Securing disability back pay is often the only way to catch up financially after going months (or years) without income while waiting for the Social Security Administration (SSA) to process your application for disability benefits.
Back pay, officially called “past-due benefits,” refers to cash payments owed for periods where you met the non-medical and medical requirements for disability benefits but had not received a favorable determination from the SSA.
If the SSA approves your claim for SSDI or SSI benefits, there is a high likelihood that you will receive these retroactive benefits because of how long Social Security claims take to resolve.
Indeed, there is a large backlog of disability claims pending with the Social Security Administration.
And the data suggests many of you will be denied twice and have to file a request for an evidentiary hearing before an administrative law judge (ALJ) before the SSA allows benefits.
These steps take time, sometimes years.
Though subject to limitations discussed later in this article, disability back pay routinely equals tens of thousands of dollars for winning claimants. Indeed, my Social Security law firm has helped multiple individual claimants recover more than $100,000.00 in past-due disability benefits after winning their cases (or obtaining a remand) in federal district court.
This article explains how to get as much Social Security disability back pay as possible, with actionable tips.
Keep reading to learn more.
And call us at (804) 251-1620 or (757) 810-5614 or complete our online form if you have questions about SSDI or SSI or need help with your claim.
We represent disabled adults in Virginia, Maryland, D.C., North Carolina, West Virginia, and Pennsylvania. And we are ready to put our knowledge, skills, and resources to work for you.
The Social Security Administration publishes a document titled, Hearings, Appeals, and Litigation Law Manual (HALLEX).
HALLEX provides policy statements from the SSA’s Appeals Council and procedures that Disability Determination Services (DDS) and the Office of Hearings Operations (including its administrative law judges) should use when deciding claims.
HALLEX I-1-2-7, entitled Past-due Benefits, defines these payments under the SSDI and SSI programs.
In SSDI claims, past-due benefits mean the total cash benefits accumulating for all beneficiaries (yourself and dependents) because of a favorable administrative or judicial determination, up to but not including the month the SSA issued the decision.
A different definition applies to past-due benefits under the SSI program, which is title XVI of the Social Security Act.
In SSI claims, “past-due benefits are the total amount of federal and federally administered state payments accumulated because of a favorable decision through the month of effectuation, including any amounts sent to a state/subdivision under an interim assistance reimbursement agreement, minus any continuing benefits, interim benefits, presumptive disability or blindness payments, and emergency advance payments.”
No.
You will not automatically receive back pay if the Social Security Administration allows your SSDI or SSI claim.
But many of you will. Indeed, most (if not all) of the disabled adults whose claims we have won receive disability back pay.
The reason most Social Security disability claimants receive back pay is simple: These cases often take a long time to resolve, including multiple appeals.
Cash benefits accrue while you wait for a decision, beginning with the application date (or earlier for SSDI claims with alleged onset dates before the application filing date).
Many of you, therefore, will receive back pay if the SSA approves your disability claim at the reconsideration or hearing levels. Only those whose claims are awarded quickly at the initial application level will not receive disability back pay.
Several factors determine the amount of past-due benefits you will get if you win your disability claim.
These factors, which vary from case to case, include the following:
The most important factor affecting your back pay is the date you file your Social Security disability application.
Your application date limits how far back you can receive retroactive benefits.
Under the SSDI program, you can receive retroactive benefits starting twelve months before the date you apply for benefits (so long as you prove you were disabled then).
Because the SSDI program has a mandatory five-month waiting period, you must prove that you became disabled at least seventeen months before your application date to get the twelve full months of back pay.
For example:
Suppose you filed for SSDI benefits on January 10, 2020, alleging you became disabled on May 15, 2019.
In this scenario, the SSA would not find you disabled before May 15, 2019. And therefore, your back pay could not begin to accrue until November 2019 – five full months after the SSA deems you disabled.
Now let’s view a different scenario.
Suppose you filed a claim on January 10, 2020, but alleged an onset date of October 1, 2017.
The SSA may agree with you.
But even if so, your past-due benefits will be limited to January 1, 2019, through January 2020. Because of the waiting period, SSDI beneficiaries are not entitled to payment until the sixth month after their established onset date of disability.
