The Social Security Disability Insurance (SSDI) application process is notorious for taking a lot of time. This can be an anxiety-inducing period for many people who can only rely on SSDI payments for their survival. As a result, many are forced to wonder why it is taking so long to hear back from the Social Security Administration (SSA).
Part of the long waiting time is the mandatory five-month waiting period that every applicant must go through. Apart from this, the waiting period depends on what kind of condition you have, as some are approved more quickly than others.
Keep reading below as we talk about why it is taking so long to complete the SSDI application process and how you can potentially expedite it.
Why is it Taking So Long to Hear about SSDI Results?
SSI and SSDI are two different disability programs that are administered by the Social Security Administration.
People who are extremely low-income and have no other means of meeting their basic necessities are eligible for SSI benefits. Individuals who have worked and paid Social Security taxes on earnings or income from self-employment for an adequate amount of time are eligible to receive SSDI benefits.
When an individual applies for either SSI or SSDI, their application is sent to a local Social Security field office, which then evaluates the application to verify the applicant’s non-medical eligibility. For SSI applicants, this includes verifying their income and resources, while SSDI applicants verify their past employment. The applications are then sent to a local office of the Disability Determination Service, a federally funded organization that operates in every state.
Your application will be evaluated by the local office of the Disability Determination Service (DDS) which processes it to see if you satisfy the necessary medical requirements to obtain either SSI or SSDI benefits.
It does so by reviewing your medical history and, if necessary, setting up a second opinion exam with either your treating doctor or an impartial medical expert. The staff of DDS will then evaluate the claim and decide whether or not to grant it.
This stage of the process is referred to as the initial determination of disability.
Social Security estimates that it will take three to five months before you receive notice of the initial disability finding; however, there are several variables that could cause a delay, such as:
- Hospitals and other medical facilities’ turnaround times for fulfilling DDS requests for copies of patient’s medical records.
- Failure to appear for scheduled appointments for a consultation examination that the DDS had planned for you.
- Failure to respond to requests for information regarding the application or to schedule a consultation examination made by the DDS.
A disability advocate will make sure you don’t miss important medical visits and reply quickly to Social Security notices.
Your disability advocate will also coordinate with your treating physicians to speed up the transfer of any medical records that can help your case and lead to a disability acceptance letter.
The 5-Month Waiting Period
There is a five-month waiting period before you can receive Social Security Disability Insurance benefits, which usually begins on the date you became disabled. Your first payment of benefits will not be made until the sixth full month following that date.
If Social Security determines that your disability started on January 15, for instance, your first payment will be scheduled for the month of July, but you won’t receive it until the month after it’s due. This is because Social Security distributes benefits in the month after the month for which they’re due.
Keep in mind that the date that your disability began, which is referred to by Social Security as the onset date, is not the same as the day that your application for SSDI received approval or the date that you filed for the program.
It is possible that you may have been unable to work due to your medical condition for several days, weeks, or months before you claimed benefits (this is known as your “onset date”).
This translates to the fact that, in the event that your application is accepted, it is possible that you will not be required to wait for your benefits for an excessively long period of time after that.
In November 2022, the typical processing period for an SSDI application by Social Security was 204 days, which is equivalent to roughly seven months.
Even if you submitted your claim on the same day that you became handicapped, there is still a possibility that the waiting period will have passed before your claim is accepted.
Let’s imagine that in October 2022, you decided to apply for Social Security Disability Insurance because of your persistent back pain that was getting worse.
Social Security approved your claim in February 2023 after reviewing your medical records and other information and concluding that your health became so bad that it prevented you from working on July 15. Your very first payment would be for the month of January, but you wouldn’t get it until the month of February.
And what if Social Security decides that your disability began even earlier, in April 2022? Although you were technically eligible for benefits as early as October 2022, you were unable to receive them due to the pending status of your application.
If this is the case, Social Security may be able to pay you back payments for the three months that passed between the conclusion of your waiting period and the day that it approved your application for benefits.
Why is There a Waiting Period?
There has always been a five-month waiting period since the beginning of the Social Security Disability Insurance program in the middle of the 1950s.
The purpose of this is to ensure that applicants really do have a condition that will remain for an extended period of time rather than a temporary illness or injury from which they may recover quickly, and to discourage people who are able to work from applying for the program.
According to the findings of the Congressional Research Service, doing away with it would have a significant financial impact on Social Security.
How to Expedite Your SSDI Claim
There are exceptions to this waiting period. In this section, we’ll discuss how you can expedite your SSDI application.
Compassionate Allowances (CAL)
With the Compassionate Allowances (CAL) program, applicants with illnesses and other medical conditions that automatically qualify under the Listing of Impairments with very little objective medical evidence can have their claims processed more quickly.
