Frequently Asked Questions After a Favorable Social Security Disability Benefits Decision

Do I have to do anything such as visit the Social Security Office or complete some forms in order to get paid my Social Security disability benefits?

No. The Social Security Administration (SSA) will process your claim and send you your benefits automatically. But if you have children who were under age 18 (or under age 19 and still in high school) at any time after your “date of entitlement,” it will be necessary to put in an application for them to receive benefits; but your own benefits will still be processed automatically.

How long will it take for SSA to pay me?

As a rule, it takes one to two months for back benefits to be paid and monthly benefits to begin in a Social Security disability case in which no SSI application was ever filed. (When there is SSI involved it takes considerably longer.)

But these are only general rules. In some cases, it takes as long as 3 months for back benefits to be paid. When it takes more than 90 days for back benefits to be paid in a Social Security disability case, it may mean that there has been a bureaucratic mix-up somewhere in the system. In that case it will be necessary to take some sort of action to deal with the delayed benefits.

If 90 days pass from the date of the decision and I am still not paid my back benefits, is there anything that can be done to speed up payment?

It is possible that your attorney may be able to do something if you are not paid after 90 days. Be sure to telephone your attorney to explain that you haven’t gotten paid after about three months. It may be necessary at that point to contact the payment center.

How far back will my benefits go?

Your benefits should begin with the month of the “date of entitlement” in your case. Many people ask why benefits don’t begin on the date they were found disabled. Social Security disability benefits never begin on the date one is found disabled because of the waiting period of five full calendar months. Another rule limits payment of back benefits to 12 months before the date of the application. Therefore, your benefits begin either 12 months before the date of application or five full months after the date you were found to be disabled, whichever is later.

What will the amount of my monthly benefits be?

The amount of your first month’s benefits is shown in your Social Security file. However, the Social Security Administration may recalculate your benefit amount before it pays you. If the Social Security Administration recalculates, it may come up with a higher benefit amount because, for example, all of your earnings might not have been posted when the original calculation was made. Also, there are cost of living increases that are applied every December.

Will I receive a notice from the Social Security Administration explaining my benefits?

Yes. That notice is usually called a Notice of Award. This notice will show the “date of entitlement” and the amounts of benefits for all months of back benefits. It will show the total amount of benefits to be paid to you. It will show the amount of benefits withheld for direct payment of attorney’s fees. It may also give you information about your Medicare eligibility and monthly Medicare premium. It may also give you some information about when to expect a “continuing disability review.”

When will I get the Notice of Award?

The Notice of Award will come around
the time that you receive your check for past-due benefits or direct deposit of benefits if you signed up for direct deposit. The Notice of Award often comes after you receive your past-due benefits.

Should I sign up for direct deposit?

Direct deposit is a great convenience. It is very dependable. You can sign up by contacting your local Social Security office. But if you don’t sign up before your disability hearing then it might be too late to have your back benefits paid by direct deposit because the Social Security Administration may have already sent out your check for back benefits.

There are a couple of problems with direct deposit of past due benefits. SSA sometimes has people sign up for direct deposit right when they apply for benefits. Sometimes, people forget that they even signed up and they keep looking for a check in the mail when the money has already been deposited to their bank account. Worse yet, sometimes people close the bank account that they told the Social Security Administration they wanted to use for direct deposit. If this were to happen to you, you would find that it will take a while to straighten this out. It might be necessary for you to go to the Social Security office to update the Social Security Administration on your current account information.

If l get paid first, should I wait until I receive the Notice of Award before I cash the check or spend my past-due benefits?

There is no problem with cashing the check. But it is best that you deposit your check in an interest bearing savings account and not spend it all until you receive the Notice of Award so that your attorney can make sure that attorney’s fees were withheld and that you have not been overpaid. It is also a good idea to make two photocopies of the check before you deposit it. Send one copy of the check to your attorney and keep the other for your records.

Why would there be a problem if I were overpaid?

If you are paid too much, the Social Security Administration almost always figures it out eventually. Then, after you have already spent all of the money, it will send you a letter demanding that you repay the overpayment. If you do not have the money to repay the full amount of the overpayment, the Social Security Administration may threaten to cut off your checks until the overpayment is recouped. Usually it will accept a more reasonable reduction of your monthly checks, but this is still a hassle and you may have trouble making ends meet during the time that your check is reduced. Under some circumstances it may be possible to get repayment of all or part of the overpayment waived; but this is not something to count on.

When will my regular monthly benefits begin?

Usually regular monthly benefits begin the month after you receive your check for past-due benefits, although occasionally people get a check for regular monthly benefits first. Your check will be sent out to arrive on the second, third or fourth Wednesday of the month, depending on what day of the month you were born. The check will pay benefits for the previous month. Thus, for example, the check for January’s benefits will come in February.

Will I be eligible for Medicare?

Medicare eligibility begins after you have received 24 months of Social Security disability benefits. Note that to receive Part B of Medicare (which pays for doctor visits), you pay a premium that will be deducted from your Social Security disability monthly check.

Disabled people with relatively low income and assets may be eligible for other programs that pay for medical expenses not covered by Medicare and/or pay the Medicare premium for you. To find out if you are eligible for any such programs, you need to check with your county welfare department.

If you have health insurance coverage already, you need to figure out how Medicare works with your health insurance. Many health insurance policies state that Medicare is to provide the primary coverage with your present health insurance paying only for what Medicare doesn’t cover. You need to check with your health insurance company when you get your Medicare card.

