To quote an old lottery slogan, “you can’t win, if you don’t play.” It may seem obvious, but you cannot receive Social Security disability benefits if you do not apply.

If fact, many Social Security regulations about Social Security eligibility start with this simple requirement:

Step 1: You apply.

As I have written about before, Social Security uses the protected filing date (PFD) to decide how far back your benefits can go.

From time to time, I receive a phone call like this:

I’ve been disabled since 1994, but Social Security only wants to pay me 12 months of back benefits!

I see. When did you apply for benefits?

Last month…

I then explain how Social Security pays back benefits using the protected filing date as the starting point.

Here is what it comes down to: if you want Social Security benefits, you have to apply!

SSDI and SSI provide different medical benefits:

• Supplemental Security Income provides Medicaid benefits which can pay for treatment, specialists and surgeries.
• Social Security disability insurance provides Medicare benefits, including Medicare Part D, which pays for prescription drugs.

If you get both SSDI and SSI, you may be able to get both Medicare and Medicaid.

Getting both SSDI and SSI is also helpful in mitigating the 5 month waiting period in SSDI cases. While you may not be able to get your Disability Insurance during the first 5 months, you may still be able to get SSI benefits during that time.

Keep in mind that this requires the alleged onset date to be the same as the protected filing date because of the limits on back benefits in SSI cases.

We have talked a lot about how far back can you get Social Security benefits. 

I want to make sure there is no confusion: Social Security does NOT limit you to only 12 months of back benefits.

There is a limit in how far BEFORE your protected filing date (PFD) you can get benefits (12 months in a Social Security Title 2 Disability Insurance claim — SSDI or DIB).

However, this is only part of the total amount of back benefits most people are entitled to.

If Social Security approved your claim as soon as you applied, then you might be limited to 12 months of back benefits (because you won as soon as you filed).

In most cases though, it takes months or years to win your case. Potentially, you are eligible to get benefits for the entire time you are kept waiting AND up to 12 months before you filed for benefits.  

Of course, Social Security requires that you prove that you were disabled that entire time.

If you are disabled, how far back will Social Security pay benefits? Back to when the disabiilty began?

It depends on whether you are applying for Social Security Disability Insurance (SSDI or DIB), or Supplemental Security Income (SSI).

Social Security Supplemental Security Income (SSI) pays benefits back to the “Protected Filing Date (PFD),” the date you contacted Social Security and asked to apply for benefits.

Social Security Disability Insurance, on the other hand, pays benefits up to 12 months before the Protected Filing Date.  However, you should also keep in mind the “5 month waiting period.”

Note: these are maximum back benefit payments. Social Security has to find you disabled back to the PFD (for SSI) or 12 months before the PFD (for SSDI) to get those back benefits.

If you apply for Social Security Disability Insurance benefits (SSDI or DIB), you may be surprised that Social Security keeps the first 5 months of back benefits.

This is referred to as the “5 month waiting period.”

If you awarded benefits back to January 1st, Social Security actually keeps the benefits for January, February, March… all the way through May.  Your disability insurance benefits will start in June.  

What?!?!  But, it is my money!

I know! But, that is how the system works!

However, there is an exception to the 5 month waiting period.

Bear with me while I go over some basics:  Disability Insurance benefits can only be paid 12 months prior to the Protected Filing Date (PFD). 

If your PFD is January 2009, at most you can get benefits back to January 2008. If your Alleged Onset Date (AOD) is January 2008, Social Security applies the 5 month waiting period (keeping your benefits for January through May) and your benefits begin to paid as of June 2008.  

Here is the exception to the 5 month waiting period: if your Alleged Onset Date (AOD) is 5 months or more BEFORE the 12 month maximum back payment period, you do not lose 5 months of benefits?

What? Go over that part again.

Let me put it another way. If your Alleged Onset Date is 17 (or more) months before the protected filing date (PFD), you are eligible to get the maximum 12 months of back benefits prior to Protected Filing Date.

Just keep in mind that you cannot just pick a date 17 months before you applied as your Alleged Onset Date (AOD) and leave it at that.  You have to prove you were disabled back to the Alleged Onset Date. The further back you have prove your disability, the more difficult your case becomes.

The Protected Filing Date (PFD) is the date you contacted Social Security and asked to file an application.

What is so special about that?

The PFD is used to determine how far back your benefits can be paid.

What makes it “protected?”

Since the application process takes time, Social Security does not want to penalize you for delay between the time you ask to start an application and the time you actually finish it.

For example: if you contact Social Security on January 2nd to start an application (Social Security is closed on new year’s day), but do not turn in all the paperwork until February 1st, Social Security will use January 2nd as your protected filing date, even though you did not actually turn in your application until February.

This could mean an extra month of benefits for you.

Nate Craig of Truth of the Matter Asserted has a great article about what it means if a judge wants you to change the date you became disabled, or in Social Security parlance “amend your alleged onset date (AOD).”

Often, by the time the claimant’s hearing comes to be scheduled, the ALJ will review the file for the first time. During this review, the ALJ will determine if the onset date is established by the medical records. Most factors of a proposal to amend an onset date will be either a specific medical finding that seems to correlate with the claimant’s limitations or the claimant has earning posted to their earnings record, including unemployment benefits.

Long story short, if the Judge is asking you to amend the onset date, they essentially are going to award benefits.

Nate makes a great point, but there is one exception to this general rule of thumb: SSI cases.

In a SSI (Supplemental Security Income) case, you can only get benefits back to the Protected Filing Date (PFD), the date you requested to file an application.  However, in many SSI cases I see, people (understandably and correctly) claim that their disability began when they stopped being able to work. Normally this is months before they ever filed for Social Security. 

I regularly see Judges asking claimants to change their Alleged Onset Date (AOD) to the Protected Filing Date (PFD).  However, this is just a streamlining measure and does not necessarily mean the judge will approve the case. At least, not in my experience.

However, with this one exception, if the ALJ asks to amend the AOD to any other date, that is usually a good sign!

Read the rest of Nate’s excellent article here.