How far back are Social Security Disability benefits awarded on an appeal?If you file an initial an application for disability) and your case is approved, then the following will occur. The disability examiner will, after reviewing your medical records, determine your EOD, or established date of onset. This date will be when, in the opinion of the social security administration, your state of disability is considered to have begun. Does this established onset date truly determine how far back your disability benefits can be paid? Potentially. The issue can get confusing because there are fundamental differences between the Social Security Disability and SSI disability programs. And there can also be significant differences between claim approvals that occur at the application level or reconsideration appeal level, and claim approvals at the disability hearing level. Regarding the differences between SSD and SSI, we should point out that, in the case of SSI, benefits can be paid all the way back to the time that the disability application was filed. In the case of SSD, benefits can also be paid all the back to the time that the claim was filed, but potentially twelve months retroactive to this date as well, assuming, of course, that the medical evidence will support a disability onset date that far back. Differences between the hearing and the initial steps Now, how can things occur differently at a disability hearing versus an initial claim or reconsideration appeal? To a great degree, things occur very much the same at the hearing level. As at the earlier levels of the system, both medical evidence and work activity will be used to determine if the claimant has the ability to return to their past work or perform some type of other work while earning a substantial and gainful income. However, one of the great differences between hearings and the lower levels of the system is that administrative law judges who approve claims can decide to reopen prior denials...for those individuals who have had the misfortune of being denied on multiple and separate claims. A reopening occurs if it is found that the medical evidence indicates that the claimant was actually disabled at the time that they were previously denied (i.e. they were improperly denied). And reopening an earlier case, of course, can pave the way for significantly larger awards of disability back pay. Suffice it to say, back pay amounts can cover very long periods of time. And the longer a case goes on, such as when multiple appeals have been filed, the greater the amount of back pay that may be received. And this is why individuals who are filing for disability benefits should be very careful that they do the following: 1. When submitting a disability claim to the social security administration, be sure to indicate all known physical and mental impairments, when those impairments began, and when they became disabling to the extent that work activity was significantly affected, either reducing it or preventing it altogether. 2. Be sure to supply detailed information about your medical records and history of treatment. Many applicants for Social Security Disability and SSI realize that an awarding of benefits will be based on a determination that involves current medical records. They may not, however, realize how important older medical records are for establishing "onset", which can determine how much back pay is awarded. And in cases where a claimant's DLI, or date last insured, is in the past (meaning that their coverage for title II Social Security Disability benefits is time-limited and finite), proving the existence of a disability as far back back as possible can not only affect a back payment calculation, but whether or not disability benefits will even be awarded. About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here. 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These pages answer some of the most basic questions for individuals who are considering filing a claim. Filing an application for disability, how do I apply |
