Why do I have to wait Five-Month’s for my disability benefits?

July 6, 2021 in
social security disability claim

Anyone who is approved for social security disability insurance benefits is subject to a five-month wait period before they are eligible to receive benefits. This five-month wait period begins in the first full calendar month after your disability date. In effect, what this means is that Social Security will withhold five months of approved benefits before starting your monthly benefits. Or, if you are calculating retroactive benefits, they will withhold five months from your retroactive benefits.

There are exceptions to the five-month wait rule. If you are applying for supplemental seucir5yt income, or SSI benefits, there is no five-month wait period. However, those benefits are only eligible to be paid out from the date you initially filed for those benefits. This is an important distinction because if you are approved with a remote alleged onset date, your benefits will only begin after the date you filed for the benefits. For example, if you are approved with an alleged onset date of January 1, 2019, but you did not file for these benefits until June 20, 2019, you will only be paid out benefits as of the filing date, that being June 20, 2019.

Another exception to the five-month wait rule is if your claim for benefits is a reinstatement. Meaning you were previously approved and receiving social security disability insurance benefits but that for whatever reasons those benefits were stopped. If your claim for reinstatement is approved you will not have to wait five months again. That is of course assuming your reinstatement is within five years from your first alleged onset date to the current onset date.

A third exception to the five-month wait period is for dependent or auxiliary benefits. Any dependent benefits that are due are not subject to the five-month wait period.

A final exception to the five-month wait period is if your disability results from amyotrophic lateral sclerosis, or ALS. If your claim for benefit was approved based upon ALS you are not subject to the five-month wait period.

So why is it that social security keeps five months of your benefits? It is said the purpose of the five-month wait period is to ensure benefits are not paid out to people with short-term disabilities. The social security disability program requires a 12-month durational requirement. Meaning, you must show you have been disabled for a minimum of twelve months or that you are expected to meet SSA’s definition of disability for 12 months. The five-month period helps ensure your claim is not simply for short-term disability benefits but that you will be disabled for a minimum of 12 months. It is also said that the five-month wait period is used as a sort of processing fee by social security for processing your application for benefits.

Applying for social security disability benefits is not a quick and easy thing. You first need to submit your application for benefits which can be done either online, in person, or via phone. This application can take anywhere from 1-2 hours depending upon the extent of your information. Once your application is submitted, social security will review your claim to determine if you meet the technical and medical requirements of the program. To meet the technical requirements of the program you must have worked long enough and paid enough taxes on your earnings to have this disability insurance coverage. Generally, if you have worked and paid taxes on your earnings the past five out of ten years you will likely have disability insurance coverage. The next question is to whether you are currently working. If you are currently working and earning over a certain amount per month you will be deemed technically ineligible to receive disability benefits. Substantial gainful activity is a term social security uses to determine if your monthly income precludes you from applying for disability benefits. If you are earning over substantial gainful activity then you are not eligible for benefits. But if you are earning less than substantial gainful activity, or not working at all, you will be able to proceed with your disability claim. The amount of substantial gainful activity changes every year. In 2021 substantial gainful activity is defined as $1,310 a month in gross.

If you meet the technical requirements of the program, social security will then evaluate your medical claim for benefits using a five-step sequential evaluation process. The first step in the process is again to determine you are not engaging in substantial gainful activity. Assuming you are not, social security will then proceed to the second step. The second step of the process determines whether you suffer from a severe impairment. For an impairment or condition to be severe it must pose more than a minimal impact upon your ability to work. This can be through one condition alone or in combination with multiple conditions, both physical and mental. Remember, when you are applying for these disability benefits, social security is not reviewing just one area of your body. They review your body as a whole, both physical and mental conditions, and how they impact your ability to work. The threshold for determining if you suffer from a severe impairment is very low with deference typically given to the Claimant.

The third step of the evaluation is determining if your alleged conditions meet one of social security’s listed conditions that are automatically found disabling. It is very difficult to be found disabled under a social security listing as they require very specific proof of the condition. Assuming you are not found disabled based upon a listing, social security will then review your functional ability to determine if you are capable of performing your past relevant work. If you are not able to perform your past relevant work then they will consider whether there is other work available in the national economy.

If you are found disabled, social security will advise the date you first became disabled. You will then be able to calculate your retroactive benefits, or when your monthly benefits will start five full calendar months from your initial disability date.

There are discussions as to eliminating the five-month wait period. These discussions are promising since the five-month wait period was eliminated for patients with ALS. However, this time frame has not been eliminated as of yet for other alleged conditions. As you can imagine, applying for disability benefits is a complicated task. The regulations of this program are listed in the code of federal regulations which is very large. There are multiple exceptions to every rule. To ensure you are maximizing the benefits you are eligible for call us today at the LaBovick Law Group for a free consultation at (561) 625-8400. We will fight to obtain the benefits you have worked so hard for.