Receiving Social Security Disability Benefits While on Appeal
In some cases, if the SSA stopped payment of your disability benefits because they allege your condition(s) improved, you may be able to continue receiving your disability benefits while your case is on appeal. There are, however, different rules for DIB and SSI benefits.
Timelines: The following timelines apply to both DIB and SSI benefits:
Request for Reconsideration
You must file a request for reconsideration within 10 days of receiving your notice of cessation along with your request for continued monetary, Medicare, or both of them. While you may have 60 days to appeal the termination of benefits, to continue getting your benefits while on appeal, the time limit is 10 days (15 maybe if you add 5 mailing days for the termination notice to reach you; It is our position NOT to rely upon the additional five days to get an appeal in). You must also tell Social Security which benefits you want continued.
SSA Form 795, Benefit Continuation Election Statement, is the form you need to fill out to continue receiving benefits while on appeal.
Also, if alleged medical improvement is the basis the SSA is using to terminate your benefits, an in person hearing can be obtained even at the reconsideration level.
Request for Hearing
If the request for reconsideration is not successful, the next level for appeal is to request a hearing. Again, a request for a hearing must be filed, along with a second request for continuing benefits within 10 days after the reconsideration denial. The good news is that if you “missed the boat” to request continuing benefits when filing the request for reconsideration, you are not prevented from making the request when requesting a hearing.
If you were not successful at the hearing level in getting your benefits reinstated, and you wish to appeal to the Appeal’s Council, the SSA will not allow you to continue receiving disability benefits. If the Appeals Council, however, sends your case back down for a new hearing, your benefits will continue without you having to make a request.
Filing Out the Benefit Election Request Form
You cannot get this form online. You must ask your local office for a SSA 795 Form or “Benefit Continuation Election Statement.”
Continuing SSDI Benefits for Others
If someone else is receiving benefits on your earnings record, you must also request to have their benefits continued while you are requesting the same for your own. In other words, they must make their own election and cannot rely upon yours.
SSI and Medicaid Benefits
If you were eligible for Medicaid and you made the choice to continue your SSI benefits, while challenging the termination or cessation notice, your Medicaid will continue with no further action.
Remember your SSI benefits are determined, in part, based upon your monthly resources. You cannot have more than approximately $2,000 to your name or $3,000 if married. If your circumstances change while the cessation is on appeal—more monthly income, gaining additional non-exempt SSI assets, or even family giving donations or room and board—your SSI benefits may be suspended or changed in accordance with your new status.
Working and Appealing
If you work while on appeal, during a trial work period, and those earnings rise higher than what social security considers substantial gainful activity ($1,180 for 2018)—your SSDI benefits can be suspended.
When Your Benefits Will End
Generally speaking, your disability status disappears in the month SSA sends you the cessation notice. Not requesting a continuing of benefits while on appeal will result in losing your disability benefits within two months after the SSA sent you the notice of cessation. The SSA calls this a grace period.
“The Down Side:” Repayment of Benefits
Social Security will ask you to repay the SSDI or SSI cash benefits you received if you are not successful in your appeal. A waiver form, however, can be filled out and submitted to the SSA. The good news, the SSA will not ask you to repay the value of the Medicare or Medicaid benefits paid out while your case was on appeal—should your appeal not be successful.
The SSA is not required to waive the monetary repayment of disability benefits paid while you were appealing your termination of benefits. However, the SSA will consider waiving the recovery of paid disability benefits if your appeal was made in “good faith.” “Good Faith” means you cooperated with Social Security during the appeal; you provided medical and information as requested; you attended medical examinations as directed. If you, however, were not able to comply with the SSA’s directives, they must take into account any physical, mental, educational or linguistic limitations that you suffer and may have contributed to non-compliance.