When you’re applying for Social Security disability (SSD), you’ll typically need to provide the Social Security Administration (SSA) with a lot of medical documentation. Exactly what type of medical documentation is required will depend on your medical condition or conditions. The medical records the SSA is looking for may include doctor’s notes, diagnostic test results, and other documentation.
The first question many SSD applicants have is where to get the documentation they need. Here’s what you need to know about finding the best doctor for your disability claim.
Your Own Doctor Can Be Your Best Resource
The SSA doesn’t require that medical documentation come from a doctor on their roster or one they’ve pre-approved. In fact, they often prefer information from the doctor who has been treating you. Your own doctor may already have test results and other documentation the SSA wants to see. That makes the process more efficient and saves them from having to pay a doctor to conduct exams or run tests.
Your own doctor may also be able to provide more in-depth information about the limitations you face and the progress of your medical condition, since you may have been seeing them before you became disabled, or started treatment with them early in your disability.
What if Your Doctor Won’t Participate?
Some doctors are reluctant to get involved in the SSD application process. This can happen for different reasons. In some cases, the doctor doesn’t believe disability is warranted. In others, they simply don’t want to take on the extra work of providing a statement and other information. Others have different reasons.
If concern about the complexity of the process and time commitment is an issue, you may be able to persuade your doctor to participate by doing the legwork and showing them exactly what would be required–it’s not very time-consuming. If they still don’t want to participate, you can:
If you’re being treated by both a general practitioner and one or more specialists, ask your other doctor(s) to complete documentation
Obtain your medical records and test results from the non-participating doctor
Seek a new doctor who will cooperate with the SSD application process
You’ll want to consider practicalities in finding the right doctor, such as working with someone in an accessible location and making sure the doctor is in-network for your medical insurance.
Sometimes, A Specialist May Be Required
In some cases, you may need to seek out a new disability doctor to provide documentation for your SSD claim. While the SSA will generally accept information from any qualified medical professional, there are situations in which a particular type of specialist’s input will carry more weight.
One common example is a mental health condition. It’s not unusual for a person’s primary care doctor to prescribe medication for a mental health condition such as anxiety or depression. If that’s the case, your primary doctor can certainly provide information to the SSA in support of your claim for Social Security disability. However, both diagnosis of mental health conditions and assessment of the limitations they cause can be nuanced.
There is no scan or blood test or other objective measurement that proves you suffer from the condition, or the extent of your disability. In that situation, a psychiatrist may be able to provide more detailed information, and the SSA may give greater deference to their opinion.
Seeking a New Disability Doctor
If you do need to look for a disability doctor in your area, either because your doctor won’t cooperate or because you need a specialist or additional testing conducted, here’s what you should consider:
Look for a doctor who cooperates with the SSA disability process–there’s no sense starting with a new physician only to find that they won’t provide what you need. You can start by searching online using terms such as “disability doctor near me” and “doctor for disability evaluation.”
Look for a doctor who is conveniently located, especially if your disability makes it difficult for you to travel to appointments. You may need to see the doctor more than once or undergo testing.
A doctor with credentials specific to your type of disability may be especially useful.
Social Security Consultative Examinations
When the SSA determines that you haven’t provided enough medical information for them to make a determination on your SSA application, they may ask you to undergo a consultative exam. This may happen under circumstances such as:
When the SSA determines that additional testing is needed for them to make a determination
When your diagnostic tests or doctor’s notes are too old or not consistent enough to allow them to make a determination
When the SSA wants you to undergo this type of exam, they will send you a letter. It is very important that you attend this appointment, arrive on time, and undergo any testing they have requested. If you don’t cooperate or miss your appointment, the SSA will make a determination based on the information they have. Since the exam is requested when the SSA decides they don’t have enough information to deem you disabled, that decision is very unlikely to go your way.
In that situation, you can request reconsideration–the first step in the SSA appeals process–and provide additional information. But, the need to appeal can delay your claim by several months to two years or more.
Your Disability Benefits Advocate Can Help
If you’re working with an advocate to secure SSD benefits, your advocate can help you assess when your treating physician is likely the best choice and when you may want to seek out another medical provider to provide documentation for your SSD application. Your advocate may also be able to help you find a doctor who will work with you and help coordinate the collection of the information you need from your physician. That’s just one of many ways an experienced advocate can help keep your claim moving forward smoothly. To learn more about how Disability Help Group can assist with putting together the strongest application or appeal possible, call 800-800-3332 right now, or fill out our contact form here.
