What Happens After the Social Security Administration Finds You Disabled and You Receive a Favorable Decision in Your Social Security Disability Case

 

Congratulations! You’ve won your Social Security disability case. Now what?

 

This article answers some of the questions you may have after receiving a favorable Social Security disability decision in your claim for Social Security Disability Insurance (SSDI) benefits or Supplemental Security Income (SSI). If you have a question that is not answered in this article, contact disability lawyer Richmond and Norfolk SSD attorney Corey Pollard for a free consultation.

 

Answers to Questions You May Have After Receiving a Favorable Decision in Your SSD Case

 

How long will it take for the Social Security Administration (SSA) to pay me?

 

SSDI benefits are processed in Baltimore, Maryland or at a regional payment center. Usually it takes 60 to 90 days for the SSA to issue a check for past due benefits and to begin paying your monthly benefits if you have a claim for SSDI benefits only. Your birthday determines whether you’ll receive your check on the second, third, or fourth Wednesday of every month. The check covers benefits from the previous month. For example the check for November’s benefits will come in December.

 

SSI benefits are processed at your local Social Security field office. It can take longer to receive these benefits because of where the decision is processed. On average my clients receive SSI payments within four to six months of the date of the favorable decision. The SSA will pay your SSI benefit on the first of each month.

 

It can also take longer to receive back benefits owed under your SSI claim. If your SSI back benefits are worth more than three times the monthly federal SSI benefit rate, which is around $700, then your SSI back benefits will be paid in three installments six months apart. You may, however, be able to receive your SSI back benefits in one payment if you contact the SSA and explain your financial situation. Social Security regulations say that the SSA has the discretion to increase the amount of your installment payments by the amount of outstanding debt you have for food, clothing, shelter, or medically necessary expenses.

 

If you’re receiving workers compensation benefits currently or have negotiated a workers comp settlement in the past five years it could take much longer. In my experience it can take the SSA as long as six to seven months to pay SSDI benefits if it has to evaluate your claim for a potential offset based on the receipt of workers comp benefits. This is why you should contact a workers compensation attorney before settling your claim – to make sure your settlement documents contain language that protects your right to SSDI benefits and that maximizes the amount of money that goes in your pocket.

 

Do I need to give the SSA any additional information to get paid?

 

If you’re receiving SSDI benefits only then you do not need to take additional action to get paid. Payment is automatic unless you’re seeking auxiliary benefits for a child whom is 18 or younger. In that case you will need to complete an application for your dependent children to receive benefits, though your own benefits will be processed automatically.

 

Because SSI benefits are based in part on your financial situation, the SSA will ask you for updated financial information before you get paid SSI benefits. The SSA will contact you after you receive a favorable decision to obtain this information, which can be provided either over the telephone or in person at your local Social Security field office.

 

Will the SSA send a letter explaining my benefits?

 

Yes. The SSA will send you a letter called a Notice of Award. This notice will tell you the following:

 

  • The date your disability benefits will begin

 

  • The total amount of back benefits you’re owed

 

  • The total amount of benefits you’re owed based on back benefits and monthly benefits accrued since the date of your favorable decision

 

  • The amount of benefits withheld for attorney fees

 

  • The date you will become eligible for Medicare or Medicaid

 

  • The amount of your monthly Medicare premium

 

  • Whether the Administrative Law Judge (ALJ) who presided over your case at the Social Security disability hearing has suggested a continuing disability review in the future.

 

When will the SSA send the Notice of Award?

 

You will receive the Notice of Award around the same time that you receive your check for past due benefits. It’s common for the Notice of Award to come after you’ve received a check for all your back benefits. But if you do not receive a Notice of Award within two weeks of receiving your past due benefits, contact the SSA or your disability attorney and ask for a copy.

 

Will the SSA pay my benefits by check or can I sign up for direct deposit?

 

We recommend that you contact your local Social Security office and ask to sign up for direct deposit after you receive your favorable disability decision. Usually it much more convenient and efficient than receiving paper checks from the SSA. And you’ll receive your benefits on the same day each month instead of having to worry about getting your check in the mail.

