefe has dedicated his entire career to Social Security law. Allow his years of wisdom to benefit your claim. Call (508-283-5500) or visit us today!
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