The path to securing Social Security disability (SSD) benefits can be a long one. Even if your benefits are approved following your initial application, you can typically expect to wait three to five months for a decision. That timeline may be longer when the Social Security Administration (SSA) is especially busy or the SSA needs to ask for additional information.
If you have to appeal the decision, the wait will be much longer. Exactly how long the process will take depends in part on how many levels of appeal you have to go through and in part on where in the country you are located. All together, the SSD application and appeals process can range from several months to two or three years–in some cases, it may be even longer.
When Do Social Security Disability Benefits Start to Accrue?
The good news about the SSD process is that while you may have to wait for a decision, you don’t have to wait to start accruing benefits. You won’t actually receive SSD payments while the process moves forward, of course. But if you are ultimately approved, your right to benefits will be backdated.
That means that when your disability benefits are approved, you’ll usually be entitled to back pay.
How Does SSA Determine the Start Date of SSD Benefits?
The SSD back pay timeline varies depending on when you applied for benefits in relation to when your disability started. In part, that’s because there is a five-month waiting period for benefits after your disability starts.
For example, if you became disabled in January and applied for benefits in March, your benefits wouldn’t date back to your application date–the five month waiting period would apply, starting in January. So, you would start to accrue benefits in July. It’s also partly because in some cases, the SSA will backdate your benefits for up to a year prior to your application date. For example, if you became disabled in February of 2023 but didn’t apply for benefits until September of 2024, your benefits could be backdated 12 months.
Determining exactly how far back you are entitled to benefits can be tricky, and an experienced SSD benefits advocate can be your best resource.
When Will I Get My SSD Back Pay?
When your SSD claim is approved, you will get a letter from the SSA. Typically, you’ll receive your first regular monthly benefit payment in approximately 30 to 45 days. However, if you applied right away when you became disabled and were approved quickly, your 5-month waiting period may not yet have expired.
The SSD back pay timeline is slightly different. Most people receive their back pay in one lump sum within about 60 days after approval. However, in some cases it takes a little longer.
Issues that May Affect the SSD Back Pay Timeline
There are several possible reasons that it may take longer to get your SSD back pay.
The SSA is missing information or has incorrect information. This may happen when you have moved and didn’t update your address with the SSA, or when you haven’t responded to a request for information such as your bank account information.
Your back pay is being offset to cover debt to the government, such as unpaid federal taxes or student loan debt.
The SSA has received a garnishment order for a domestic support obligation, such as spousal support or child support.
You received workers’ compensation for part of the time and the SSA needs to adjust your back pay.
If you have applied for both SSD and SSI, those applications will be assessed separately. The timeline for a determination may be different, and back pay is handled somewhat differently. For example, with SSI benefits start to accrue either the month after you apply or after you become eligible, whichever is later. You will not receive SSI back pay for any time before you filed your application.
The combination of SSI and SSD benefits can be complicated. For example, since SSI is need-based, a lump sum SSD distribution you receive as back pay may disqualify you from receiving SSI. However, there may be ways to protect or reinstate your eligibility. An experienced disability benefits advocate can tell you how this interaction might play out in your case and how you can best protect your interests.
Is There Any Way to Get Back Pay Faster?
There is no way to expedite SSD back pay, but there are ways you can impact the timeline at every step. For example, ensuring that your application is complete and accurate and that you have provided all necessary documentation will help avoid delays in the application process and improve your chances of approval without the need for an appeal.
Filing appeals promptly rather than waiting until near the end of the 60 days allowed can help, too. However, you should never rush an appeal. The most important thing is to take full advantage of the opportunity to provide additional information and documentation.
At every stage of the process, it’s important to respond promptly to any requests from the SSA, and to keep the SSA up to date on your current contact information. Be sure to read any communications from the SSA carefully, and if you have questions, get help right away.
Disability Help Group is Here for You
When you’re embarking on a complex process and don’t necessarily have in-depth knowledge of the process, the right advocate can make all the difference. At Disability Help Group, our advocates are dedicated to putting their knowledge and experience to work for people seeking disability benefits. Whether you are just preparing to apply for SSD or have been denied and want to appeal, we can help. Call 800-800-3332 or fill out our contact form HERE to learn more.
