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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

AND

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).

Resources:

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.








  • What medical conditions will get you approved for disability?

  • What kind of Mental Problems Qualify for Disability?

  • Which conditions will social security recognize as a disability?

  • Tips for getting Social Security Disability or SSI benefits approved







  • SSDRC Homepage:

    Social Security Disability and SSI Resource Center



    The Most Basic questions about Getting Disability Benefits

    Social Security Disability SSI and whether or not you can work

    Common Mistakes to avoid after being denied for Disability

    Social Security Disability SSI Questions and Answers

    More Social Security Disability SSI Questions and Answers

    Common Questions about Social Security Disability and SSI

    Winning Social Security Disability or SSI Benefits

    The SSI Disability Benefits Program

    Social Security Disability SSI and Doctors - Yours and Theirs

    Social Security Disability and SSI Claim Reviews

    Social Security Disability SSI System and Benefits for Children




    Denials, Appeals, and Getting a Disability Lawyer or Representative

    What you should know about Social Security Disability and SSI Denials

    Questions about Disability Lawyers and Hiring a Disability Attorney




    Various Types of Benefits including SSI, Mental, and Child benefits

    Social Security and SSI based on Mental Disability

    Social Security Disability or SSI Benefits for Children

    Disability Benefits through Social Security




    Filing for Social Security Disability or SSI Benefits

    Social Security Disability SSI: Medical Evidence and Records

    Filing your claim for disability benefits

    Eligibility for receiving disability benefits




    Resources on this site

    Social Security Disability, SSI Terms and Definitions

    Previously answered questions regarding SSD and SSI



    The SSDRC Disability Blog




    For Individuals living in North Carolina

    Disability in North Carolina

    North Carolina Disability Lawyer

    Getting disability in North Carolina








    Filing for disability in California

    How do I Apply for Disability Benefits in California

    How long should you wait before you apply for disability?

    SSD and SSI applications in California

    What do you do if your California disability claim is denied?

    Do you file for your children when you apply for disability in California?

    Should you apply for disability in California after a denial?

    How long does a disability case take in California

    After you file for disability in California

    Filing for disability in California and your condition

    Filing a disability claim in California, long filing process




    The California disability process

    Do I need to be disabled a year in California to get disability?

    The Social Security Disability process in California

    California Disability determination process

    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

    California Social Security Disability status

    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




    How long does disability take in California?

    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

    Finding a new disability attorney in California




    Applying for SSI in California

    Filing for SSI disability in California

    SSI disability denied in California

    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

    Can you be turned down for disability in California if your doctor says you are disabled?




    Disability hearings in California

    Disability Hearings in California

    California quick disability hearing

    How do I win my Social Security Disability Hearing in California?

    How long does it take to get a disability hearing in California?




    Disability denials in California

    Disability Denied in California

    If a disability claim is denied in California

    Appealing a Social Security Disability denial in California

    If you get denied Social Security Disability in California

    Why are Most Disability Cases Denied in California?

    Getting approved or denied for disability in California




    Disability appeals in California

    How do you file a disability appeal in California?

    How many disability appeals do you get in California?

    If your California disability appeal is denied, can you get another appeal?

    If your disability reconsideration is denied in California

    Filing a reconsideration appeal in California

    Why was I denied disability in California?




    Qualifying for disability in California

    Qualifying for disability in California

    Qualify for SSD in California

    Will I Qualify For Disability Benefits in California?




    Disability lawyers in California

    Using a Social Security Disability Attorney in California

    Cost of a California disability attorney

    Why do disability lawyers in California sometimes not take cases?

    Hiring a Disability Lawyer in California

    Social Security Disability Attorney Fees In California

    How do Disability Lawyers in California get paid their fees?

    Should you get a disability lawyer before you get denied in California?

    Lawyer for a disability hearing in California

    Why was I denied disability in California?