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Do I have to go 12 months without income to get benefits?

One common question we get on our disability forum is, “Do I have to go 12 continuous months without income to get SSDI benefits?” I am not sure where this misconception originated, but I think it has to do with the rule that a claimant’s condition must be expected to LAST for 12 continuous months for the Social Security Administration (SSA) to consider a claimant disabled. This does not mean they have to WAIT 12 months to apply.

Claimants who have a condition which is not expected to last at least 12 continuous months or result in the claimant’s death will have their Social Security Disability (SSDI) applications automatically denied.

How long do I have to be out of work to apply for SSDI?

So, if you do not have to be out of work for 12 continuous months before you apply for SSDI than how long do you have to wait? SSDI benefits do have a five month waiting period so if you are approved immediately, which is unlikely for most claimants, you will have to wait five months to get your first SSDI payment.

Claimants should, however, apply for SSDI as soon as they are not performing what the SSA calls “substantial gainful activity” or SGA. Claimants who are working or performing SGA work are automatically denied SSDI benefits, as well as those whose condition is not expected to last 12 continuous months.

This type of denial is considered a nonmedical denial and cannot really be appealed. In fact, claimants who are working too much are denied immediately before the SSA requests their medical records and reviews the severity of their condition.

What is Substantial Gainful Activity?

By definition, SGA work for a non-blind worker is$1,010 in 2012 and $1,690 for a blind individual. Consider, however, it would be possible for a worker to make less or no money and still be denied because the SSA said their work was too substantial. For example, workers who are able to work 30 or 40 hours per week, even if it was volunteer work and they were not realizing pay or profit, could still be denied benefits because the SSA would argue their work was “substantial” and the SSA would not consider them disabled.

When should I apply for SSDI?

The most important thing that claimants need to understand is that they should apply for SSDI as soon as they are not able to perform SGA work. Some claimants start to work part-time and then let their work taper off for several years, to the detriment of their SSDI benefits because the SSDI payment is based on the claimant’s average earnings and their payroll tax contribution to Social Security.

Claimants who have the highest average earnings will have contributed the most into the system and can expect to receive the highest SSDI payout. If your average earnings gradually start to decrease, you will be paying less in taxes, but your SSDI benefit will also start decreasing.

Claimants who stop working all together for many years and then decide to apply may also find that they have passed what is their date last insured or DLI and no longer qualify for SSDI benefits.
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