What you may not know is that when you’re finally approved, you could be owed a substantial amount in back pay, often delivered as a lump sum. This back pay is meant to cover the months (or even years) you waited while your claim was being reviewed. For many people, it can provide much-needed financial relief after a long and stressful process.
These benefits come in two forms: benefits owed to you from the date of your application, and in some cases benefits reaching back up to one year prior to the time you applied for SSD.
SSD Back Pay and Retroactive Benefits
Back Pay is Based on Your Filing Date, Not Approval
If you’re approved for SSD, you may be entitled to back pay.
Back pay may be owed to you if your application is ultimately approved, and the Social Security Administration (SSA) is saying you were eligible when you applied.
There’s a five-month waiting period after you become disabled, but once that has been satisfied, your benefits are backdated. For those who are approved at the initial application stage, this may mean just a few months of back benefits. But, if you have to go through reconsideration and an ALJ hearing to get approved, it may take two years or more from the time you apply to the time you are approved. When that happens, you can expect a substantial lump sum payment to catch up.
This is one reason it’s important not to miss any deadlines in the appeals process. If you miss out on an appeal and have to start the application process all over, you’ll lose out on benefits for any date before your claim was denied.
Retroactive Benefits May Add up to 12 Months of SSD Benefits
Your eligibility for disability is based on the date you became disabled. However, many people don’t file for Social Security disability benefits right away. When you are approved for SSD benefits, the SSA will look at the date you became disabled, and then apply a five-month waiting period. If that five-month waiting period ends earlier than the month when you applied for SSD, you may be entitled to retroactive benefits.
So, if you became disabled 10 months before you applied, you could be eligible for five months of retroactive benefits. (10 months of disability minus the five month waiting period.) But, if you became disabled 17 months or more before you applied, you could be entitled to 12 months of retroactive benefits. You can’t get more than 12 months of retroactive benefits, even if you became disabled more than 17 months before applying. So, it’s in your best interest not to wait too long to apply for disability benefits.
Top 5 FAQs About SSD Back Pay
1. What is SSD back pay, and how is it calculated?
It’s the money you’re owed from the time your disability began (Established onset date, EOD) to when your claim is approved, minus a 5-month waiting period.
2. Will I receive my SSD back payment as a lump sum?
Yes, usually. But if it’s a large amount (typically over $5,000–$6,000), it may be split into smaller payments.
3. How long does it take to receive SSD back pay after approval?
Most people receive SSD back pay within 30–60 days after approval, although the timeframe can vary. If it’s delayed, yoy can contact the Social Security Administration.
4. Are there any deductions from my SSD back pay?
Yes. Common deductions include attorney fees, federal debts, overpayments, and offsets like workers’ comp.
5. Do I have to pay taxes on my SSD lump sum back payment?
Possibly. If your total income is high enough, up to 85% of SSD back pay may be taxed. A tax pro can help manage the impact.
Make Sure You Get all the SSD Benefits You Deserve
A simple mistake like reapplying instead of pursuing an appeal could lose you months or even a year or more of benefits. Most people applying for SSD aren’t familiar with every aspect of the process and the appeals process, and you don’t have to be. At Disability Help Group, our advocates have extensive experience helping people like you assemble the strongest possible application or appeal. To learn more about how we can help, call (800) 800-3332 or contact us here now.
Getting Social Security Disability for Asperger’s Syndrome
Whether a person qualifies for Social Security disability (SSDI) for Asperger’s syndrome depends on the severity of the condition and how it impacts the applicant’s ability to earn a living. Any medical condition can form the basis for an SSDI claim if the applicant can show that the condition prevents them from engaging in substantial gainful activity (SGA) for at least a year.
Here’s what you need to know about Asperger’s syndrome, when it may qualify a person for SSDI benefits, and what type of documentation is typically required to prove your claim. Keep in mind that this information is not a substitute for personalized advice and guidance from an experienced disability benefits advocate. If you have questions about claiming Social Security disability for Asperger’s or you’re ready to file a claim, call us at 800-800-3332 to schedule a free consultation.
Asperger’s Syndrome and the Autism Spectrum
Though many people have a pre-existing diagnosis of Asperger’s syndrome, that is no longer an official diagnosis. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013, eliminated the diagnosis and instead treats the condition formerly known as Asperger’s syndrome as part of the autism spectrum. Those who were previously diagnosed with Asperger’s syndrome or who were diagnosed later now fall into the category of Level 1 autism.
