How the SSA Awards Lump-Sum Disability Back Pay

by fihguide   ·  5 years ago  

If a disability forces you to stop working, chances are very good that you’ve been injured or sick for a while now. If your symptoms slowly got worse over time, the idea of collecting back pay for that entire period’s such a relief! After all, you probably haven’t been able to work a full-time schedule for months. Collecting back pay will give you significant peace of mind as you heal or better manage your condition’s symptoms moving forward.

3 Things the SSA Uses to Calculate Your Lump-Sum Back Pay

Let’s review how the Social Security Administration (SSA) calculates back-pay amounts for approved claimants:

1. First, the amount of back pay you’ll receive depends on your work history.

There are two types of disability benefits available to those with approved claims. The first, SSDI, is short for Social Security Disability Insurance. Your FICA tax contributions withheld from every paycheck pays for SSDI benefits. In other words, it’s your money — you’ve been paying for this insurance for years! If you’ve worked full-time for 5 in the 10 most recent years before your claim’s approved, you can collect up to 12 months of back payments in addition to monthly SSDI.

If you haven’t worked consistently or recently enough in the past, you may still qualify for some federal disability benefits. However, a program called Supplemental Security Income (SSI) pays for these benefits, which aren’t funded out of beneficiaries’ past paychecks. Instead, SSI payments come from the U.S. Treasury. As a result, you can get one month of back pay upon approval, but no other retroactive payments.

2. Your back payment amount depends on how soon you applied for benefits after your doctor diagnoses your condition.

There are two important dates to understand when it comes to calculating how much back pay you’ll get. The first is your “alleged onset date,” or AOD. It indicates the date when your disability began — or, more specifically, the date you could no longer work due to your disability. If you don’t write down a specific AOD on your application forms, the SSA sets your AOD as the date when you first applied for benefits.

Here’s where things get a bit tricky.

After your claim’s approved, the SSA will change your AOD to an “established onset date,” or EOD, to use in its place. Back pay covers any amount the SSA would have paid if they immediately approved your claim on the date you filed. Since the SSA has a mandatory five-month waiting period, they’ll automatically owe you those months’ backpay on approval — and possibly more.

3. The SSA may also owe you up to a year’s worth of retroactive pay from SSDI.

Many people stay sick or disabled for years before filing a disability benefits application. If that describes you, then you may qualify for retroactive pay. This type of back pay covers the 12 months before your EOD. If you qualify for it, you’ll get retroactive pay in addition to the five months in back payments you’re owed.

How to Qualify for Lump-Sum Retroactive & Back Payments

To receive retroactive payments, you’ll need to present medical records that show an earlier onset date for your condition than the one the DDS medical examiners choose. Only people with approved disability claims are eligible for retroactive pay. Finally, there must be no official reason to withhold your retroactive or back payments. (Some reasons for withholding lump-sum SSD payments include things like unpaid income taxes or child support.)

If you feel the SSA set the wrong EOD and you deserve more retroactive pay, you can always appeal. You’ll need lab or test results to support your request as well as your doctor’s completed RFC forms. “RFC” stands for “Residual Functional Capacity,” and it covers how well you mentally or physically function. You’ll also want to provide any previous disability claims you filed with the SSA in the past. Finally, if this process seems totally overwhelming to you, talk to a local Social Security lawyer. No lawyer will charge you for a one-time consultation about your disability claim. Not sure where to find one that’s qualified in your area? We can match you with one in your ZIP code today, free of charge!

Related: Next Steps After Submitting Your Online Evaluation Form