SSI’s rules limit the retroactive benefits available under the program.
If you win your SSI claim, you can receive back pay from the application date to the date the SSA approves your claim. Retroactive payments, however, cannot go further back than the application, even if you prove you were disabled before you submitted the claim.
Here is an example of how it works:
You applied for SSI on March 5, 2021, alleging you became disabled on June 1, 2020.
After denying your case at the initial and reconsideration levels, an ALJ awards benefits on October 1, 2022. The favorable decision finds you disabled as of June 1, 2020.
Despite this finding, you would not receive retroactive SSI benefits from June 1, 2020, through the end of March 2021. Instead, you would receive back pay from April 2021 through September 2022 (the first full month after you applied through the month before the favorable decision).
An effective way to get more disability back pay (particularly past-due SSDI benefits) is to push your alleged onset date of disability as far back as possible.
When you apply for disability benefits, you will have to tell the SSA the date you became unable to work because of your medical impairment. This date becomes your “alleged onset date” of disability.
You cannot receive back pay for the period before your alleged onset date of disability.
As such, I recommend choosing the earliest date possible to serve as the alleged onset date.
In addition, ask your treating physicians to include their opinion on the date you could no longer work in the disability letters they complete.
Another critical factor determining your maximum disability back pay amount is the date the SSA finds you disabled.
This date is called the established onset date of disability. And it is the first date the SSA believes you could not work because of your health.
You cannot receive back pay for the period before your established onset date of disability.
Your primary insurance amount is another factor affecting the back pay calculation.
The more you paid into the Social Security system while working (through FICA taxes), the higher your PIA.
And the higher your PIA, the more past-due benefits you will receive, all other factors remaining equal.
Months or even years could pass from when you apply for disability benefits to when you have a hearing with an ALJ and receive a decision. Indeed, the process usually takes from one to two years for many of my clients. And this time is in addition to any delay between your health worsening and applying for SSDI or SSI.
Here is why:
The SSA denies more initial claims and applications than it approves, which means there is a high likelihood you will need to go through several levels of appeals before you get approved.
And you may have to wait months (or longer) for a decision at each level.
The time you wait, which depends on what stage the SSA allows your claim, affects the back pay amount.
No provision in the Social Security Act or the SSA’s Rules and Regulates limits how much you can receive in disability back pay. Indeed, no such limitation exists.
Depending on how long it takes your case to win and whether there are multiple remands from the federal court or Appeals Council, you could receive $100,000.00 in retroactive benefits or more.
The SSA will pay retroactive benefits in one lump sum.
Typically the SSA will deposit this sum directly into your bank account.
Usually you receive SSDI back pay within 60 days of the SSA approving your claim.
This timeline to receive disability back pay is an estimate, however, as it could take longer. Indeed, you have probably noticed the SSA often moves slowly.
For example, the Social Security Administration often takes longer to process approved claims when you have negotiated a workers compensation settlement that includes the appropriate disability offset language.
Some of you will receive SSI back pay in a lump sum.
But others will receive retroactive SSI benefits in installment payments.
Program Operations Manual System (POMS) Section SI 02101.020 states that the SSA may pay large past-due SSI benefit amounts in up to three installments in six-month intervals.
As far as the Social Security Administration is concerned, you can use disability back pay however you want.
Long-term disability insurers, however, might seek reimbursement from your back pay if you received long-term disability insurance payments while waiting for the SSA to decide your claim. But this is a private matter outside the SSA’s jurisdiction.
If a disability lawyer represents you, the SSA will deduct the approved attorney’s fee from the back pay amount and pay your lawyer directly.
The standard fee is twenty-five percent of past-due benefits, up to $7,200.00 (a recent change).
Your attorney will not collect a fee from your future monthly SSDI or SSI payments.
You may feel frustrated or distressed during the Social Security disability process.
But do not give up.
You are not alone.
And our disability lawyers can help you get all the past-due benefits owed under the SSDI and SSI programs.
Call us at (804) 251-1620 or (757) 810-5614 to build the evidence needed to push the onset date of disability as far back as possible and recover the maximum amount of back pay.