Symptoms of Asperger’s Syndrome/Level 1 Autism
Level 1 autism is the mildest form of autism. It was originally classified separately, as Asperger’s syndrome, because the language and cognitive delays that are common to move severe forms of autism are generally absent. In fact, people with Asperger’s/Level 1 autism tend to have higher-than-average language skills and cognitive processing.
Difficulty initiating or responding to social engagement
Difficulty switching between activities
Inflexible thinking
Difficulty with organization and planning
The current DSM manual characterizes this level as “requiring support.” Whether that means a person is unable to work for a living depends on the specifics of the condition and whether the person has additional medical or other types of limitations.
SSDI for Asperger’s Syndrome
As with other medical conditions, there are two possible paths to approval of SSDI benefits. The first is to meet or equal a listing in the Social Security Blue Book. The second is a more holistic evaluation that considers factors outside your medical condition.
Disability Benefits for Autism Spectrum Disorder Under the Blue Book
A worker seeking SSDI for Asperger’s syndrome/Level 1 autism will be evaluated under section 12.10 of the Social Security Blue Book. The same listing criteria are applied to all autism spectrum disorder claims.
To qualify for disability under the Blue Book listing, the applicant must fulfill two separate sets of criteria. First, they must provide medical documentation of BOTH of the following:
Qualitative deficits in verbal communication nonverbal communication and social interaction, AND
Significantly restricted, repetitive patterns of behavior, interests or activities
The applicant must ALSO show either extreme limitation in one of the areas listed below or marked limitation in two:
Understanding, remembering and applying information
Interacting with others
Concentrating, persisting or maintaining pace
Adapting or managing themself
Can You Get Disability for Asperger’s If You Don’t Meet the Blue Book Listing?
An applicant who doesn’t meet all of the Blue Book criteria may still qualify for disability benefits. If you don’t qualify under the Blue Book analysis, the Social Security Administration (SSA) will automatically go on to evaluate your claim in a different way.
This analysis considers physical and mental limitations, pain, and other medical factors that may impact your ability to do work. The SSA then considers two questions:
Are you able to do work you have done in the past?
Because the SSA is looking for work you can do now, this analysis doesn’t take into account every job you’ve ever held. Instead, it is focused on recent work and work you performed for a long time.
If the SSA determines that you are able to do work you’ve done in the past, you will not be considered disabled and your claim will be denied. If they find that you are not able to do work you’ve done in the past, the process moves to the next step.
Are you able to do other work?
In answering this question, the SSA considers several factors, including:
Your age
Your educational level
The type of work you have done in the past
Whether you have transferrable skills
The SSA uses a grid that combines all of these factors to determine whether or not you are disabled. There are different grids for different levels of residual functional capacity.
Applying for SSDI for Asperger’s Syndrome
The symptoms of Asperger’s syndrome/Level 1 autism aren’t the type that lend themselves well to objective testing. An SSDI applicant won’t be able to produce a scan or blood test that proves the severity of their Asperger’s symptoms, or even that they have the condition. That means consistent records from one or more well-qualified medical providers will be crucial to establish your claim.
This type of claim is often less clear-cut than a claim for a measurable physical impairment, and unfortunately that means that many claims are initially denied. At Disability Help Group, our experienced advocates know what type of documentation is necessary to prove an autism spectrum claim, and how to assemble that documentation. We’ll work with you to put together the strongest application and package of evidence possible, to maximize your chances of approval.
If you’ve already applied and been denied, we can help with that, too. But your time is limited. You have just 60 days from a denial to move your case to the next stage. If you miss that deadline and have to start over, you could lose out on back benefits. You’ll want to contact us immediately after receiving a denial so we can assess the reasons for the denial and assemble the necessary documentation.
Widows benefits and Social Security disability benefits are both monthly federal benefits administered by the Social Security Administration (SSA) and based on work credits accrued. However, there are significant differences between the two. First, widows benefits are based on the deceased spouse’s work record, not the recipient’s.
Second, disability benefits can be awarded at any age, but are only available to workers who meet the SSA’s definition of “disabled.” Widows benefits, with certain exceptions, are only available to people who have reached a certain age.
