You might get back pay from Social Security Disability Insurance or Supplemental Security Income, depending on the circumstances of your disability case. Back pay provides compensation for any money owed to you while waiting on a favorable decision from the Social Security Administration. Back pay may be available for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).
Understanding Disability Back Pay
When the Social Security Administration approves you for SSDI or SSI, it assigns you an established onset date. This is the date when you became eligible for benefits after being unable to work because of your impairment. Therefore, you should receive back pay between this date and when the Social Security Administration approved you for benefits.
However, not everyone who receives approval for benefits through the appeals process will receive back pay.
Factors That Determine Whether You Receive Back Pay
The amount of back pay you may qualify to receive — and if you qualify at all — depends on several factors. This includes:
- Whether you are eligible for SSDI, SSI, or both
- When you first suffered a qualifying impairment
- When you applied for benefits
- How long it took for you to get benefits through the appeals process
In general, those with a longer wait between their application and their appeals hearing can expect to receive more back pay, assuming the Social Security Administration does not assign them a new onset date during the appeals process.
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Supplemental Security Income Back Pay
SSI is a need-based program, and those who meet the strict criteria and receive approval begin drawing benefits immediately. There is no waiting period for SSI. Once approved, you could be eligible for benefits dating back to when you filed your application.
Example of SSI Back Pay
It took the Social Security Administration 11 months to approve your claim. As a result, you are eligible for the maximum payment of $735. The Social Security Administration would owe you a total of $8,074. You would receive that $8,074 in three payments.
Social Security Disability Insurance Back Pay
Back pay for SSDI differs from back pay for SSI in a few important ways:
First, there is a five-month waiting period for SSDI. This means that even if the Social Security Administration approves you based on your initial claim, you must wait five months from your established onset date to begin receiving benefits.
Different Payout Schedule
SSDI also pays out differently than SSI. If you apply for and receive only SSDI benefits, you will receive your back pay in a lump sum relatively soon after you receive approval.
Example of SSDI Payment
The Social Security Administration took 15 months to approve you for SSDI. You receive $1,000 per month. Because of the five-month waiting period, you would be entitled to 10 months of back pay. In addition, you would receive a $10,000 lump sum.
You May Be Eligible for Retroactive Benefits
Lastly, getting approval for SSDI may allow you to also recover retroactive benefits. These benefits cover the period between your onset date and the date you applied, or 12 months, whichever is less. So, for example, if you became disabled in January but did not apply for benefits until October, you may be eligible to receive up to ten months of retroactive benefits.
What if My Initial Social Security Disability Claim Was Denied?
The Social Security Administration reports that nearly 80% of disability claims are denied. These claims are denied for several reasons, including a lack of a qualifying condition or non-medical reasons, like having too high of an income to qualify. You will not qualify for any back-pay if your initial claim is denied.
If your disability claim was denied, do not fret. The SSA offers a multi-tier appeals process to those whose claims were denied. There are four steps to this process, including:
- Reconsideration: An SSDI or SSI reconsideration involves a new Adjudicator being tasked to your case. They will review the evidence you provided with fresh eyes and choose to either approve your case or reinstitute your denial.
- Administrative Law Judge (ALJ) Hearing: During this step, an ALJ will examine and determine the outcome of your case. Claimants are entitled to legal representation during ALJ hearings.
- Appeals Council: This step serves to review the evidence that existed at the time of the hearing, what was said at your hearing, and the way the ALJ wrote the decision. The Appeals Council can deny a request for a review of the decision, send the case back to the ALJ for another hearing to correct whatever mistake was made, or in some cases award disability.
- Federal court review: If denied by the Appeals Council some cases can be fought in Federal Court. This process can be complicated and it is highly recommended that you consult with a lawyer to make sure that your case meets specific requirements.
This approach applies to both those seeking SSDI or SSI benefits. In addition, you can request a medical or non-medical reconsideration, depending on the reason for denial involved with your case. Remember, you are entitled to legal counsel throughout this process.
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Should I Choose SSI or SSDI for Disability Benefits?
SSI and SSDI are not the same programs. They have a similar goal – provide an income to those who cannot earn a living on their own – but have different approaches to this goal. These are the basics of each program:
- SSI: This program is specifically for those who are disabled or above the age of 65 and below a specific income limit. In addition to income, an individual or couple’s resources are considered. You do not need to have worked to qualify for SSI. In 2022, individuals on SSI can receive up to $841 a month.
- SSDI: This program functions like a state-run insurance agency. To be eligible, you must have a qualifying disability and have worked a specific number of years prior to becoming disabled. You effectively “pay in” to SSDI benefits by paying federal taxes. In 2022, SSDI recipients receive an average of $1358 a month.
The Blue Book and Qualifying Conditions
To qualify for SSI (if you are under 65) or SSDI, you must prove that you meet the SSA’s disability parameters. These parameters are outlined in the SSA’s Blue Book. A few qualifying conditions include:
- Musculoskeletal disorders
- Respiratory disorders
- Mental disorders
- Neurological disorders
This is not an exhaustive list of qualifying conditions. What is truly important about qualifying conditions is that you can prove to the SSA that you cannot work at your full capacity. The SSA website notes that claimants are “responsible for providing medical evidence showing he or she has an impairment(s) and the severity of the impairment(s).”
A disability lawyer from our firm can help you apply for benefits or appeal a denial. They can advise you on the inclusion of additional pieces of evidence that could strengthen your case.
Get Help with Your Benefits and Disability Back Pay
We cannot guarantee you will receive back pay, even if you win your Social Security Disability appeal. However, the team from Berger and Green will present a solid case to try to recover as much back pay as possible when we handle your disability appeals case.
We can often present medical evidence and other proof to the Administrative Law Judge overseeing these hearings. Using this evidence, we try to convince the Administrative Law Judge of the accuracy of the established onset date you included on your application. This may enable you to recover substantial back pay, depending on how long you waited on your hearing.
You can reach a Pittsburgh Social Security Disability attorney from Berger and Green today by calling our offices. We offer free consultations, and you do not owe us any attorney’s fees until we get you approved for benefits.