SSDI: What Happens Once Your Claim Has Been Approved

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So you have applied for SSDI and your claim has been approved. Now what? You are probably asking yourself questions like: How much money am I going to receive? When will I get it? How often? Am I going to receive these payments for life? These are all important questions to ask. While all of them can be answered on the Social Security Administration website, we have provided a summary of these answers and more below for you:

How Much Money Will I Receive?

As you understand, each person who applies for Social Security disability has their own unique story. The short and easy answer to this question, then, is that it depends. The amount of money you receive for your disability will depend on the amount of money you have earned and paid into the SSA. Once you have been approved, you can calculate your earnings online on the SSA website by looking at your account.

According to Nolo, SSDI recipients generally receive between $300 and $2,200 a month. Currently, the average SSDI payment in 2014 is $1,148. The maximum disability benefit in 2014 is $2,642.

Medicare Coverage

If you are disabled, you will automatically be enrolled in Medicare after receiving disability benefits for two years. Medicare has two parts to it: hospital insurance and medical insurance.

  • Hospital insurance will help pay for inpatient hospital bills and minimal follow-up visits. This part comes from the taxes that you paid into the SSA, so you will not have to pay anything additional for this service.
  • Medical insurance  will help pay doctors’ bills, outpatient hospital care, and other medical services. You will need to pay a monthly premium for this coverage if you want it.

Private companies can offer Medicare plans that can be tailored to your needs. For more information, visit the SSA “How do Medicare Advantage Plans work?” website. You may also receive help paying for prescription medication as prescribed by your doctor.

Depending on your circumstances, you may be able to receive financial help with your Medicare premiums, deductibles, and coinsurance as well. This help, however, is decided by the state in which you live.

When and How Often Will I Receive Payments?

The SSA will determine your “established onset date,” or EOD, which gives an exact date to when your disability began. If your application is approved, your first Social Security benefit will be paid for the sixth full month after the EOD, or the date your disability has been determined to have begun. From then on, you will receive monthly payments.

For example, if your disability began on July 15, 2014, your first benefit would be paid for the month of January 2015, the sixth full month of disability.

Social Security benefits are paid in the month following the month for which they’re due. This means that the benefit due for January would be paid to you in February, etc.

Do I Have SSDI for Life?

Once you have been approved for SSDI and begin receiving your monthly payments, you are not necessarily guaranteed a monthly paycheck for the rest of your life. Generally, you will receive your monthly payments as long as you are disabled. However, if your health improves to the point where you are no longer considered by SSA as “disabled,” or if you are able to go back to work, your payments will end.

Under law, the SSA will review your personal disability case to make sure that you are still disabled while you are receiving benefits. How often your case is reviewed varies from case to case. If the SSA determines that your condition is expected to improve, then you may be subject to more frequent reviews.

As a rule of thumb, the SSA follows the following criteria when reviewing your cases:

If your medical condition is:

  • “Expected,” your case will normally be reviewed within six to 18 months after your benefits start.
  • “Possible,” your case will normally be reviewed no sooner than three years.
  • “Not expected,” your case will normally be reviewed no sooner than seven years.

What Else Can Cause My Benefits To Stop?

In addition to your medical condition improving and the SSA determining that you are no longer disabled, your benefits can also stop if you receive an average income that the SSA deems “substantial.” This also is determined on a case by case basis. For example, in 2014, the average earnings of  $1,070 or more per month ($1,800 or more per month if you are blind) is usually considered substantial.

If You Go Back to Work

Obviously, if you are able to go back to work, then you may no longer be considered for disability benefits. There are circumstances in which you can receive payments as you are starting to go back to work. These payments are used by the SSA as incentives to help you get back into the workplace, and they include continued monthly payments and Medicare coverage as you try to work.

There are other circumstances which could reduce your benefits checks or eliminate them altogether. For example, if you receive certain other government benefits like workers’ compensation, public disability benefits or pensions based on work not covered by Social Security (i.e. government employment).

Workers’ Compensation and SSDI

Workers’ Compensation is made up of payments given to workers who have been disabled while working their respective jobs. If you receive Workers’ Compensation, the total of this and other benefits cannot exceed 80% of your average current earnings.

Other Ways Your Payments Can Be Reduced

Besides receiving pay from Workers’ Compensation, if you are receiving pension payments from a company or other entity that did not pay into Social Security (see Windfall Elimination Provision) then your payments can be reduced. Your spouse, widow, or widower’s benefits may also be reduced (see Government Pension Offset).

Can My Family Also Receive Benefits?

After you have been approved, the following family members may also be eligible to receive benefits on your record:

  • spouse
  • divorced spouse
  • children
  • disabled child
  • adult child disabled before age 22

There is, however, a maximum amount that your family can receive. Individually, each member of the family that qualifies under your record to receive payments can only receive up to 50% of your disability rate. As a family, the total amount that the family members can receive is between 150% and 180% of your benefit.

If the total exceeds this range, then their payments will be reduced. Your personal payments, however, will not be affected.

Photo courtesy of: Rory MacLeod