SSDI: Notice of Approval or Disapproval
Once the Disability Determination Services (DDS) Analyst makes a decision about whether or not you are disabled, your file is returned to the Social Security field office. You are then sent a letter notifying you of the decision. Note that many files will be in an electronic format, with no paper copies.
However, at the end of the determination process, you will be mailed a letter informing you that your claim for Social Security Disability Insurance (SSDI) has been approved or disapproved. Read your letter carefully. It provides important information.
IF YOUR CLAIM HAS BEEN APPROVED
If you are approved for Social Security Disability Insurance, you won't have to wonder because the letterhead on the letter includes "Notice of Award." This letter is an important document. DO NOT LOSE IT!
The Notice of Award also contains some information you should be aware of:
- Onset Date -- The "onset date" is the date set by Social Security as the date you became disabled. Usually the letter will state: "We found that you became disabled under our rules on (month)(day)(year)." This date serves as the start of the five month waiting period before SSDI benefits become payable.
- Benefit Amount -- The letter will tell you the amount of your benefit. If your benefit is reduced for any reason such as you are also receiving a State Disability benefit, the letter will state both the reduced amount and the amount you will be eligible to receive once the other payment stops.
- Date You Start Receiving Benefits -- The letter will state the date that you will start receiving benefits, a date five full months after the Onset Date. For Example: If your Onset Date is December 14, five full months is June 1 (you don't count December because it's not a full month).
- Estimated Time of Continuing Disability Review -- The letter will usually also state the number of years before Social Security will review your file in a Continuing Disability Review.
- Additional information -- If there are other facts, such as money withheld to repay past overpayments or other unusual features of your benefits, they will be stated in the letter.
The Notice of Award letter is valuable and should be kept in a safe place for several reasons:
- If you have health coverage which is extended under COBRA, a copy of the Award needs to be submitted to the COBRA administrator to obtain the 11-month OBRAcontinuation. To qualify for OBRA, the COBRA administrator must receive a copy of the Notice of Award letter within 60 days of your getting it -- and this must be within the 18 months during which you receive COBRA.
- A copy of the letter should be sent to any other providers of disability benefits, including individual Disability Income and Group Long Term Disability insurance companies.
- Your Medicare coverage starts 24 months from the date you are entitled to receive SSDI. The letter provides proof of the start date for the calculation. In the example above, if the benefits began on June 1, 2015, then Medicare starts on June 1, 2017 (24 months later.)
- It is also advisable to learn what to do on an on going basis to keep your benefit. To learn more, click here.
IF YOU RECEIVE A NOTICE OF DENIAL (That your claim has not been approved)
- The denial letter is obvious since "Notice of Disapproved Claims" will be a part of the letterhead. The letter will tell you in general terms why your claim is denied.Usually it is "We have determined that your condition is not severe enough to keep you from working."
- The letter will list what records were used to arrive at that decision so you can quickly see what records they may have missed in case you want to file an appeal.
- The letter will also describe the appeals process, including deadlines.
- NOTE: Appeals must be filed within 60 days after receipt of the denial letter.
Don't give up!!!
Definitely consider appealing. Depending on the state in which you filed, you may have to go through a Reconsideration before you can get to the Administrative Law Judge level but historically, almost 2/3rds of those who appeal to the Administrative Law Judge level are approved. This could be in part because the judge sees you face-to-face. S/he can gauge subjective symptoms as well as assess whether s/he thinks you are telling the truth. See Appeals After A Denial Of A Claim For Social Security Disability Insurance
To Learn More
More InformationSSDI: 101