Ask Larry

Shouldn't We Have Received A New Award Letter With Back Pay?

Hi Larry, My husband has stage 4 colon cancer, he was diagnosed in Oct 2019 , he didn't apply for SSDI until Oct 2020, he worked 2019 until Dec, and only 2 months in 2020.
He applied online and was contacted by the local field office , he had more forms to fill out. he did so on the phone with the rep.
CT sends the medical determination to Boston, a rep from there then sent more forms for him to fill out, he sent them.
He was approved with a Date of Dec.2020.. with payment not until July 2021. we were perplexed so after weeks of leaving voicemails etc we finally got ahold of the reason, the local field office accidentally entered Dec 2020 when she should have entered 2019. She said she was going to fix it ...so we wait more ...meanwhile his my SSA account online still says Dec 2020 as disability date with no back pay etc.
Next we get papers in the mail from a new Rep in Boston, requesting the same forms to be filled out, exasperated I called to find out why , I know these forms get sent to Kentucky to a scan center, so why fill them out again??
The rep I spoke to in Boston, was VERY nice, unlike the others, he wasn't sure why he received my husbands info from out local office and said he tried to reach the local rep, so I explained to him that likely because she made the typo with the determination year.... He said he understood and would see what he could do to help fix this.
we then get a letter Feb 5th stating they they reviewed his case and find he was medically disabled Dec 2019 and the non medical portion was being reviewed and that another letter will follow. We contacted the Boston Rep again to ask what is going on, and he told us he sent us that letter and that he closed the case, and our field office is now handling it and to contact them, we contacted the rep we had been given in the original decision, this woman is very bitter to say the least, regardless, she basically bantered about the things the Boston rep told us ,, we explained we just wanted to know if the update in his file had been made and whats happening.. she uttered something about payment being "in processing" .. at this point after her sayin...maam to me multiple times, I no longer wanted to ask questions, as I said , she was not nice at all. To this date we have no further mailings from SSA, we've only the original award letter with the decision date of Dec 2020 with he benefit amount reflective of that, and the letter saying they changed it to 2019. the My SSA online account has not been updated to reflect any change , my question is , shouldn't we have received a new award letter showing a new benefit breakdown, with backpay ? Does this sound like a typical way to handle a typographical error on the reps end?? and do we have to deal with the rep we were given in the original letter? this woman clearly does not like her job, is very unhelpful and very difficult to reach, and lastly, would this payment "in processing" happen without a new recalculation seeing they changed his disability date by a year ?? thank you for reading this , and any reply is appreciated,
His wife

Hi. I'm sorry to hear about your husband's illness and about the poor treatment you've received from Social Security.

It might help to understand the process involved for handling disability claims. Social Security offices don't make determinations on whether or not a person medically qualifies for Social Security disability (SSDI) benefits. Instead, they contract with state disability determinations services (DDS) to make those determinations. Social Security offices have jurisdiction of everything except the medical determinations, though, such as determining whether or not a person meets the insured status requirements for SSDI, calculating SSDI benefit rates, and determining when a person's work activity ended or fell below substantial gainful activity (SGA) level.

Establishing a date of onset for SSDI is a twofold process. In addition to being medically disabled, a person must actually stop performing SGA level work before they can be considered disabled for SSDI purposes. If your husband continued working into 2020, a date of onset in December 2019 couldn't be established unless his work in 2020 was below SGA level, or if it was an unsuccessful work attempt (UWA).

Apparently the person you spoke with in Boston is with the DDS, and it sounds like they've determined that your husband met the medical requirements for SSDI in December 2019. That determination would then have been sent back to the Social Security office, and a claims representative there would be responsible for making sure the non medical requirements are met and calculating the benefit rate. If your husband's date of disability onset is approved as of December 2019, his initial month of SSDI entitlement would then be June 2020. There is a 5 calendar month waiting period for SSDI benefits.

Unfortunately, the error that was made regarding your husband's disability onset date would require manual processing to correct the mistake. Final processing of SSDI claims after receiving a favorable DDS determination is normally fairly quick and fully automated. Manual processing, on the other hand, takes a substantial amount of time. The claims representative in the local office would need to sign off on the award and transfer jurisdiction of the claim to the regional processing center. One of more employee(s) there would then need to authorize the award and make the required inputs to the computer system setting up payment. In your husband's case, that would involve changing all of the incorrect information initially established on Social Security's computers. If they don't get the computer coding correct, then their input rejects and they must try again.

I'm not sure exactly where in the process your husband's claim currently is based on the information you've gotten from Social Security, but there's probably not much you can do at this point other than periodic follow ups with Social Security to check on the status.

Best, Jerry

Posted: 
Feb 27 2021 - 10:53am
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