One of my readers asked:

I had my hearing 2 weeks ago in Denver. The judge made an immediate favorable decision. My lawyer told me that most people get their benefits before they even receive the decision. I’m waiting patiently.

Congratulations on the win!

I have written about how long it takes after a hearing to get a decision, as well as my experience with how long it takes to actually get the benefits.

Personally, I have never seen benefits paid before the receiving a decision.

However, I have started to see some cases where a client receives a letter from the local Social Security office scheduling an appointment to process benefits before the decision is delivered. Clearly, the Judge’s office is entering the decision and Social Security acting on it immediately (and kudos for that), while the decision takes a few days to be delivered by the post office.

This does not happen all the time. In fact I have only see this is a small portion of cases and only on SSI cases. This makes sense since the local office only processes benefits (after a win) on SSI cases. Disability Insurance (SSDI) benefit cases are processed by a regional payment center.

Unfortunately, in many other cases, it takes four to six weeks after the decision before an appointment is scheduled at the local Social Security office. Since this may cause a hardship, it is sometimes possible to get a case expedited for dire need.

In some disability decisions, the judge ask Social Security to review the case, sometimes as short as six months, sometimes the judge asks for a review in a couple of years.

I thought you said that most Social Security disability cases were for “open” disability — where there is no foreseeable end to the disability.

Compared to a “closed period of disability” case, that is true. In a closed period case, either you, or the judge, picks a date when your disability ended, and it is always a date in the past.

Here, the judge expects your condition will improve in the future and you may no longer be disabled.

This does not mean your benefits will automatically end. However, Social Security will review your case to see if your disability continues.

• If your disability continues, your benefits may continue as well (assuming there is no other problem to cause your benefits to stop).
• If your are no longer disabled, your benefits will probably stop.

As in every Social Security disability case, it is vitally important to keep treating even after your have won.

If you do not have a supportive doctor when Social Security reviews your case (and almost all cases are reviewed at some point), a Social Security doctor (who has never seen you) or a Social Security technician may decide based on your limited medical evidence that you are no longer disabled.

Before you put yourself through the drudgery of going down to your local Social Security office, check the Social Security website to see if you can take care of your problem without going in.  

There are a lot of things you can take care of online.

Did you know you can do all of the following at the Social Security website?

• Apply for retirement benefits.
• Apply for disability benefits.
• Check your application status.
• Appeal a recent decision / denial.
• Find out what benefits you can apply for.
• Find out if you can get extra help with your Medicare prescription drug costs.
• Estimate your future retirement benefits.
• Find your full retirement age.
• Estimate your disability and survivors benefits.
• Request a Social Security Statement.
• Change your address or telephone number.
• Get a replacement Medicare card.
• Request a Proof of Income letter to verify Social Security benefit information.

Click for more information about what you can do online at Social Security.

After waiting months (even years) to get your Social Security hearing, and then months more to get the decision, you finally have it!  Social Security has found you disabled. It is “Favorable” (either Fully Favorable or Partly Favorable).

Ok, now what? When do my benefits begin?

Here’s the thing: Social Security disability claims have two parts:

Part 1. Determining if you are disabled? That was what the hearing was about.
Part 2. Determining your eligibility for benefits, the benefit amount, and the amount of back benefits if any.

Part 1 is done. Part 2 is just starting…

Social Security needs to determine your monthly benefits and the amount of your back benefits.

If you were applying for both Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), your benefits for each program are calculated separately by different Social Security offices. In other words, your file now flies off in two separate directions. SSDI is processed by a regional payment center, while your SSI benefits are processed by your local Social Security office.

Once the processing is complete, you will receive separate notices about your benefits for each program. In the upper left side of each notice it will either say “Retirement, Survivors & Disability Insurance” or “Supplemental Security Income.” That is how you know whether the letter is talking about your SSDI or SSI benefits.

Your SSDI benefits will probably be calculated first. Once your monthly benefits and back benefits are calculated you will receive a “Notice of Award” letter, summarizing your benefits. This is usually followed by an “Important Information” letter, which gives you more information, including when you can expect payment.

Your SSI benefits are handled by your local Social Security office. You have to be disabled and qualify financially to receive SSI. Your local Social Security office will contact you to go over your income and assets to see if you still qualify. Please note: Social Security will consider your SSDI benefits in determining your financial eligibility for SSI.  So, your SSI benefits may be reduced or eliminated for any months that you also receive SSDI benefits.

Just as under the SSDI program, you will receive a “Notice of Award” letter followed by an “Important Information” letter describing your Supplemental Security Income benefits and when you can expect a check.

Processing your benefits should take approximately thirty (30) to ninety (90) days.

The good news is that this part of your Social Security case is mostly automatic.  You may be asked to provide paystubs, bank statements or other documents, but remember you are in the home stretch!

photo credit: thomas_sly

A lot of things happen after you approved for Supplemental Security Income benefits.

First, Social Security needs to review your financial eligibility.

Second, Social Security must reimburse the State for any interim assistance you recieved while waiting for your SSI decision. In Colorado, the interim assistance program is called Aid for the Needy Disabled (AND). This means that if you received AND and won your Social Security SSI case, Social Security will first repay the Department of Human Services (Department of Social Services).

Third, Social Security pays out your back benefits in installment payments.

What!?! My brother is on SSI, they didn’t make him wait to get his back benefits.

The way Social Security handles SSI back benefits was changed on May 8, 2006. If you are entitled to receive more than three months of back benefits, your benefits will be paid in three installments paid every six months (Deficit Reduction Act of 2005 and 42 USC § 1383(a)(10)(A), (B)). The first and second installment payments are limited to three months worth of SSI benefits. However, the first and second installments can be increased to more than three months of benefits to pay for the following:

1. Outstanding debts for: food, clothing, shelter, or medically necessary services, supplies or equipment, or medicine; or
2. Current expenses or expenses anticipated in the near term for: medically necessary services, supplies or equipment, or medicine, or for the purchase of a home. 42 U.S.C. § 1383(a)(10)(B).

Installment payments do not apply in two situations:

1. If you have an impairment that is expected to result in death within 12 months; or
2. If you are ineligible for SSI benefits and are likely to remain ineligible for the next 12 months (for example, if you are only entitled to back SSI benefits because you are also receiving Disability Insurance benefits under Title II and the monthly amount exceeds the monthly SSI benefit payment. 42 U.S.C. § 1383(a)(10)(C).

For more information on how to qualify for one of these exceptions, see POMS SI 02101.020.