What Happens After Social Security Disability Benefits are Awarded
By Pitt Dickey

This column will take a look at some of the things that happen when a person is awarded Disability Insurance Benefits by the Social Security Administration (SSA). To be eligible for Social Security Benefits, a person must have a health problem that can be expected to last for at least twelve months which prevents that person from either returning to the type of work he has done in the past or from performing full time employment in any other type of work that exists in the American economy.

We will use the example of Claude Sutton who has been awarded Social Security Disability Benefits as a result of serious complications that he is suffering from insulin dependent diabetes. Like many Social Security disability claimants, Claude was denied at the initial and reconsideration levels of review. He requested a hearing before an Administrative Law Judge and after a hearing the Judge approved his disability claim.

How much are the benefits and when do they begin?

After his claim is approved, Claude will receive a Certificate of Award from the SSA which tells him how much his monthly payments will be. This statement usually advises when the claimant’s case will be reviewed to see if his condition has improved to the extent that the disability payments could be stopped. The first monthly payment cannot begin until after five months of disability. In Claude’s case his disability onset date was found to be 2 January 1998, this means that his first monthly payment could not begin until 1 June 1997. This waiting period is similar to the deductible people have on their car insurance in that they have suffered a loss but they don’t get paid for the full amount of the loss.

The amount of the monthly payment is based upon how much Claude has paid in Social Security taxes over his working career. If Claude has received worker’s compensation payments or other disability payments then the amount of his SSA disability payments may be reduced. The amount of the monthly payment increases each year based upon a cost of living increase that is set by federal law. In recent years due to low inflation this annual increase has been quite small.

How long do the payments continue?

The monthly payments will continue as long as Claude continues to be disabled. His case will be reviewed periodically by the SSA to determine if he is still disabled. If he returns to work he is obligated to advise the SSA of this fact. The act of returning to work does not necessarily terminate Claude’s right to receive disability payments depending on such factors as whether he is not able to continue to work, the number of hours he makes and income earned.

If Claude is still receiving disability benefits, on his 65th birthday his disability benefits are automatically converted to the Social Security retirement benefits which will usually be about the same amount as the disability payment. The monthly disability checks are for the month that has just been completed. Claude’s check that he receives in December 1998 is actually for benefits due for the month of November 1998.

After Claude has received disability benefits for 24 months he will then be eligible for Medicare benefits. The Medicare benefits can begin even sooner than the 24 months under certain emergency health conditions such as when a person has chronic kidney disease requiring regular dialysis or a kidney transplant.

Benefits for Children of Disabled Workers

Once Claude begins to receive disability benefits, his minor children can be eligible for monthly benefits resulting from Claude’s disability award. The children’s benefits will terminate the month before each child reaches age 18 unless the child is not married and is either disabled himself or is enrolled full time in an elementary or secondary school. If Claude’s daughter Mary’s benefits stop when she turns 18, the benefits could begin again if Mary were to become disabled again before she reaches her 22nd birthday or if she returns to school as a full time secondary student before she becomes 18.

The student will continue to receive the disability benefits during vacation periods of four months or less if she plans to return to school at the end of the vacation period. The student will receive a form from SSA at the beginning of each year to complete regarding her school status. If this form is not returned on time the SSA can stop the student’s benefits.

A child can still get disability benefits up until age 19 so long as she is still enrolled in secondary school on a full time basis. If the student’s 19th birthday occurs during the school term, the benefits can be extended two additional months to let her finish the term. If the student drops out of school or goes to part time status in school the SSA must be notified so that no payments are made that the student for which the student is not eligible.

If Claude and his wife have a baby after Claude’s disability benefits begin, then the child born after the disability will also be eligible for disability benefits based on Claude’s award. Claude should notify the SSA immediately upon the birth of this child as otherwise the SSA is unlikely to start the new baby’s benefits on its own.

Pitt Dickey has practiced law in Fayetteville since 1978. He has handled SSA disability claims for over nineteen years. He practices with the firm of Smith Dickey Dempster & Carpenter, P.A. at 555 Executive Place, Fayetteville, N.C. He can be reached at 485-8020. Copies of his prior Social Security Disability articles are available on line at www.smithdickey.com.