Overview of Disability
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Social Security List of Conditions
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Medical Evidence and Disability
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SSD SSI Definitions
SSDRC authored by Tim Moore
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Social Security Disability in California & the two year waiting period for Medicare Benefits
A great many claimants in California go without proper access to medical care at the very time:
1. their condition has become disabling
2. they are trying to document their condition for the social security administration (difficult to do if you can't get seen by a doctor and get medical records generated).
Here's a quote from emphysema.net:
"Before they can get Medicare coverage, people with disabilities must first receive Social Security Disability Insurance (SSDI) for 24 months. But SSDI generally does not begin until five months after an individualís disability has been certified. As a result, people with disabilities face three consecutive waiting periods prior to getting health coverage: (1) a determination of SSDI approval from the Social Security Administration; (2) a five-month waiting period to receive SSDI; and, (3) another 24-month waiting period to get Medicare coverage"
The quoted information is essentially accurate, but it's still potentially misleading to say that you actually wait 5 months for benefits and it's misleading also to refer to the medicare situation as a "two year wait" because in some cases by the time a person has been approved for disability benefits, the two year requirement for medicare will already have been served.
How is this? Well, here's how it works: when you file for disability, you allege an onset date for your disability. That is, you state when you think you became disabled. This is called AOD, or alleged onset date. If you get approved for disability, you're given an EOD, or established onset date. This is the date on which it is determined that your disability actually began (according to the medical records).
1. Social Security Disability Medicare Health Coverage
2. Do I automatically get Medicare if I'm approved for disability?
3. If you are applying for Social Security disability when does Medicare start?
4. Disability and Medicare- how does it work?
Do you get disability benefits starting with your EOD? If your disability claim was for SSI, yes. If your disability claim was for SSDI (social security disability insurance), the answer is no. Social security disability claims are subject to a five month waiting period. That does not mean that you "wait" five months for benefits. It simply means that the social security administration confiscates (what else would you call it) five months of your benefits.
So, social security disability benefits (remember, we're talking about SSDI, not SSI) begin five months after your established onset date, or EOD. This is called your date of eligibility. But you don't actually do any waiting. They simply rob you of five months of your benefits. When does medicare start for a social security disability recipient? Medicare starts two years after the date of eligibility, which is your date of entitlement.
Now to address an issue that can be confusing, if things aren't already. In some cases, depending on the claimant's established onset date, they will have to wait 2 years before receiving medicare. But...in other cases, if the onset date is pushed back, or established, far enough back, the two year period will already have been served by the time a social security disability claimant's case has been approved.
This is one reason why it can be important to have representation at a disability hearing----to get the most favorable onset date possible. Now (another potentially confusing wrinkle), how far back the onset can be established will depend on when a social security disability claimant filed an application. This is a limiting factor; however, SSDI benefits can be paid 12 months retroactive to the date of an SSDI application.
Also, if the medical evidence warrants, earlier applications for SSDI benefits that were filed by a claimant can be "reopened".
Aain, another reason to consider representation at the hearing level, since a competent and qualified claimant's representative (attorney or non attorney) will get for their client the best outcome possible---in other words a disability rep who's worth anything will work (via argument and obtaining the records) to not only win a claimant's case, but also establish the earliest possible onset date. Because "onset" doesn't affect just the size of the backpayment, it can affect medical coverage.
Return to: Social Security Disability Resource Center, or read answers to Questions
Filing for disability in California
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SSD and SSI applications in California
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Do you file for your children when you apply for disability in California?
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The California disability process
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The Social Security Disability process in California
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Disability approval criteria in California
California Social Security Disability decisions
Steps to Win Social Security Disability benefits in California
Questions about disability in California
How much can you make in California and still apply for disability?
California Social Security Back Pay
Can Disability benefits be garnished in California?
Disability two year medicare waiting period in California
California review of Social Security Disability claim
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VA disability and California Social Security Disability
Can a Congressman in California help on a disability case
How do examiners make disability decisions in California?
Applying for disability benefits in California
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How long does it take to get a decision on a disability case in California?
Why do disability claims take so long in California?
How Long Will It Take To Get My Disability Decision If I Appeal in California?
Disability claims in California with certain conditions
Applying For Disability On the Basis of Back Pain in California
Filing for Disability with Fibromyalgia in California
Social Security Disability For Mental Illness in California
Winning California disability
Will a lawyer improve the chance to win disability in California?
Getting approved for disability in California
Winning disability in California
California Disability Lawyers and Representation
Getting a disability attorney in California
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Applying for SSI in California
Filing for SSI disability in California
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Are SSI claims in California denied more than SSDI claims?
How to apply for SSI Disability in California
Doctors, medical records, and medical exams
Doctors and applying for disability in California
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Disability hearings in California
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Disability Denied in California
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Appealing a Social Security Disability denial in California
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Qualifying for disability in California
Qualifying for disability in California
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Disability lawyers in California
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Should you get a disability lawyer before you get denied in California?
Lawyer for a disability hearing in California
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