How Does Social Security Calculate Back Pay for a Claimant Who is Approved for Both SSI and SSDI?



Social Security disability payment calculationsSocial Security’s two disability programs use the same standard for determining disability but the rules for payments and back pay are completely different.  These rules are confusing and inconsistent and the best way to understand how they work is to look at each program separately the consider examples of how concurrent claims (claims involving both SSI and SSDI) work together.

The SSI Program

First, let’s look at the SSI program.  SSI, which stands for supplemental security income, is essentially a welfare program that pays benefits to claimants who do not have enough earnings to qualify for SSDI.  Unlike SSDI, which looks at what you have paid into the system from taxes to determine your monthly benefit, SSI benefits are set out by Congress.  For 2013, the most an SSI recipient can get is $710 per month.  For 2012, the amount was $698 and for 2011 the amount was $674.

SSI payments are also subject to a variety of offsets, meaning that your monthly benefit payment may be reduced if you are receiving other state or federal benefits, if you receive support from family members or even if you live with someone who is working and who earns more than a set amount.

When you apply for SSI benefits, the earliest you can get paid past due benefits is the date you apply.  So, if you apply for SSI on November 3, 2011 and allege that you became disabled on May 17, 2009, your past due benefits can start no earlier than November 3, 2011.  If your hearing is in March, 2013, and you win, you would get past due benefits from November, 2011 through March 2013 but you could not recover past due benefits prior to your November, 2011 application date.

Unlike SSDI however, there is no “5 month waiting period” for SSI, so your past due benefits would start as of your application date and not be delayed by 5 months.

The SSDI Program

SSDI stands for Social Security Disability Insurance and it represents a kind of insurance program that you fund through payroll taxes.  Unlike Social Security retirement, however, SSDI looks only at the 10 year period of time prior to your disability onset date.  In order to be covered you must show that you have worked and paid into the system for approximately five out of that ten year period.  The calculations are slightly different for younger workers, but for purposes of this article, you will be insured if you earned around $4,000 per year for five out of the last ten years, counting backwards from the date you became disabled.

When you apply for SSDI, your lawyer will be able to show you your date last insured for SSDI – in order to recover SSDI benefits you must be found disabled prior to that date last insured.  For example if your date last insured is September 30, 2012, you are eligible for SSDI if the judge finds that your disability began on September 28, 2012 but you would not be covered if it began on October 3, 2012.

When you apply for SSDI, you can allege an onset date in the past but you can only get paid for 1 year prior to your application date.  For example, if you apply for SSDI on November 3, 2011 and you allege an onset date of May 17, 2009, you can only get paid starting on November 3, 2010.  You cannot collect past due benefits for the May, 2009 – November 2, 2010 period of time.

SSDI payments are also subject to a “5 month waiting period.”  This means that you do not get paid SSDI for the first 5 full months starting with your onset date.

In the example above, the five month waiting period would run from June, 2009 through October, 2009.  Since the five month waiting period runs well before the 1 year look back, the waiting period would not change at all the size of your lump sump back benefit check.

Combining the Rules for SSI and SSDI

Now let’s look at a scenario where both SSI and SSDI come into play.  Suppose that you applied for SSI and SSDI on November 3, 2011 and you allege an onset date of September 4, 2011.  You appear at a hearing and the judge approves your claim as filed.  In this case:

  • you become eligible for SSDI as of September 4, 2011.
  • the “5 month waiting period” runs from October, 2011 through February, 2012 – remember that the waiting period calls for 5 full months, so the partial month of September, 2011 does not count
  • you are first eligible for SSDI as of March 1, 2012
  • the earliest you can get paid SSI is November 3, 2011, the date you applied
  • you would get SSI payments for the period of time November 3, 2011 through February 28, 2012
  • as of March 1, 2012, you would begin to receive the higher of the two payments – in other words, you don’t get an SSI payment + an SSDI payment – once the SSDI kicks in, it offsets your SSI dollar for dollar

These calculations get more confusing because SSI and SSDI will each send you a series of letters setting out what you are going to be paid and when.  SSI first sends out letters as if there is no SSDI, but later will send you letters stating that your SSI has been terminated.  As you might imagine I starting getting phone calls when these termination letters arrive, although they only mean that you will not continue to get SSI as of the date your SSDI kicks in.

About

Jonathan Ginsberg represents Social Security disability clients in Atlanta and throughout north Georgia

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