The primary benefit to being awarded either Social Security Disability (SSD) or Supplemental Security Income (SSI) is a monthly check from the United States Treasury. Besides those monthly checks, most people also get a bigger (sometimes much bigger) first check which represents their “past due benefits.” This post attempts to shed some light on exactly how the amount of past due benefits is determined.
Amount Per Month
So “past due benefits” are your monthly benefit amount, multiplied by the number of months you have been entitled to benefits when the decision is made. As a mathematical formula:
past due benefits = monthly benefit amount * number of months entitled to benefits before the decision.
To determine the monthly benefit amount, you first have to determine if your disability claim is for SSD, SSI or both. (See Have I Worked Long Enough to Qualify for Social Security Disability Benefits for a description of the difference between the programs). For those eligible for SSD, the amount per month varies per individual. This is because the SSD system pays out monthly benefits based upon the amount of contributions made into the SSA system. Every year SSA used to send out statements to everyone estimating their monthly retirement and disability benefit amounts. Unfortunately, they no longer send them out to individuals younger than 60. On SSA’s website, you can use their Retirement Estimator to estimate your monthly benefit amount.
The amount per month for SSI benefits is not based upon any contributions into the SSA system. It is based upon whether the individual meets certain income and resource criteria. Many disabled people do not qualify for SSI benefits at all. Because SSA considers the “household” income and resources when determining eligibility, often a working spouse will result in SSI ineligibility. If eligible, each state has established a maximum amount of benefits per month. In Maryland in 2012 the maximum SSI monthly benefit is $678 per month.
Number of Months of Past Due Benefits: SSD
Once you have figured out your benefit amount, you then have to determine when you first became entitled to benefits to calculate the past due benefits. The date your disability began, or onset date, is not the date when your benefits begin. In SSD cases, you are first entitled to benefits starting the sixth month after the onset date. This is sometimes referred to as the “5 month waiting period.” Besides the waiting period, the other limitation is that you can get past due benefits for at most 1 year before the initial application for benefits. The interplay between these two limitations can best be seen by example.
In each of the following examples we are going to change the date on which the SSA has determined that the Claimant became disabled, the “onset date.” While the onset date will change, the following will not:
- Claimant’s monthly SSD benefit is $1000,
- Claimant applied for SSD benefits on April 1, 2011, and
- Claimant received a favorable decision on April 1, 2012.
Claimant is determined to be disabled on April 1, 2000
In this example, the SSA determined that the Claimant was disabled 10 years before their application. Using just the 5 month waiting period, the Claimant theoretically could be entitled to benefits beginning on October 1, 2000 (six months after the onset of disability). However, because of the 1 year limit on past due benefits, the first month of entitlement is actually April 1, 2010 (1 year before the application for benefits). The past due benefits would be from April 1, 2010 through April 1, 2012. This is 24 months which multiplied by $1000 per month amounts to past due benefits of $24,000.
Claimant is determined to be disabled on April 1, 2010
Here, the Claimant is determined to be disabled exactly 1 year before his application. Consequently, the 1 year limit on past due benefits has no affect. The 5 month waiting period does limit the past due benefits. The first month of entitlement is not until October 1, 2010. The past due benefits run from October 1, 2010 through April 1, 2012. This amounts to 18 months of past due benefits, or $18,000.
Claimant is determined to be disabled on March 1, 2012
In this final example, the SSA has determined that the Claimant is disabled after the actual application for benefits. This can happen if the Claimant reaches an age, after applying for benefits, that precipitates a determination in their favor. (See Age: A Crucial Factor in your Social Security Disability Case). In this example the 1 year limit has no effect as the benefits do not begin until after the application. Applying the 5 month waiting period, though, means that benefits are not payable until September 1, 2012. Thus although there is a favorable decision, there are no past due benefits and the monthly benefits do not even begin for another 5 months!
Number of Months of Past Due Benefits: SSI
SSI cases have only one limitation on past due benefits: no money before the application for benefits. There are no past due benefits beyond the date of the application. There is also no five month waiting period. Thus the first month of eligibility for benefits is the onset date, so long as it is not before the date of the application.
The first check you receive, however, may still be less than the amount you calculated using the above analysis. There are a few deductions that may be taken from past due benefits before your check is issued. First, if you had representation, SSA will typically hold out an attorney’s fee equal to 25% of the past due benefits up to $6,000. This money will usually be sent directly to your attorney. Second, if you received state or local cash assistance while waiting for the SSA decision, you may have to pay back the local or state agencies. SSA will pay those local or state agencies directly out of your past due benefits. Finally, if you were receiving workers’ compensation benefits, there may be a reduction in the monthly benefit amount, which would reduce the amount of past due benefits. This workers’ compensation offset will be the topic of a future post.
By David Galinis