The CAL program covers more than 200 different medical issues.
The Social Security Administration states that CAL conditions are formulated using feedback from the general public, advocacy group outreach, Social Security and Disability Determination Service community feedback, advice from healthcare and scientific experts, collaboration with the National Institutes of Health (NIH), and data gathered from previous public outreach hearings.
When determining eligibility for disability benefits, the Social Security Administration looks at which conditions are most likely to meet the criteria.
There is no one-of-a-kind application or form that is specific to the CAL initiative, and the program is not run independently from the Social Security Administration’s other two disability programs, which are SSI and SSDI.
People who have a CAL condition can apply for benefits through the regular process that the SSA uses for submitting claims for disability benefits, and the Social Security Administration will speed up the application process for people who have a CAL condition.
Presumptive Disability (PD)
Presumptive disability payments are meant to help disability applicants make ends meet while the Social Security Administration decides whether or not to approve their disability claim based on “presumed” allowances.
An applicant may be eligible to receive benefits for a period of up to six months while the Disability Determination Services investigates their claim and comes to a conclusion.
The severity of the applicant’s conditions and the applicant’s chances of being approved are taken into consideration when the Social Security Administration makes its judgment about the provision of PD payments. Presumptive determinations do not take financial difficulties into account.
A claimant could be entitled to a presumptive decision and start receiving disability benefits if they have a condition such as (but not limited to) Down syndrome, Lou Gehrig’s disease (ALS), an end-stage renal disease that calls for dialysis, or severe mental deficiencies (in the event that the person seeking assistance is a minimum of seven years of age and has no ability to submit an application on their own).
If an applicant’s disability claim is denied in a final decision, the applicant will not be required to refund PD payments made by the Social Security Administration. While the SSA regional office makes most PD determinations, DDS might suggest presumptive payments under certain conditions.
Terminal Illness (TERI)
A terminal illness (TERI) is a medical condition that has a high likelihood of causing the applicant’s death within a relatively short period of time. It is not necessary for the applicant to mention that the illness is terminal on the application in order for it to be expedited under the TERI program.
A DDS claims examiner or field office representative can refer an application to the TERI program if a doctor or other source has stated that the claimant’s sickness is terminal or if the claimant is getting hospice care in a hospital or at home.
In addition, the case is introduced into the TERI system if the applicant has sought disability benefits on the basis of ALS (formerly known as Lou Gehrig’s Disease) or AIDS.
The illnesses described below are examples of those that qualify for the TERI program, although this does not constitute a comprehensive list; any terminal illness may be eligible for TERI expedited processing.
- Metastatic, advanced, recurring, or incurable cancers
- Esophageal, liver, pancreatic, gallbladder, and brain cancers
- Dependence on a cardiac life-supporting device
- Heart or lung failure that is chronic and requires round-the-clock care and oxygen.
- In a coma for at least 30 days
- Congenitally or genetically flawed infant
- Being placed on the transplant waiting list
Before issuing a TERI ruling, the DDS disability examiner must, as with any other disability case, consult with a medical specialist.
Dire Need
The Social Security Administration will prioritize a disability claim if the applicant cannot afford basic necessities while waiting for a hearing with an Administrative Law Judge. The submission of a “dire need” letter can help speed up the processing of a claim of this nature.
This letter notifies SSA of the aforementioned circumstances and indicates why the claimant may be in jeopardy if forced to wait the customary period of time for a hearing. The applicant does not have to offer evidence to back up their claim of extreme poverty.
However, the SSA may request proof if it finds information that conflicts with the claim. Every claimant who reports financial difficulty will not have their file automatically labeled as a “dire need” case since doing so would prohibit the SSA from helping the most serious cases.
When sending in a letter expressing an urgent need, applicants should make sure that they provide as much evidence as they can to back up their request. Here are some types of evidence that could prove useful in an emergency situation:
- Landlord’s notice of immediate eviction
- A formal notice from a lending institution indicating that foreclosure is soon to occur
- Proof that the homeless shelter has terminated the claimant’s services
- Records of medical expenses, including both actual invoices and predicted costs for future care
If the applicant is lacking any necessities, they should inform the SSA of this fact when they apply. In the event that their circumstances deteriorate after the application has been submitted, they should inform the local SSA field office of this.
The Social Security Administration may withdraw the emergency categorization from the applicant’s disability claim if their situation improves.
Conclusion
If you’re applying for SSDI, it’s good to keep in mind that there will be a long waiting period before you are approved for benefits. Talk to a Social Security Disability attorney to find out your options for expediting your application.
