6 Things That Happen After You’re Approved for SSDI

The Social Security Administration’s (SSA) procedures for approving disability benefits are quite complex, and the application process can be daunting for most individuals. However, not many know what to expect once their application for disability is approved.

After being approved for Social Security Disability Insurance (SSDI), a claimant can expect to receive a decision letter that will outline the SSA’s decision. After that, a claimant can expect to be mailed the notice of award, which outlines some of the basic information about their disability benefits.

Many other things happen after SSDI is approved, and we’ll discuss them in detail in this article.

Things That Happen After You’re Approved for SSDI

Following are some things that happen once you are approved for SSDI:

Notice of Decision

If your initial application and reconsideration were both denied by the Social Security Administration, you may have filed for a hearing before an administrative law judge (ALJ). A decision letter will be mailed to you in these situations. Your eligibility for Social Security Disability Insurance benefits will be determined by the ALJ’s ruling, which will be communicated to you via a notice of decision.

There are two categories of favorable decisions: those that are fully favorable and those that are partially favorable for Social Security Disability. Both outcomes indicate that you have been granted benefits. The difference only exists concerning the determination of the onset of your disability.

If the ALJ fully rules in your favor, it implies that the date you claim your disability began is the correct date. Generally, the date of disability onset corresponds to the date you stopped working. 

If the Administrative Law Judge partially ruled in your favor, they have decided either that your disability began on a date later than the one you submitted with your application, or that you were disabled for a time and your disability has now ended. The latter is referred to as a “closed period” of disability.

Notice of Award

If your disability claim is approved by the Social Security Administration or an Administrative Law Judge, you should get a Notice of Award (NOA) within one to three months. However, this time frame might vary widely depending on the caseload of your local SSA field office.

Most questions that arise early on regarding disability compensation are addressed in the Notice of Award. These include:

• The determined onset of disability.
• The award amount for disability benefits.
• The first month of your benefit payments.
• The total amount of retroactive benefits or disability payments to which you are entitled (paid all at once).
• The estimated date of your first disability back payment.
• When you should expect to undergo a continuing disability review.

You have the right to file an appeal if you disagree with the Notice of Award for whatever reason you may have. 

This could be because you think you are owed more in disability back pay or because your monthly benefit amount is incorrect. The instructions for filing an appeal can also be found in the award notice.

Monthly payments, as outlined in the award letter, will continue to be made during the appeals process. If your appeal is upheld, the Social Security Administration will adjust your payments accordingly.

Pre-Effectuation Review Conference 

A pre-effectuation review conference (PERC) is necessary if you are approved for Supplemental Security Income (SSI). 

A PERC verifies that you are still financially eligible for SSI benefits. If you are only getting SSDI benefits, a PERC is not necessary.

Continuing Disability Review

All people receiving Social Security disability benefits must undergo CDRs, or continuing disability reviews. They may seem alarming, but in most cases, you don’t need to worry. 

A CDR helps the Social Security Administration decide if your condition still prevents you from retaining employment. Benefits are typically sustained by over 90% of beneficiaries after a CDR.

When the Social Security Administration (SSA) decides that you are eligible for SSDI, you will be placed in one of three medical categories. Your classification will be based on the type of disability you have, its severity, and the prognosis for recovery. 

Your case’s CDR frequency is determined by the category you’ve been assigned to. That would include the following:

• Medical Improvement Expected: Every 6–18 months
• Medical Improvement Possible: Every 3 Years
• Medical Improvement Not Expected: Every 7 years, not more than once every 5 years.

Offsets to Benefits

Your payout may be partially offset in particular situations, for instance, if you were given worker’s compensation as a result of an accident that occurred at your place of employment. 

While the SSA should readily consider any offset, human error occurs from time to time. It’s also possible that you failed to inform the SSA of any other benefits you received that could be offset.

Check with the Social Security Administration to be sure they have deducted any necessary offsets from your benefits award. Otherwise, you’ll have to pay back the difference between your benefit award and the amount that you could have gotten if the offset had been imposed correctly.

Medicare

After two years of receiving disability payments (this includes any payments that accrued while you were waiting to be approved), the Social Security Administration will enroll you in Original Medicare (Parts A and B). In the case of people with ALS, however, Medicare coverage will begin the month you become eligible for disability benefits.

Medicare Part A (Hospital Insurance) provides coverage for hospitalizations, skilled nursing facility stays, hospice care, and certain home health care. The money for this coverage comes from the taxes you paid when you were employed.

Medicare Part B (Medical Insurance) is a subpart of Medicare that helps pay for things like doctor visits, outpatient care, some medications, and preventative care. A monthly fee is required to maintain this coverage.

People who are eligible for both Original Medicare (Parts A and B) and the Medicare Advantage Plan (formerly known as Medicare Part C) have the option of enrolling in a private health insurance plan that has been approved by Medicare. 

Medicare Part D, also known as Medicare prescription drug coverage, helps with the cost of medication prescribed by a doctor. 

