After you apply for Social Security Disability in Virginia, you may have to wait months or even years before you receive a final decision on your claim. Because it takes so long to process disability claims, most people who are approved for Social Security Disability Insurance (SSDI) benefits or Supplemental Security Income (SSI) are owed back payments. If you are approved for benefits you will receive retroactive payments from the date you are found disabled, even if you applied for benefits later.

Social Security Disability backpay can mean thousands of dollars in your pocket. When you’ve been unable to work because of your health, every dollar counts. As your Richmond Social Security Disability lawyer we’ll help you fight for every dollar and medical benefit you’re owed, including backpay and ongoing monthly payments.

Below are answers to some of the most common questions we get about about Social Security Disability backpay in Virginia, Maryland, and elsewhere:

What is an Alleged Onset Date of Disability?

When you complete your Virginia Social Security Disability application you’ll have to tell the Social Security Administration (SSA) the date you became unable to work because of your physical condition or mental disorder. This date is called your “alleged onset date” of disability.

Why is the Alleged Onset Date Important for Your Social Security Disability Claim?

Your onset date determines how you much you will receive in Social Security Disability back pay. With a claim for Social Security Disability Insurance (SSDI) benefits you can receive retroactive pay as far back as 12 months from the date you apply for benefits – so long as you prove disability as of that date. Because the SSDI program has a five-month waiting period, you would have to prove that you became disabled at least 17 months before your application date to get the 12 full months of back pay.

For example, let’s say you filed for SSDI benefits on January 1, 2016 and alleged that you became disabled on June 1, 2015. The SSA would not find you disabled before June 1, 2015, and your back pay would not begin to accrue until November 1, 2015 – five months after the date you’re found disabled.

Now let’s say that you file a claim on January 1, 2016 with an alleged onset date of January 1, 2008. Even if the SSA finds you disabled as of January 1, 2008, your past due benefits will cover only the period January 1, 2015 through December 31, 2015.

With Supplemental Security Income (SSI) there is no retroactive pay based on your alleged onset date. If you are approved you will get back pay from the date you filed your your SSI application through the date of the decision, then monthly SSI payments thereafter.

Can My Alleged Onset Date Prevent Me from Getting Approved for SSD?

Yes – in two situations.

If you have too much in assets, resources, or income to qualify for SSI, then you must file a claim for SSDI. SSDI benefits are based on your work history and how much you have paid into Social Security. With SSDI, there is a Date Last Insured (DLI). This is the date you no longer have coverage under the program. Usually your DLI is five years after the date you last worked at the substantial gainful activity (SGA) level.

If your alleged onset date of disability is after your DLI, then Social Security will deny your claim. You must prove that you’re disabled before your DLI to receive benefits.

Also, you must prove that your severe medical condition has lasted, or is expected to last, for at least 12 months. That is 12 months from the date you allege you became disabled. If you file an application for benefits and allege that your disability just began, then the SSA may deny your claim and find that it is too soon to determine if your disability will last 12 months.

Can the SSA Amend My Alleged Onset Date?

Yes. The SSA may find you disabled as of a date later than your alleged onset date. This is called an amended onset date. Usually the amended onset date corresponds with you turning 50, 55, or 60 – or having a major surgery or diagnosis after you filed your application.

Some administrative law judges (ALJs) like to negotiate. At your hearing, the ALJ may ask you to amend your alleged disability onset date. Doing so will guarantee that you are awarded disability benefits, but will affect the amount of Social Security Disability back pay you receive. Changing your alleged onset date is called moving for an amended onset date.

An Example of Moving for an Amended Onset Date in Your Social Security Disability Claim

We can explain the amended onset date of disability and how it will affect your Social Security claim through an example:

Let’s say you worked until January 10, 2014, which is when your back pain and headaches became so severe that you had to stop working. A few months later you filed your application for Social Security Disability.

When you file your claim for benefits, the Social Security Administration (SSA) will ask for alleged onset date of disability. This is the date you claim your inability to work began. In this example the alleged onset date would be January 10, 2014.

After your initial application is denied, you file a request for reconsideration. When that is denied, you file a request for hearing before an ALJ.

At the hearing the ALJ says that he thinks you are disabled, but that your disability did not begin until August 1, 2015. That is when you underwent your second back surgery. The ALJ asks your Richmond Social Security Disability attorney to move for an amended onset date – specifically August 1, 2015, with the understanding that he will then grant a fully favorable decision.

You can accept the amended onset date, or reject it and move forward with hearing.

You have two options when the SSA awards your claim at the initial or reconsideration level, but amends the alleged onset date: 1) You can accept the decision or 2) You can file an onset appeal. We recommend that you call or e-mail an experienced Social Security Disability lawyer to decide how to move forward.

Advantages and Disadvantages of Accepting an Amended Onset Date of Disability

There are advantages to accepting an amended onset date in your SSD or SSI claim:

  • It is less likely that the Appeals Council will remand or reverse an ALJ’s decision when the claimant moved to amend their onset date of disability
  • You will leave the hearing knowing that you have been approved for Social Security Disability benefits.

There are also two disadvantages to accepting an amended onset date:

  • You are giving up the potential right to additional back pay by moving your disability onset date forward
  • Because your case is being awarded using a later date, you will have to wait longer to qualify for Medicare or Medicaid

Changing your onset date of disability is a big decision. Make sure you understand the consequences before agreeing to do so in writing. Depending on the date offered, it may be a great decision and one that helps you start to recover medically and financially.

What is the Maximum Back Pay Amount I Can Receive for My Social Security Disability Claim?

A question we often get is, “If I am approved for benefits, what is the maximum back pay amount I can receive from Social Security?” Let’s take a look.

There is No Maximum Amount of Back Pay You Can Receive from Social Security

When you read the Social Security Act and the Social Security Administration’s (SSA) Rules and Regulations, you will not find any provision that establishes a maximum back pay amount. Such a limitation doesn’t exist. Instead you have to review the law and examine multiple factors to find the answers, which will vary from case to case.

The most important factor affecting your back pay is the date you file your Social Security Disability application. Your application date limits the maximum back pay amount you can receive.

Under the Supplemental Security Income (SSI) program, the first date you can receive benefits is your application date. You cannot receive SSI payments for any period before the date you filed.

The Social Security Disability Insurance (SSDI) program is different. SSDI claimants can receive back pay for the period 12 months before the date of their application.

The second most important factor that determines your maximum back pay amount is the date that the SSA finds you disabled. This is also called your established onset date of disability, and it is the first date that you were unable to work because of your medical impairments according to the SSA. You will not receive any back pay for the period before your established onset date of disability. If the SSA finds you disabled the first month that you file for benefits, then you will have no back pay under either SSI or SSI.

Another important factor is Social Security’s five-month waiting period. Though there is no waiting period for SSI benefits, SSDI beneficiaries are not entitled to payment until the sixth month after their established onset date.

Your primary insurance amount (PIA) is another factor that determines your maximum back pay. The more money you paid into the Social Security system while working, the higher your PIA. The higher your PIA, the more past due benefits you will receive, all other factors remaining equal.

Finally, the level at which your claim is awarded affects how much you receive in back payments. It can take years to get a hearing before an administrative law judge because of backlogs in the hearing offices. If you are not awarded until the hearing level, then you may receive a significant amount of back pay.

There is no formula to determine the maximum back pay you can receive for your Social Security claim. We have seen the amounts range from a few hundred dollars to more than $50,000.

Have a question about your case? Call or e-mail Social Security Disability lawyer Corey Pollard for a free consultation.