If you are approved for Social Security Disability Insurance (SSDI) Benefits, how much you are entitled to will depend on a number of factors. This article will help to explain how your benefits are calculated, including ongoing monthly benefits, retroactive and back due benefits, and additional payments for your family members. Disability benefits from Supplemental Security Income (SSI) will be discussed in a separate article.
How SSDI Monthly Benefits are Calculated
Your monthly benefit amount is based on a number referred to by Social Security as your “Primary Insurance Amount” or PIA. Your PIA is calculated based on your past earnings when still part of the workforce. Those claimants with very high past earnings can receive the maximum monthly PIA, which is $2,861 (as of January 2019). Most claimants, however, will receive a lower amount based on their past earnings, with the average PIA being $1,173 (again, as of January, 2019). Remember, certain deductions, including your Medicare premium, can affect the amount you receive each month.
To calculate your monthly benefit, you can reference your Social Security statement (which is mailed to you every five years by the SSA). You can also check your statement online on the SSA’s website, or use the SSA’s online benefits calculator to enter the earnings yourself. If you engage an advocate (such as Citizens Disability) to represent you, they should also be able to help you find out your PIA.
How Retroactive Benefits and Back Due Benefits are Calculated
Because of the often lengthy wait time between application and approval, many claimants are entitled to retroactive and/or back due benefits if approved for SSDI.
Retroactive’ benefits will cover part of the period beginning from the date that the SSA determines you were unable to work until the date that you applied for disability benefits.
‘Back due’ benefits are your retroactive benefits (retroactive to the application date, described just above) plus any other benefits for the period of time after your application but before SSA pays you ongoing, monthly benefits.
Once approved, you will be paid the benefits (your PIA, minus any deductions) you were entitled to for each month of this period, usually in a lump sum.
The total amount of retroactive and/or back due benefits you receive can be impacted by your application date and waiting period. If you are eligible for Social Security Disability benefits, there is a five-month “waiting period” from the onset date determined by the SSA.
It should noted that the SSA can set the Onset Date to any date that they deem appropriate based on the facts of the case – and that date may be very different than the date a claimant asks for. Because the Onset Date controls when benefits begin, it can be very helpful to have an advocate working for you that has the knowledge and skill to prove the earliest possible Onset Date.
Another consideration that will affect your retroactive pay is the date you applied for disability benefits. A claimant is only eligible to receive retroactive pay up to a year prior to the date of their application. Also remember, the fee you pay to your appointed representative (your advocate) also comes out of your back-due benefits.
Finally, it should be understood that the information presented here is focused on SSDI benefits; Supplemental Security Income (SSI) back due benefits only date back to the application date, at most.
Example:* “David” became disabled and unable to work in January 2015. David did not apply for disability benefits until March 2017, and was approved in April 2018 with the disability onset date that he applied for (January 1, 2015).
His five-month waiting period began January 2015 and ended after May 2015. David would be entitled to retroactive benefits for a year prior to his application date, which would be from March 2016 to February 2017. He would also be entitled to additional back due benefits from the date of his application in March 2017 until the date SSA begins to pay him for his ongoing monthly benefits.
So, his retroactive benefits would be 12 months, and the additional back due benefits would be for all the months in between March 2017 and when his first monthly check showed up. That would be awarded as a lump sum, in addition to his ongoing monthly benefits.
David’s representative’s fee would come out of his back due benefits. His monthly Medicare premium will come out of his monthly benefits now that he is Medicare eligible, beginning around March 2018, and participating in Medicare.
*Please note that this example is meant to be illustrative of the process, not a precise representation of a real case; in a real-life situation the exact dates may be different.
Benefits for Family Members
Children of disabled individuals may also be entitled to receive benefits if they are under age 18, or age 19 if still in high school. This includes biological children, adopted children, and dependent stepchildren. Dependent grandchildren may also be entitled to receive disability benefits under certain circumstances if their parents are deceased or disabled, and the disabled grandparent provides regular support to the grandchild. A disabled individual’s spouse may also be eligible for disability benefits if they are over the age of 62, or caring for a disabled individual’s child under the age of 16. The maximum family benefit is 150% of the disabled individual’s PIA.
About Citizens Disability, LLC:
Since 2010, Citizens Disability has been America’s premier Social Security Disability institution. Our mission is to give a voice to the millions of Americans who are disabled and unable to work, helping them receive the Social Security Disability benefits to which they may be entitled.