 

Sometimes the SSA will ask for your bank account information when you apply for disability benefits. Make sure you write down the information you gave the SSA and keep it in a safe place. If you need a Social Security hearing to get approved – and most people do – then it may take more than two years to receive a favorable decision. During that time you may have closed the bank account that you gave the SSA initially. If so make sure you contact the SSA and update it on your current bank account information.

 

What should I do if the SSA sends me a check for more than the amount of benefits I’m owed according to the Notice of Award?

 

Contact your attorney right away and send him a copy of the check in question.

 

The SSA will figure out that it has over paid you. It always does. And when it does it will send you a letter demanding that you repay the overpayment. If you don’t have the money to reimburse the government then it will threaten to suspend your benefits until the money is recovered.

 

Usually the SSA will allow you to negotiate a lower reduction of your monthly disability checks. And sometimes it will even waive all or part of the overpayment. But you can’t count on this. That’s why we recommend notifying the SSA right away if it’s made a mistake and overpaid you.

 

Will my back benefits affect my SSI eligibility?

 

SSI is a federal welfare program for disabled adults and children. There is a limit on how much income or the amount of assets you may have to receive SSI benefits.

 

Your back benefits will likely exceed the amount of assets you can have to receive SSI payments. But the SSA will give you nine months to spend your past due benefits. After that you must have less than $2,000.00 in assets if you are single or $3,000.00 in assets if you’re married to continue to receive SSI benefits. Your home and several other items are on the list of assets that don’t count against the asset limit.

 

How much is the attorney fee?

 

Our retainer agreement sets your attorney fee at 25% of past due benefits paid, including any auxiliary benefits paid to your family, up to $6,000.00. Your attorney fee will never be more than $6,000.00.

 

Will the SSA send the fee check to my attorney directly?

 

Yes. The SSA will send your attorney his fee directly. If the actual amount of the fee is less than the fee listed in the Notice of Award then the SSA will send you a check for the additional amount withheld when it sends you the check for back benefits.

 

Do I have to pay any expenses?

 

Yes. You will need to pay back your attorney for expenses advanced in your case. Usually this includes the costs of obtaining medical records, narrative statements, and deposition testimony from your treating medical providers. The SSA will not pay for these things. Nor will it reimburse your attorney for these expenses. But they are an important part of proving that you’re disabled under the Social Security Act.

 

Your attorney should provide you with a breakdown of the expenses in your case. Go through the breakdown carefully and make sure that the expenses are appropriate. We do not charge clients for phone calls, office supplies, or postage and handling expenses.

 

Will I have to pay taxes on my Social Security disability benefits?

 

Many of you will not have to pay taxes on your disability insurance benefits, but this depends on your total income. If your family’s combined income exceeds $32,000.00 or your individual income exceeds $25,000.00 then you will likely have to pay income tax on part of your disability benefits.

 

We recommend hiring a tax advisor. If you fall into the group whose Social Security disability benefits are taxable you may be able to deduct a portion of the attorney’s fee.

 

Will I receive health insurance coverage if my Social Security disability claim is approved?

 

You become eligible for Medicare after you have received 24 months of Social Security disability insurance benefits. Keep in mind, however, that you may have to pay a premium to receive Part B of Medicare. Part B pays for doctor visits.

 

Disabled adults may qualify for other programs that pay for medical treatment and expenses that are not covered by Medicare or that help with Medicare premiums. You should contact your local Social Services office for more information. We also keep a list of community organizations that can help.

 

You become eligible for Medicaid automatically if you’re found eligible for SSI benefits. Medicaid eligibility will begin three months before SSI eligibility begins, though your Medicaid card may be dated back to the date when your SSI began.

 

What if I already have health insurance coverage?

 

Some of you may have health insurance coverage already, either through a spouse, the military, COBRA, or the Affordable Care Act.

 

If you’re approved for SSDI, you need to contact your private health insurance company and ask how Medicare will work with your current health insurance coverage. Some private health insurance policies state that Medicare will provide primary coverage with your current coverage paying for whatever Medicare doesn’t cover.