When Do Disability Payments Start?

Once your Social Security disability claim is approved, you should expect to get your first disability payment within a month or two. Sometimes it takes a bit longer than expected as unfortunately, delayed payments are the norm. 

The Social Security Administration (SSA) does not delay starting SSI payments. 

In most cases, it is dispatched on the first day of each month, except for those months in which the first day falls on a Sunday. In that case, it will be sent to you on the last business day of the preceding month. 

You must be disabled for a full five months before you are eligible to receive your first payment for disability benefits, regardless of whether the application gets approved in the very same month that your disability began. If you become disabled in June 2020, for instance, you may expect your payments to begin in December of that year. 

If your medical condition qualifies for the Compassionate Allowances Program, you may be eligible for an exception to this policy. 

In most cases, nevertheless, the waiting period is consumed by the approval procedure itself. Your check could be further delayed if you receive additional payments such as workers’ compensation or retirement benefits for work that is not covered by Social Security. 

This is because your claim needs to be processed personally by a claims specialist. The amount and start date of your disability payments will be detailed in the award letter you receive from the SSA. 

The notification will also provide your established onset date in case there is any confusion about when the disability began. After 90 days, you can check on the progress of your Social Security Disability Insurance claim by calling the SSA. 

You can do it yourself, or your disability attorney can help you. The process will go more quickly through a disability attorney because they are familiar with the system and who to speak with.

What Other Benefits Can I Get With SSDI?

Here are some other benefits you can get while you receive SSDI benefits:

Medicare

You will be qualified for Medicare after you have been entitled to Social Security Disability Insurance benefits for 24 months.

Medicare is a federal health care program that primarily serves those who are 65 and older. Payments for medical expenses, including hospital stays and doctor visits, are covered by Medicare.

Medicare Part D can be an alternative to paying out of pocket for your medication needs. You will be responsible for the premium, as well as any deductibles and copayments that may be required.

Medicare is an essential program for people who are disabled because it allows them to cover their medical expenses without having to purchase private health insurance, which can be difficult and expensive if they do not have a workplace to help pay for their payments.

COBRA

After leaving your employment, the Consolidated Omnibus Budget Reconciliation Act (COBRA) may allow you to continue your employer’s health insurance for a limited time.

The typical length of time an employee can remain on their company’s health insurance plan is 18 months; however, those who are disabled may be eligible to extend their coverage for an additional 5 years.

If your employer was paying a portion of your premiums while you were employed, they will likely no longer do so after you leave your position. As a result, the cost of your coverage will increase, and you will be responsible for the entire premium. 

Additionally, your employer is allowed to charge you up to 150% of the premium for the additional 11 months of coverage, which brings your total coverage period to 29 months.

Supplemental Security Income (SSI)

SSI is a Social Security disability benefit for people who are:

• Over the age of 65
• Blind
• Disabled
• Have insufficient work credits or no work credits at all to be eligible for SSDI
• Don’t qualify for SSDI because they haven’t worked in a while
• Have a limited income and assets, as well as disabled dependents

Income and asset requirements must be met to qualify for this program. If an individual’s SSDI payment is less than $914 per month or $1,371 for a couple (in 2023), he or she may be eligible for and receive SSI payments as well. 

Receiving multiple benefits at the same time is referred to as “concurrent benefits.”

If an individual is working and earns some income, the income cap may be adjusted accordingly. You can find all of these regulations on the website of the Social Security Administration. SSDI recipients who also receive SSI may be eligible for Medicare.

Workers’ Compensation Disability Benefits

Work-related injuries and illnesses could entitle you to both workers’ compensation and Social Security Disability Insurance. If the sum of your Social Security Disability Insurance and Workers’ Compensation Disability benefits is more than 80% of your average pre-disability earnings, the total amount will be reduced.

Whether you receive a lump sum or installments for your workers’ comp, this holds. The settlement amount resulting in a lump sum payment is calculated to determine how much you would have gotten monthly if the money had been paid to you in installments instead. 

This is done to calculate how much of your disability payments will be reduced so that your total benefits don’t exceed 80% of your average pre-disability earnings.

Private Insurance Disability Benefits

If you are disabled and have private disability insurance, you may be eligible to receive monthly benefits equal to a percentage of your wages (as specified in your policy). 

The payments you receive from this will have no impact whatsoever on the amount of money you receive from SSDI.

Public Insurance Disability Benefits

If you happen to reside in one of the few states that offer its own disability benefits program or are a member of the Civil Service Retirement System, you may be eligible for a variety of public disability benefits. 

Your Social Security Disability Insurance income may be lowered if the sum of your SSDI and public disability benefits is greater than 80% of your average earnings before your disability began.

Conclusion

There are a few things that happen once your disability benefits are approved. It’s important to be prepared for each of them. Navigating disability benefits is difficult, but it becomes much easier once you know what to expect at each stage.