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SSDI and injured when should I apply for benefits?

Social Security Disability Insurance (SSDI) is offered to claimants who have a severe health condition or injury which does not allow them to perform substantial gainful activity. Claimants will only qualify for SSDI benefits if their condition is expected to last at least 12 continuous months and they are insured for SSDI benefits.

Recently on our SSDI form a user asked, “If I have an injury can I qualify for SSDI benefits and when should I apply?”


Five-month waiting period and SSDI benefits

Assuming you are eligible for SSDI benefits, there is a five-month waiting period before the SSA will pay you your benefits. This means qualifying claimants will receive their SSDI benefit for the sixth full month after the date the SSA finds their disability started.

So should you wait to file benefits until your six month of disability? No, in fact, if you are disabled and cannot work and you expect your condition to last at least 12 continuous months, it is important to file for SSDI benefits immediately.

Although there is a five-month waiting period, assuming you are eventually awarded benefits, it can take months to receive benefits. In fact, if your claim is denied and you have to appeal it to the appeals court, it could take years to receive benefits.

Onset Date and five-month waiting period

So how do you know when the five-month waiting period begins? If you have just been injured and stopped performing work at a substantial level the onset date of disability will be the date you were injured.

Some claimants, however, stop work and wait several months to apply for benefits. In this case, the onset date of your disability (the date the SSA will key your payments from) is not the date you file for disability but rather the date the SSA determines your disability began.

The onset date cannot be earlier than the date you stopped performing substantial gainful activity or SGA work, but it can be before the date you applied for SSDI. To determine this date the SSA will examine your medical records and determine when they believe your disability started.

Back pay and your onset date of disability

If you became disabled and waited to file for disability the SSA will review your medical records and determine your onset date. The maximum amount of past due benefits paid by the SSA is 12 months, which begins from your established onset date.

SSDI benefits, however, are always reduced by the five-month waiting period. So if your onset date is 17 months before you apply for SSDI benefits, you will be eligible to receive the maximum 12 months of back pay (i.e. 17 – 5 = 12).

Bottom Line:

Disability applicants can wait months to receive SSDI benefits. If you are injured and cannot work you should apply for SSDI benefits immediately. If you have been injured several months ago the SSA will establish your onset date, subtract 5 months for the waiting period, and pay you back pay for the remaining months (up to the maximum of 12 months).
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