 

Those of you who are receiving medical treatment for job injuries through workers compensation need to be careful. Medicare is a secondary payor to workers compensation insurance. You must protect Medicare’s interests when negotiating a workers comp settlement, or else Medicare may pursue legal action to recover monies from you before it will pay for medical care related to the job injuries.

 

My favorable decision says that the Appeals Council may review the decision “on its own motion.” Should I be worried?

 

The Appeals Council, which is located in Northern Virginia, has the power to pull your case and review the administrative law judge’s decision. If the Appeals Council reviews your case and decides that the decision is wrong, it has the power to take away your benefits.

 

This happens in a small percentage of cases but it is still a risk. If the Appeals Council is going to take away your disability benefits you will usually receive written notice within 60 days of the judge’s favorable decision.

 

Am I guaranteed Social Security disability benefits for the rest of my life if I receive a favorable decision?

 

No. The SSA will conduct a continuing disability review in your case every one to three years. Sometimes the favorable decision states when the SSA should conduct a review in your case.

 

When the SSA conducts a continuing disability review it will ask you to complete a questionnaire regarding your medical treatment, your health condition, and any work, education, or vocational training you’ve had. We recommend reviewing your answers with a disability attorney before returning the forms. You want to protect your legal rights to disability benefits and avoid making simple mistakes.

 

If the SSA determines that you’re no longer disabled then it will send you a notice. The notice explains your appeal rights. Read the notice carefully and act quickly. If you file your appeal within ten days of the date of the notice then your disability benefits will continue during your appeal.

 

What can I do to decrease the risk that the SSA will suspend my disability benefits in the future?

 

The SSDI process is based on medical evidence. So is the continuing disability review process. The best thing you can do to insure that your benefits will continue is to keep treating with your doctor. Even though the medical treatment may not cure you, it is an important part of continuing to receive SSDI or SSI benefits. When the SSA conducts its review it will see that you continue to require medical treatment.

 

What is the probability that the SSA will suspend my disability benefits?

 

It is easier to keep your benefits than it is to prove you’re disabled initially. The majority of people are found disabled after a continuing disability review and keep their benefits.

 

What can I do to improve communication with the SSA?

 

After a long fight with the SSA to get your SSDI or SSI benefits it is natural to be skeptical about the SSA. But you shouldn’t have too many problems with the SSA after you’re approved for benefits. Here are some things you can do to improve your communication with the SSA:

 

  • Keep copies of all letters, decisions, and notices you receive from the SSA. Don’t throw away anything!

 

  • Read every document you get from the SSA and take action if necessary. The documents contain important information.

 

  • If you’re having a problem with the SSA go to your local Social Security field office.

 

Do I need to contact my disability lawyer whenever I get an notice from the SSA?

 

No, you don’t have to call or email your attorney whenever you receive a notice from the SSA. But you should contact your attorney when you receive the Notice of Award so that he can check to make sure that everything is correct.

 

Can I get a copy of my Social Security disability file?

 

Of course. You can have a paper copy of your Social Security file for free if you stop by my office and pick it up. Or we’ll mail you a copy for the cost of postage and handling.

 

We keep a paper copy of your file for a few months after the resolution of your case. After that we destroy the paper file and keep an electronic copy of all your exhibits.

 

Will my disability benefits stop if I start working part-time?

 

Maybe. This is fact-specific and depends on how much you make. We have a handout that explains how much you’re able to earn while receiving Social Security disability benefits. Contact us for a copy.

 

A Disability Attorney Who Can Help You After You Receive a Favorable Social Security Disability Decision

 

Corey Pollard can help if you have questions about your SSDI or SSI benefits after receiving a favorable decision from the SSA. We represent disabled adults and disabled children in Richmond, Norfolk, Virginia Beach, Portsmouth, Chesterfield, Charlottesville, Fredericksburg, and Newport News. All you have to do is call, text, or email us to get a free consultation.

 

 

 

 

Corey Pollard
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