5 Month Waiting Period?

Most people who apply for Social Security disability are quite reasonably concerned about getting paid – both their past due lump sum benefit check as well as on-going benefits.   There is a lot of misinformation out there about how SSDI and SSI benefits are calculated, and about the 5 months waiting period in SSDI claims.

Before discussing the 5 month waiting period, it is important to understand a fundamental difference between SSDI and SSI benefits:

SSDI benefits are a type of insurance payment – you have paid taxes into the system and now that you meet Social Security’s definition of disability, you will be paid benefits under your “policy.”  The amount of your payment depends on how much you paid in – if you worked and paid taxes on a $20,000 per year salary, your SSDI benefit will be less than if you had earned and paid taxes on $100,000 per year.  In my practice the average SSDI payment ranges between $1000 and $2,000 per month

SSI benefits are essentially welfare benefits for people with low income and minimal assets.  The amount of your SSI payment is set by statute – currently less than $700 per month.

There are different rules for SSDI and SSI when it comes to your disability onset date

In either SSDI or SSI you can (and should) allege the earliest possible onset.  Perhaps you stopped working 2 years ago but did not file for disability, hoping that your medical condition would improve to the point where you could go back to work.  In an SSDI case, you can get paid up to 1 year prior to the date of your application.  In an SSI case, you can only get paid as of the date of your application.

How the 5 Month Waiting Period Works

The 5 month waiting period applies only in SSDI claims – the rule basically says that you do not get your SSDI benefits for the first 5 full months from the date that you are deemed disabled.   If your onset date is on the 4th of a month, that month does not count (this is why I encourage my clients to allege an onset date on the last day of the previous month.) Here is an example of how this works:

Example 1:  Tom stops working on March 15, 2010, but he does not file for SSDI until June 4, 2011.  He alleges an onset date of March 16, 2010.  If the judge accepts Tom’s onset date and approves his claim, he will get paid as of September 2010.   Because his claim is SSDI, he can get paid up to 1 year prior to his application date (i.e.  June 4, 2010).

Example 2:  Tom stops working on March 15, 2009, but does not file for SSDI until June 4, 2011.  He alleges an onset date of March 16, 2010.  If the judge accepts Tom’s onset date and approves his claim, he will get paid as of June, 2010.  The five month waiting period began to run in April, 2009 thru August, 2009, which is more than 1 year prior to Tom’s application date.  Since Tom can collect as of June, 2010 and his five month period ran prior to June, 2010, he will be eligible for past due benefits as of June, 2010.

If you are confused by the 5 month waiting period and how it impacts your right to collect benefits 1 year prior to your application date, you are not alone.   Usually it is easier to understand when I sit down with my clients and show them how it works on paper using the relevant dates of their case.

Why did Social Security Create a 5 Month Waiting Period?

I have heard several reasons for this provision.  One argument is that SSA wants to discourage claimants from applying until they are fairly certain that their medical issue will be long lasting.  If you know that you will not be paid for the first 5 months of your disability, in theory you would be less inclined to file for disability.

My guess is that SSA uses the 5 month waiting period to save money.  Ultimately it does not really matter why SSA has this policy – this is the current state of the law and given the country’s economic woes, I would not expect Congress or the Social Security Administration to change this rule anytime soon.