Social Security Disability Insurance (SSDI) benefits are offered to claimants who have a severe mental or physical health condition that does not allow them to perform substantial gainful activity (SGA) for at least 12 continuous months. However, claimants often wonder if their condition has to be permanent to win benefits.
Conditions that Are not Permanent
Given new medical discoveries and advancements, it is possible to have a severe health condition that will last 12 months yet that will not be permanent. If you have a condition that is expected to last for 12 continuous months, you may apply for benefits (assuming that you meet the non-medical requirements for SSDI) as soon as you are not working and performing substantial gainful activity. Substantial gainful activity is defined as working and earning $1,130 or more per month (for the non-blind) and/or working too many hours.
Work Condition Improves
What happens if you recover and are able to return to work? The SSA supports a claimant’s efforts to return to work. They have special programs such as the Ticket to Work program and a trial work period that may help you.
For example, the trial work period allows you to test your ability to work for at least nine months within a 60-month period without threatening your SSDI benefits (a trial work month is any month in which your total earnings are over $810). Talk to the SSA about this program if you have questions. Do not attempt to return to work without understanding how earnings affect your eligibility for SSDI benefits, or you may jeopardize your payments.
Closed Period Applications
Given the length of time it takes for some disability applicants to receive SSDI benefits, there are some claimants who may qualify for a closed period benefit. According to the SSA, a closed period is the “time between the onset of a disability and the time when the claimant is able to return to work and perform substantial gainful activity or SGA level work.”
For example, if a claimant files their claim, is not performing substantial gainful activity, and is disabled for at least 12 months—but returns to work prior to the approval of their disability claim—then this claimant may qualify for what the SSA terms a “closed period benefit.”
Closed period benefits can be awarded after you have returned to work. Consider, however, that the SSDI application generally must be filed within 14 months from the date that the disability ended, although some exceptions exist if you can prove that you had a good reason to miss this application deadline.
The good news is that the SSA is also more willing to grant closed period benefits because they are less expensive to pay than permanent benefits.
Short-Term Disability Benefits
SSDI benefits are not offered for any condition that is expected to last less than 12 continuous months. If you are pregnant, you have cancer or you have been in a car accident, your condition can be very serious; but if the SSA determines that you are able to return to work within less than 12 months, they can deny your SSDI application.
So what do you do if you have a short-term condition and you are unable to work? Unfortunately, there may not be a great answer for all workers. Some workers may be able to rely on short-term benefits offered by an employer; other workers may have saved enough in an emergency savings account to sustain them through periods of unemployment. Still, others may have to use credit cards or rely on family and friends for support.
When should I apply for disability benefits?
Assuming that your condition is severe, you are not working and performing substantial gainful activity, and your condition will last at least 12 continuous months, you can apply for SSDI benefits immediately. There is a five-month waiting period to receive SSDI benefits, but this does not mean that you have to wait for five months to apply. In fact, given the time it takes to receive an SSDI approval, it is a good idea to apply as soon as you cannot work.
How often will my condition be reviewed by the SSA?
Many health conditions will improve over time; others may be effectively treated with new medical discoveries or medications. With this in mind, the SSA will periodically perform a continuing disability review (CDR) to review your health status to ensure that you are disabled.
Continuing disability reviews are generally done every six to 18 months, every three years, or every seven years. For example, if the SSA labels your case "medical improvement possible" (MIP), they will try to review your case every three years. If your condition is not expected to improve, it will be reviewed every seven years. If, however, the SSA labels your case "medical improvement expected" (MIE), the case can be reviewed within six to 18 months.