The cover sheet of the favorable decision says that the Appeals Council may review the decision “on its own motion.” What does this mean?

In a very small number of cases the Appeals Council in Falls Church, Virginia, will decide on its own to take away benefits awarded by the decision of the administrative law judge. If it is going to do this, the Appeals Council will almost always send you a notice within 60 days of the date of the judge’s decision. (In an extremely small number of cases the Appeals Council will reverse a decision after the 60 days have run.) This is rare, so it is unlikely that the Appeals Council will do this in your case; but if it happens you will have to work out with your attorney how to deal with it.

I understand that I should not spend all of my back benefits until we figure out if attorney’s fees were withheld. Does it happen very often that attorney’s fees are not withheld?

No. Not very often. But it does happen once in awhile.

What’s the difference between attorney’s fees and expenses?

In addition to the fee, attorneys ask you to pay them back for the cost of medical records or reports, and other things that they paid to get in your case. The Social Security Administration will not pay for these things nor will it send your attorney any money for such expenses out of your funds.

Will the check for attorney’s fees be sent out around the same time that I get my check for back benefits?

Yes.

Will I have to pay taxes on the Social Security disability benefits I receive?

Probably not, but this depends on the amount of your total income. Most people won’t have to pay taxes on their Social Security disability benefits. Couples whose combined incomes exceed $32,000 and individuals with income exceeding $25,000 will pay income tax on a portion of their Social Security disability benefits. The IRS has an odd way of figuring out total income for this rule. The IRS uses adjusted gross income as reported on Form 1040, plus one-half of the total Social Security benefits received for the year, plus non-taxable interest.

Single people with incomes over $34,000 and married people with incomes over $44,000 pay tax on a higher percentage of their Social Security disability benefits.

Here’s an odd thing: People whose Social Security benefits are reduced because of the worker’s compensation offset or offsets for other public disability benefits must count the amount of Social Security benefits not paid when determining taxability of their benefits. But if a child receives benefits on a parent’s account, those benefits count only for determining if the child must pay taxes on Social Security benefits received.

If you fall into the group of people who may be taxed on Social Security disability benefits only because you received a large check for past-due benefits during the year, you still may not have to pay tax on your Social Security benefits. Th
e IRS has set up a way to recalculate your back benefits and consider them received in the year you should have gotten them rather than in the current year. Ask the IRS for a copy of Publication 915.

If your Social Security disability benefits end up being taxable, note that a portion of the attorney’s fee may be deductible. However, this depends on the “2% of adjusted gross income” ceiling on miscellaneous itemized deductions. If you have to repay a long term disability insurance carrier because of receipt of Social Security disability benefits you may get special tax relief. Ask the IRS for Publication 525.

The Social Security Administration is supposed to send you a Form 1099 by February 1st of the year after your back benefits are paid. If you will have to pay taxes on your Social Security disability benefits, be sure to compare the information on the Form 1099 with the information on your Notice of Award. The Form 1099s from the Social Security Administration are often wrong. You will need to bring any errors to the attention of your tax preparer. For this reason it is important for you to keep track of how much you actually receive from the Social Security Administration.

Tax law is very complex. Please talk to a tax specialist if you have any questions about taxes on your Social Security benefits.

What is a “continuing disability review”?

The Social Security Administration is required periodically to review the cases of all people who are receiving disability benefits. Usually cases are reviewed every three years; but some cases are reviewed more often. Sometimes the decision will direct the Social Security Administration to conduct a review at a certain time. Often the Notice of Award will tell you when to expect a review.

What will I have to do for a “continuing disability review”?

You will be asked to complete a form about your medical treatment, any vocational training or work and how your condition has changed since the time you were found eligible for disability benefits.

What if the Social Security Administration finds that my disability has ceased but I’m still not able to work?

The notice, which you will receive from the Social Security Administration following a “continuing disability review,” will explain your appeal rights. Read this notice carefully. If you appeal within ten days of the date you receive the notice your benefits will continue during your appeal. So be sure to act quickly.

Is there anything that I can do now to help ensure that my benefits will continue?

The very best thing you can do is to continue seeing your doctor. A lot of people with long-term chronic medical problems stop seeing their doctors because no treatment seems to help. This is a mistake for two reasons. First, it means that when the Social Security Administration conducts a review, no medical evidence will exist to show that your condition is the same as it was when you were first found disabled. Second, and perhaps even more importantly, doctors recommend that even healthy people after a certain age periodically have a thorough physical examination. This is even more important for people who already have chronic medical problems.

Is the Social Security Administration going to make it as difficult to keep my benefits as it did to get them in the first place?

No. Not at all. The disabilities of the vast majority of people are found to continue at the initial evaluation. Few people have their benefits stopped.

Is there anything I can do to make dealing with the Social Security Administration easier?

You shouldn’t expect as many problems dealing with the Social Security Administration while receiving benefits as you had trying to get benefits in the first place. Sometimes, though, some people have problems. Here are some things you can do to try to minimize the hassle:

• Keep all decisions, letters, and notices you receive from SSA in a safe place.
• Read everything you get from the Social Security Administration. The booklets that come with award letters and notices are well written and informative.
• When reading the booklets you receive from the Social Security Administration, pay special attention to the kind of information you are required to report to the Social Security Administration. Report promptly and in writing and keep a copy with your Social Security papers.
• Don’t necessarily believe everything they tell you at the Social Security Administration 800 number. If you have an important issue to take up with the Social Security Administration, sometimes it is better to go to your local Social Security Office.