Widows benefits are a type of survivor benefits. Though you may hear these terms used interchangeably with “death benefits.” Social Security does offer a death benefit, but it is a small, one-time payment that is separate from these monthly benefits.
Widows Benefits
Widows benefits, technically known as survivors’ benefits, are available to certain dependents of a deceased worker who earned Social Security benefits. The widow or widower of a qualified worker is entitled to Social Security survivors’ benefits if certain qualifications are met:
Widows Benefits Age Requirements
In most circumstances, the surviving spouse of a deceased worker may receive widows’ benefits only if:
The surviving spouse has reached full retirement age (reduced benefits are available at age 60), or
The surviving spouse is at least 50 and has a disability
The age requirements above do not apply if:
The surviving spouse is caring for a child or children of the deceased who are under the age of 16 and receiving Social Security benefits, or
The surviving spouse is caring for a child of the deceased who is disabled and receiving Social Security benefits
Other Social Security Rules for Widows
A divorced spouse of a deceased worker may qualify for benefits under the same conditions if the marriage lasted at least 10 years. The 10-year requirement is not imposed if the former spouse is caring for children of the deceased as described above. However, remarriage may disqualify a former spouse from survivor benefits. Generally, a former spouse who remarries after turning 60 remains eligible.
However, a former spouse who remarries younger may or may not be eligible for Social Security benefits, depending on:
The type of benefits in question
Whether the former spouse is disabled
Whether the former spouse remarried before age 50
Whether the later marriage has ended
An experienced Social Security benefits advocate can help you determine which types of benefits you may be entitled to in your specific circumstances.
Social Security Disability Benefits
SSDI benefits are payable to qualified workers who are unable to engage in substantial gainful activity due to a disability that is expected to last at least one year or be fatal. To qualify for SSDI, you must have accumulated a sufficient number of work credits, including a certain number of recent credits. The exact number depends on your age when you became disabled.
SSDI Widow Eligibility Requirements
Unlike retirement benefits and survivor benefits, SSDI benefits are awarded only on your own work record. That means Social Security disability eligibility requirements for a widow are the same as they would be for anyone else.
The applicant must meet technical requirements, such as having accrued sufficient work credits to qualify for disability benefits. And, they must meet the SSA’s definition of disability based on a condition or conditions that have lasted or are expected to last for at least 12 months. There are multiple steps in the disability determination process. First, the SSA will look to see whether the person is earning enough money to be considered engaged in substantial gainful activity. Note, though, that survivor benefits do not count toward SSDI income limits. The SSA will be looking only at income earned through work or self-employment.
If they are not, the next step is to consider whether they meet or equal a listing in the Social Security blue book. If they do not, the SSA uses a more holistic analysis to determine whether they might still be considered disabled.
Can You Get Both SSDI and Widows Benefits?
You may qualify for both disability benefits and widows benefits. But, you can’t get the full amount of both benefits. Instead, your monthly benefit will be capped at the higher of the two amounts. Here’s an example of how that might play out.
SSDI and the Death of a Spouse
Imagine that you are receiving $1,350/month in Social Security disability benefits when your spouse passes away. Since you are disabled, you become qualified for survivor benefits if you are at least 50 years old. You may also qualify if you are younger than 50 but caring for your deceased spouse’s child.
Say you qualify for $1,900/month in survivor benefits. You won’t receive the full amount of each benefit, and the survivor benefits won’t replace the lower SSDI benefit.. Instead, you will continue to receive your $1,350 in disability benefits and will receive an additional $550/month in widows benefits to bring you up to the amount of the higher benefit.
Need Help Getting Social Security Disability Benefits?
SSDI benefits provide a crucial source of support for workers who become disabled. But, unfortunately, most claims are initially denied. Too often, applicants get discouraged and miss out on benefits they’ve earned through years of hard work and paying in premiums through payroll taxes.
At Disability Help Group, we have deep knowledge of the rules that govern the SSDI application process and the type of evidence necessary to submit the strongest possible application. Working with an experienced disability benefits advocate from the beginning can help avoid common missteps that can delay your claim or lead to denial.
If you’ve already applied and been denied, we can still help. Our advocates will assess the denial letter you received and other information to determine what went wrong and what additional information or documentation will most strengthen your case on appeal. To learn more, contact us here or call (800) 800-3332.
