What is the 5-month Waiting Period?
Once you have been determined “disabled” by Social Security, they will pay you but will exclude the first 5 months following the start of your disability from payment. Which means if you are found to be disabled as of January 1, 2005, then you will get paid from June 1st 2005 onward. January, February, March, April and May are the first 5 months and you will not get paid for those months. Payments pick up only after 5 full months have passed.
One reason for this may be that the Social Security Administration wants its receivers to use up sick or vacation days before collecting benefits. And of course, the Social Security Administration also saves a huge amount of money by not paying benefits for the first five months.
The five month waiting period can confuse many people. Here are a couple of real-life examples to help explain the process (which has its complications):
Example One: The claimant falls off a ladder on May 17, 2005, at his home. As a result of his injury, he herniates two disks. Being a diabetic, the claimant’s surgery is complicated and he does not recover well. Alleging an onset date of May 17th, 2005, the claimant files in November 2005. In April 2007, the judge rules in his favor in the Social Security disability case. The judge decides that the disability begins on May 17, 2005, just as the claimant alleged.
The Social Security Administration pays the claimant a lump sum to cover November 2005 through April 2007. The five month waiting period means that there is five months between the alleged onset date and when the claimant can be paid. June, July, August, September, and October comprise the five month waiting period. That is why the claimant cannot be paid until November 2005.
You may have noticed that May was not included in the 5-month period. This is because his alleged onset date was in mid-May. Only if it had been on the 1st of May would May been included. Otherwise, the 5-month waiting period kicks in starting with the 1st of the next month (sounds like another way for SSA to cut back on payments!).
Example Two: Example 2 is a little more tricky.
The claimant had a severe heart attack on September 2, 2003, which permanently damaged her heart. The claimant tries to recover and still wishes to continue working. Although the claimant went back to work and tried other jobs multiple times, she was unable to get through more than a day or two of work in every instance. The claimant ended up filing for disability years later, on January 8, 2006, alleging an onset date of September 2, 2003 (date of heart attack). In September 2007, the judge heard her case and awarded her aid with an onset date of September 2, 2003.
Now, based on what was previously said, you would think that the claimant would get awarded benefits starting in March of 2004, after the 5-month period is up. However, in this case, the start date of her receiving benefits will be January 2005 (NOT March 2004). Her lump sum payment will be from January 2005 to September 2007.
The reason is for this is due to the amount of time she waited to apply for benefits. You are only able to recieve benefit payments from as far back as a year prior to the application. Since she applied in January 2006, she could only start getting benefits starting January 2005. Luckily, though, the 5-month waiting period still counts as October 2003 to February 2004 in her case, meaning it was up by the time January 2005 rolled around.
For another in-depth example of a case in which the 5-month waiting period comes into play, please click on the link to chronic back pain case study #5.