Understand SSA's Decision

The Social Security Administration (SSA) may take six months or more to decide if you have a disability. If you have a disability and are insured, you qualify for Social Security Disability Insurance (SSDI) benefits.

Social Security sends you a letter called a disability determination notice, which tells you if they approved or denied your application.

Note: If you are an adult and your disability began before you turned 22, you may qualify for Disabled Adult Child (DAC) benefits even if you do not have a work record.

If You Are Approved for SSDI

If you are approved for SSDI:

• SSDI benefits start at least five full months after your disability began. This is called the waiting period.
  • Note: If you are approved for SSDI more than five months after your disability began, you may get a retroactive benefits payment that covers the months since the five-month waiting period ended. Example: You are approved for SSDI eight months after your disability began, so you get a one-time payment that covers your SSDI benefits for the last three months (since the fifth month after your disability began).
• The amount you get depends on your Social Security earnings record. Generally, the more you worked and paid in Social Security taxes, the more you get in SSDI benefits.
• Your SSDI benefits go into your bank account automatically each month. If you don’t have a bank account, you can have your SSDI benefits put onto a Direct Express debit card that you can use in stores to make purchases.
• Your children under age 19 may also qualify to get benefits based on your work record in any month you get SSDI benefits. Your spouse may also get benefits if age 62 or older or if caring for a child under 16. It doesn't matter whether they have disabilities. Learn more about these benefits.
• Medicare health coverage automatically starts after you get SSDI or DAC benefits for two years (24 months). Learn more about Medicare in DB101's How Health Benefits Work article.
  • Note: While you are waiting for Medicare coverage to begin, you need other health coverage. One option is Medicaid. Learn more about Medicaid in DB101's How Health Benefits Work article.

If You Are Denied SSDI Benefits

You may be denied benefits if Social Security says you are not insured or you do not have a disability. If you are not insured, you may still qualify for another Social Security benefit for people with disabilities called Supplemental Security Income (SSI). Learn more about SSI in DB101’s SSI article.

Appeals

You can file an appeal if you feel that Social Security made an incorrect decision about things like the disability determination, a Continuing Disability Review (CDR), or an overpayment:

• After you get a denial letter, you have 60 days to file an appeal. Do it quickly. If you don’t appeal within 60 days, you may lose the right to appeal.
  • If you are appealing an overpayment, appeal within 30 days to avoid having your benefits withheld while your appeal is reviewed.
  • Note: Social Security figures that you get a letter within five days after they sent it.
• If you are denied SSDI benefits for medical reasons, you can file your appeal online or call Social Security at 1-800-772-1213 or 1-800-325-0778 (TTY) and ask them to send you an appeal form. If you file online, you need to mail or deliver any new information to Social Security about your medical condition, including updates on any treatment, tests, or doctor visits.
• If you are denied SSDI benefits for nonmedical reasons, you can request a review from your local Social Security office or by calling Social Security at 1-800-772-1213 or 1-800-325-0778 (TTY).

File an appeal as quickly as possible. Once you file your appeal, it may take several months to resolve.

Note: If your application for SSDI benefits is denied and you disagree with the decision, file an appeal. Do not just fill out the application forms again — that would be refiling.