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What Happens After a Fully Favorable Decision?

 

(Gloucestercitynews.net)(October 19, 2020)--Even after the administrative judge has determined that you qualify for benefits, the process may be far from over. What happens after a favorable decision is received can become very complicated. It may take months or even years to receive a fully favorable decision in your struggle to receive Social Security benefits.

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Reasons for a Delay

After receiving a favorable decision, your first payment may take months to arrive. There are a couple of reasons for this delay in receiving your check. The post-decision process depends on the type of claim or claims you had. Most people have Supplemental Security Income and/or Disability Insurance Benefits, and each is treated a bit differently.

Supplemental Security Income (SSI)

A notice is sent to your local Social Security Administration (SSA) office informing them when a fully favorable decision is issued. You are then contacted within 30 days to discuss your finances. Your financial situation will be reviewed to calculate your monthly benefit.

Because SSI is a needs-based program, the SSI you will receive is an asset and resource-based, meaning it counts as a resource for you. Your assets can not be valued at more than $2,000. The assets that do not count include the following:

  • Your dwelling and the land it is on
  • The vehicle you or a member of your household uses
  • Personal items in the home
  • Your life insurance policies with a face value of $1,500 or less
  • Your own and your immediate family’s burial plots
  • Funds designated for burial expenses up to $1,500 each for you and your spouse
  • Property necessary for your self-support
  • Money or property in a Plan to Achieve Self-Support (PASS) if you are disabled or blind
  • Up to $100,000 in an Achieving a Better Life Experience (ABLE) account

The faster the SSA receives this information from you, the faster you will receive your benefits. Not cooperating with SSA can cause your claim to be denied.

After the review and calculation of your benefit amount, you will receive correspondence marked "Notice of Award." This notice will inform you how much you will receive each month. It typically reaches you within 30- to 60-days after your initial meeting with SSA.

Be sure to review this paperwork carefully. Your first check will follow shortly after the "Notice of Award." Back pay comes in a separate check.

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Disability Insurance Benefits (SSDI)

Notice of approval for SSDI is similar as for SSI. You will also receive an approval letter or a notice listing your "Established Onset Date."

SSDI benefits, also known as Title II benefits, are based on your earnings history. The source of SSDI payments is a central payment center in Baltimore, MD. Your SSI benefits, if any, are calculated first, as described above. Once that is finished, the information is forwarded to Baltimore. There, your monthly SSDI payment is calculated based on the amount of time you worked and the money you earned.

You will receive a separate Notice of Award for SSDI. Like the one for SSI, this correspondence will tell you what your monthly benefit will be and the amount of your back pay.

If you only have an SSDI claim, your local office will not need to provide paperwork. Baltimore will calculate your benefits, so you can usually expect to receive your information more quickly than if you had both types of claims.

It is normal to begin receiving monthly payments before receiving any back pay. SSDI back pay is sent in one payment, unlike SSI back pay.

Usually, it takes three to four months after a fully favorable decision for you to begin receiving benefits because of the necessary calculations discussed above. It is important to remember, though, that these are general guidelines. Exceptions do occur. Perhaps the most important thing to remember is to provide SSA with the requested information. Failure to do so can increase the time you will have to wait to begin receiving payments.

Partially Favorable Decisions

In some cases, you may receive what is called a “partially favorable decision.” This means the administration believes you are disabled, but they don’t agree with when you claim your disability began. You will get benefits, but not the full amount you would have gotten if you received a fully favorable decision. This could be thousands of dollars.

 

If this happens to you, you can appeal the decision if you have evidence that proves that your disability started on the date you said it did (Source: Berger and Green). This comes with some level of risk because if you appeal, your entire case will be reexamined. Upon a second review, you could be found not to be disabled at all, or they could say your disability began at an even later date. This could result in less money or even no money at all.

 

 

 

 

 

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