Many people are unfamiliar with the term “elimination period” regarding disability benefits. It’s an insurance term like “deductible” or “premium,” and an elimination period means a waiting period or qualifying period before you can begin receiving benefits. In the case of Social Security Disability Insurance (SSDI), the elimination period is five months.
With disability cases, the waiting period is in place to see if one’s disability is short-term or long-term in nature. Note that the Social Security Administration does not pay out short-term or temporary disability benefits. Nevertheless, the SSDI elimination period begins from the “official date” when the medical condition becomes disabling. Let’s examine the SSDI process and procedures to provide the full picture.
Only about 30% of disability cases are approved, and the vast majority of applicants need to appeal their original decisions. Most SSDI applicants gradually arrive at a point of permanent disability over the years, slowly becoming less and less able to work due to a chronic, degenerative condition. Because the elimination period requires one specific date to begin, many SSDI applicants will face the challenge of determining the exact date they became disabled.
However, for those who become suddenly disabled due to a horrific accident or botched surgery, it’s important to understand that you can still apply for SSDI benefits during the elimination period—there is no need to wait until the sixth month.
The sooner you file, the better, whether you become disabled suddenly or slowly over time. Remember, it often takes several months to get a decision from SSDI. In fact, it can actually take the Social Security Administration longer to review your claim if you wait until after the elimination period has ended.
If you applied immediately after a sudden disabling injury and received a decision before the elimination period ended, you would not get your first payment until the sixth month.
There are three exceptions to the five-month waiting period to start receiving disability benefits:
Some people mistakenly think that the more severe a disability is, the more disability benefits will be received—this is not the case. Just like the elimination date itself is black and white, so too are the related disabling medical conditions. As far as the Social Security Administration is concerned, you are either disabled or you are not. A quadriplegic on life support gets the same monthly benefit as someone with migraines.
Your average lifetime earnings are used by the Social Security Administration to determine SSDI benefits. At the moment, the average SSDI monthly payout is $800-$1,800/month, and the maximum amount is $3,011/month. Disabled children are covered by SSI, and their monthly benefit amount is based on a variety of factors, including where the child lives (at home vs. medical facility), the child’s resources, and the family’s income and resources. A child covered by medical insurance who lives in a medical facility is limited to receiving just $30/month from SSI.
People who apply to SSDI with gradually disabling conditions regularly receive back pay from the official date of disability (due to often waiting longer to apply). You can receive up to one year of back pay from SSDI if you apply after the elimination period. Back pay is paid out in one lump sum, is only paid out via direct deposit (not a check), and usually takes 60 days to be received.
On the other hand, retroactive pay applies to the time before the official date of disability. Retroactive pay is for people who had to wait a long time for their doctors to rule out other medical conditions and determine if their condition was going to be ongoing. For example, someone may need to undergo surgery first to see if the doctors can correct their condition.
After recovering from the surgery, then a doctor would be able to confirm with certainty that the person is or is not disabled. SSDI will cover this gap. Retroactive pay is also limited to 12 months.
If you receive workers comp, payouts from a government pension, or other disability benefits (possibly from your state or SSI), these amounts may impact how much you receive for SSDI. Some people are eligible to receive SSI and SSDI benefits concurrently. Contact a disability attorney to learn more.
At Dyer, Garofalo, Mann & Schultz, our disability attorneys can help you appeal a disability decision, strategize with you about maximizing your benefits, and simply answer your SSDI and SSI questions. Allow us to fight for you—the Social Security Administration doesn’t make it easy. We work on a contingency basis for our SSDI applicants, so you don’t need to pay us a retainer or by the hour. Our fees will come from a percentage of your SSDI back and retroactive pay.
Contact our Ohio disability lawyers through our online contact form today. We can begin protecting your financial future.
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Many people are unfamiliar with the term “elimination period” regarding disability benefits. It’s an insurance term like “deductible” or “premium,” and an elimination period means a waiting period or qualifying […]
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