It can be frustrating to wait for a positive disability decision because it takes so long. The level of favorability you are assigned will, however, determine what happens after you receive a favorable Social Security Disability Insurance (SSDI) benefits judgment.
The Social Security Administration (SSA) may consider you disabled as of the date of your application if your disability ruling is favorable. Soon after, you will start receiving disability payments, although your first payment won’t arrive until your waiting period, also known as the elimination period, has passed.
Your financial situation will be evaluated, and if you owe any money to the federal government, such as back taxes, that amount may be withheld from your past-due benefits. Other government benefits you receive may have an impact on your monthly award as well.
Your first monthly payment due date and the estimated sum will be provided in a Notice of Award. To learn more about a favorable disability judgment, continue reading.
How Does The Social Security Department Determine Your Favorability Status?
Your application for SSDI benefits will initially be evaluated to ensure that you satisfy the fundamental eligibility requirements. The process for determining disabilities will result in one of three conclusions: fully favorable, partially favorable, or unfavorable.
SSDI’s Decision About Qualifying Disabilities
To assess whether you qualify for disability benefits, there is a step-by-step procedure, including five inquiries. The five inquiries are:
- Are you working?
To determine whether your employment activity is of Substantial Gainful Activity (SGA), the Social Security Disability Administration typically uses earnings parameters. In general, you cannot be considered disabled if your average monthly earnings are more than $1,470 in 2023.
The SSA will send your application to the Disability Determination Services (DDS) Office, which will decide whether to consider your medical condition if you are unemployed or working but not engaging in SGA. The DDS bases its conclusion on steps 2 through 3 below.
- Is your condition “severe”?
For at least a year, your condition must cause more than a minimal effect on your ability to perform fundamental work-related tasks, such as lifting, standing, moving around, sitting, maintaining attention or focus, or remembering instructions. You might not be regarded as having a qualifying impairment if it doesn’t. DDS advances to step 3 if your condition does limit your ability to perform fundamental work-related tasks.
- Is your condition on the list of disabling conditions?
There is a list of medical disorders that, if specific criteria are met, are deemed severe enough to preclude SGA for each major body system. If your ailment is not included, or if you do not exactly meet the specific criteria for your ailment, DDS must determine whether it is equally serious as a medical condition that does meet the criteria. If it is, you will be regarded as having a qualifying impairment. If not, your claim is not over, and DDS will simply proceed to step 4.
- Can you do the work you did previously?
It is decided at this stage whether your medical conditions prevent you from carrying out any of your prior employment. If not, DDS determines that you lack a qualifying impairment. If so, DDS moves on to step 5.
- Can you do any other type of work?
DDS will consider whether there is other work you could undertake despite your medical impairments if you cannot perform the job you previously performed. Your age, education, employment history, health conditions, and any transferable skills you may have are all considered.
Disability benefits are determined to be payable if you cannot perform any other type of job. Your claim will be rejected if it can be determined that you don’t have a qualifying impairment because you can perform other types of work.
What Happens After You Get a Fully Favorable Disability Decision?
You are eligible for disability benefits due to your fully favorable status. The outcome of your case will be very different depending on whether or not your illness is regarded as partially favorable or unfavorable.
- Partially Favorable: Your impairment is accepted as valid. However, it was found that your disability date was erroneous, you were disabled for a brief time, or you are not presently regarded as disabled.
- Unfavorable: You are not regarded as impaired.
Either of these conclusions will, at the very least, partially prevent you from receiving assistance. The SSA’s four-phase appeals process allows you to contest any classification. You’ll get clearance and benefits in the present and retroactively if the appeals procedure confirms the validity of your impairment.
Appealing a Partially Favorable Determination
Because you must appeal the entire decision, it can be hazardous to appeal a partially favorable SSDI decision. If your appeal is rejected, your eligibility for assistance may be completely ruled out. The steps in the SSDI appeals process are as follows:
- The Reconsideration Phase is when an objective assessor who was not engaged in the first examination of your application reexamines it.
- The Hearing Phase: During this phase, an Administrative Law Judge (ALJ), who was not previously involved in evaluating your application, re-examines it.
- The Appeals Council Review: When the Appeals Council reviews the ALJ’s denial of your application.
Your application will be held if the Appeals Council determines it to be legitimate. If not, you can move on to the last round of appeals. The last stage is a federal court review, which is a civil complaint filed in federal court. Legal assistance is strongly advised to ensure you receive a fully favorable verdict during these appeal rounds.
Permanent Benefits After a Favorable SSDI Decision?
You are still subject to an SSDI evaluation procedure called a Continuing Disability Review (CDR) even if your disability is ruled favorable. Typically done every three years, this evaluation updates your assessment of your incapacitating medical condition.
Additionally, your CDR will contain the following:
- Your earnings, if any
- A list of the resources you have
- Your life situation
You will be contacted by SSA representatives for this evaluation, which is done for people receiving Supplemental Security Income (SSI), SSDI, and other benefits. Your reevaluation form might be submitted online at your discretion.
Social Security Disability Insurance Benefits
SSDI payouts are based on your prior contributions. They are available to qualified individuals who have paid into the Social Security System when they were working. The Social Security Trust Fund is where the payments that you and your employer make are kept.
These funds are used to pay SSDI benefits if you are eligible. Your prior earnings determine the amount of your monthly benefit.
Supplemental Security Income Benefits
Benefits from SSI are based on financial need. They are accessible to individuals who do not have enough financial resources and can’t show any sort of financial support. The SSI program’s payouts are paid out of a specified tax pool. Your financial situation, household size, and state of domicile all factor into the extent of your benefits.
Concurrent Benefits
Some SSDI beneficiaries will receive lesser payment amounts because SSDI payments are based on prior earnings and contributions from prior employers. You could also be eligible for SSI payments, which are nearly entirely based on financial need if your benefit award fulfills income requirements.
Conclusion
You will start receiving disability benefits soon after receiving a favorable Social Security Disability Insurance benefits decision, although your initial payment won’t start until your waiting period has passed. Your financial situation will be reevaluated, and if you are owed back pay, the amount will be determined then.
