If your Social Security Disability Insurance (SSDI) claim is denied, you do not necessarily lose the benefits you would have received while waiting for a decision. A successful appeal may entitle you to back pay covering the months you were eligible for benefits but did not receive them.
Because the appeals process can take months or even years, back pay can represent a substantial amount of money. However, how much you receive depends on when your disability began, when you applied and how long your claim took to resolve.
Appealing an initial SSDI denial
If you believe your SSDI claim was wrongly denied, you can first request a reconsideration. This allows someone who was not involved in the original decision to review your application and any additional evidence you provide. Updated medical records, treatment information and other documentation may help establish your eligibility. If reconsideration is unsuccessful, you can request a hearing before an administrative law judge.
You generally have 60 days after receiving a denial notice to file any appeal. Missing that deadline could mean starting the application process over unless the Social Security Administration (SSA) grants an extension for good cause. Starting over could also affect how much back pay you can recover. That’s why it is always to your advantage to continue a claim via appeal, so that your back-due benefits remain intact.
How is SSDI back pay calculated?
If an appeal succeeds, the SSA calculates your back pay based on the months you were entitled to benefits but did not receive payments. Several factors determine that amount, including:
- Your disability onset date: This is when the SSA determines your qualifying disability began.
- The five-month waiting period: Most applicants cannot receive SSDI benefits for the first five full calendar months of disability. The start date will be tied to your disability onset date, and may or may not be when you actually stopped working.
- Your application date: SSDI may cover up to 12 months before you applied, provided you met the eligibility requirements during that time.
- The length of your appeal: If your original application remains active throughout the appeals process, you may recover benefits for eligible months spent waiting for approval.
For example, if you are eventually approved after an appeal lasting two years, you may qualify for a substantial back payment. However, the amount will depend on your established disability date, monthly benefit amount and applicable limitations. If you had attorney representation for your appeal, this is also the money from which your attorney will be paid.
An SSDI denial does not necessarily mean losing the benefits you have already waited months or years to receive. Seeking professional legal guidance can help you understand your appeal options, protect important deadlines and pursue the back pay you may be owed.