Social Security Disability Insurance (SSDI or SSD) benefits serve as valuable support keeping disabled workers and their families financially stable. But the SSDI program includes features that are difficult to understand. The 5-month “elimination period” is one of them.
What Is an “Elimination Period” Anyway?
The so-called “elimination period” is nothing more than a waiting period before your benefits payments begin. The waiting period is five months. This waiting period is not just how long you must wait for your payments to arrive but is a five-month period during which no benefits are accrued. You do not receive any SSDI payments covering the five-month waiting period. The first month covered by an SSD benefit payment would be the sixth month after your disability started.
Why Does SSDI Have a Waiting Period?
Social Security Disability Insurance is a program intended exclusively for workers who suffer injuries and illnesses that will prevent them from performing “substantial gainful activities” over a long term, twelve months or longer.
If there were no waiting period before an SSD claimant began to accrue benefits, the Social Security Administration (SSA) would be sending benefit payments to disability claimants after as few as two or three months, only later to learn that those benefit recipients were only disabled for a relatively short time. For those who received their SSD benefits prematurely, the government would need to demand they repay the benefit payments.
Instead, to ensure that an SSD claim is based on a disability that did or is expected to last for at least 12 months, the government pays nothing for five months, counting from the “disability onset date.”
What Is the Disability Onset Date?
The 5-month waiting period (or elimination period) for SSDI benefits does not begin to be counted from your claim filing date. The waiting period starts to run from the date the Social Security Administration determines your disability began. Deciding what date someone’s disability began is not as easily established in all cases as you might imagine.
Some SSDI claims are based on disabilities that began months or even years before the SSD benefits application was filed. Identifying the date or month in which a claimant’s disability began involves an analysis of all the medical records and lab reports submitted in support of the claimant along with their work history record, and detailed information describing any changes in job description or performance.
Remember that the SSDI rules and regulations define a qualified disability as follows:
A “medically determinable physical or mental impairment that lasts or is expected to last for at least 12 months and prevents the person from performing substantial gainful activities.”
Under the SSA’s definition of a qualified disability, someone who suffers from a chronic illness and struggles through each day with great difficulty is not disabled if they continued to “perform substantial gainful activities.” That means if they worked and earned more monthly income than allowed under the SSDI rules, then they would not be eligible for SSDI disability benefit payments.
How to Establish the Correct Disability Onset Date
Several problems can arise regarding an SSDI claimant’s disability onset date, each of which can be solved with preparation and with guidance from the right experienced SSD lawyer or professional SSDI advocate.
Insufficient Medical Evidence — The main fact to be established regarding an SSD claimant’s disability onset date is when their impairment was severe enough to meet the SSA’s definition of “disabled.” The best evidence an SSD benefits applicant can present is a series of medical reports detailing either the sudden onset or the progressive nature of the patient’s impairment. A patient who seeks little medical treatment for an illness or injury and whose doctor keeps only general remarks on record may have difficulty relying on those sparse records to establish their disabled condition and onset date.
Other SSD cases involve claims in which no single impairment alone constitutes a disability, but in combination with each other, the complex of impairments will satisfy the SSDI program’s criteria for a disability. Such people usually need to have multiple treating physicians, each with a history of treating the claimant’s conditions, and each physician taking the others’ medical input into account when diagnosing the overall disabled condition of their patient.
Seek the Earliest Disability Onset Date
The 5-month waiting period during which no SSD benefits will be paid begins from the date your disability started, the onset date. The SSD benefit payments begin to accrue in the sixth month after the onset date. For example, if your disability began on December 29, your first SSD benefit payment would cover June. But if the facts of your case supported an earlier date of disability, say October, your SSDI benefit payments would begin in April, two months earlier.
London Eligibility and Attorney Scott London’s Disability Law Office has extensive experience working with clients to establish the earliest medically supported disability onset dates. You deserve to be represented by the most professional SSD / SSDI advocates in your disability claim.