Medicare Blog

how long does social security take to make a decision on medicare benefits

by Judy Koch Published 2 years ago Updated 1 year ago
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Generally, it takes about 3 to 5 months to get a decision. However, the exact time depends on how long it takes to get your medical records and any other evidence needed to make a decision. * How does Social Security make the decision? We send your application to a state agency that makes disability decisions.

How long does it take to get a Social Security disability decision?

The Social Security Administration (SSA) website claims that applicants typically wait three to five months to receive a decision —but how long realistically should you expect to wait? We’ll break down the timelines, expectations, and what-if scenarios of the Social Security Disability (SSD) application process.

How long does it take to enroll in Medicare after disability?

We automatically enroll you in Original Medicare (Parts A and B) after you get disability benefits for two years. However, if your disability results from ALS, Medicare coverage begins sooner, generally the first month you are eligible for disability benefits.

How long does it take for Social Security to review my case?

Social Security will then do a full medical review (FMR) of your case, which may take three to five months. About 2-3% of disability recipients who are initially sent the mailer are selected for a full CDR.

How long does it take to get Social Security retirement benefits?

Social Security recommends applying for retirement benefits three months before you want them to begin, because processing can take two months or longer. You can apply for retirement benefits online, by telephone or in person at a local Social Security office.

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How long does it take Social Security to process an application for Medicare?

You can also call the Social Security Administration at 1-800-772-1213 or go to your local Social Security office. It takes about 45 to 90 days to receive your acceptance letter after submitting your Medicare application.

How long is the process for Medicare?

Your initial enrollment window for Medicare spans seven months, beginning three months before the month of your 65th birthday and ending three months after that month. During this time, you have the option to sign up for Medicare online. The process is fairly simple and should take 15 minutes or less.

What does it mean when Social Security says a medical decision has been made and we are working to process your benefit application?

It means you were approved. The non-medical is just an SSI financial review.

What happens after Social Security makes a decision?

When we make decision on your claim, we will send you a letter explaining our decision. If you do not agree with our decision, you can appeal it. The first level of appeal is reconsideration. A reconsideration is a complete review of your claim by someone who didn't take part in the first decision.

Why is my Medicare taking so long?

Some applications may take longer if the Department of Health and Aged Care need to assess them. We assess your application to see if you're eligible to access Medicare benefits. If you're eligible we'll update your Medicare Provider Record to show your new status.

How far back will Medicare pay a claim?

12 monthsMedicare claims must be filed no later than 12 months (or 1 full calendar year) after the date when the services were provided. If a claim isn't filed within this time limit, Medicare can't pay its share.

How do I know if my Social Security application is approved?

If you have questions or need help understanding how to check the status of your Social Security application online, call our toll-free number at 1-800-772-1213 or visit your Social Security office.

How do I know if my Social Security disability was approved?

You can check the status of your application online using your personal my Social Security account. If you are unable to check your status online, you can call us 1-800-772-1213 (TTY 1-800-325-0778) from 8:00 a.m. to 7:00 p.m., Monday through Friday.

What does it mean when it says a decision has been made on your benefit application?

It means exactly what it said, that a decision has been made on your case. You will be receiving notice as to what that decision is via mail. At that point you will know if the claim was approved or denied and if you disagree with what was decided your appeal rights must be done in 60 days from the letter.

Why is it taking so long to process my Social Security application?

On the other hand, if you are missing information or made errors on your application, it will likely take longer for the SSA to process it. They will need to contact you for more information, or they will have to correct your errors. This can add weeks or even months to the process.

How long does it take to get first Social Security check after applying?

Once you have applied, it could take up to three months to receive your first benefit payment. Social Security benefits are paid monthly, starting in the month after the birthday at which you attain full retirement age (which is currently 66 and will gradually rise to 67 over the next several years).

How long does it take to get fully favorable decision?

In general, it may take 3 to 4 months following your fully favorable decision to begin receiving your benefits because of the calculation required as outline above.

How long does it take to get Social Security?

Typically, it takes 6 weeks to process your application and for the benefits to start. However, it will take longer if you submit incorrect information. Also, the duration for approval will depend on the number of submissions the Social Security Administration (SSA) will be processing at the time. Overall, the wait time is at least six weeks ...

How many elderly people are receiving Social Security?

At the close of 2018, approximately 60 million elderly Americans were collecting their social security benefits. The application list for the benefits is growing each year and that borders on a retirement crisis that requires solutions. Therefore, you cannot help but wonder how long does it take to get approved for social security benefits.

What is an exemption for Medicare?

Exemptions for Documentation. For those who have applied for Medicare or any social security benefits before, you are exempted from providing certain information. This helps speed up your application as your information is already on their database.

Does the SSA accept original documents?

The SSA will send you notification when they are required. Notably, SSA only accepts original documents and certifications. Alternatively, you can furnish them with copies certified by the government. You will get your copies back once the verification is over.

How long do you have to wait to receive your first SSDI payment?

Generally, if your application for Social Security Disability Insurance (SSDI) is approved, you must wait five months before you can receive your first SSDI benefit payment. This means you would receive your first payment in the sixth full month after the date we find that your disability began.

When will I get my first SSDI?

Your first benefit would be paid for the month of December 2020, the sixth full month of disability. However, there is no waiting period if your disability results from amyotrophic lateral sclerosis (ALS) and you are approved for SSDI benefits on or after July 23, 2020.

How long does Medicare cover ALS?

Medicare Coverage If You're Disabled. We automatically enroll you in Original Medicare (Parts A and B) after you get disability benefits for two years. However, if your disability results from ALS, Medicare coverage begins sooner, generally the first month you are eligible for disability benefits.

What is Medicare Advantage Plan?

Medicare Advantage Plan (previously known as Part C) – people with Medicare Parts A and Part B can choose to receive all of their health care services through plans that are offered by private companies and approved by Medicare.

What is Medicare coverage?

Medicare Coverage If You're Disabled 1 Medicare Part A (Hospital Insurance) helps pay for inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. The taxes you paid while you were working financed this coverage. It’s provided at no cost to you. 2 Medicare Part B (Medical Insurance) helps pay doctors' services, outpatient care, some medical supplies, and other preventive services. You will need to pay a monthly premium for this coverage if you want it.

When will SSDI pay in 2020?

We would pay your first benefit for the month of December 2020, the first full month of disability. We pay SSDI benefits in the month following the month for which they are due. This means that the benefit due for December 2020 would be paid to you in January 2021, and so on.

What are the other benefits that affect Social Security?

Other Payments May Affect Your Disability Benefits. If you receive certain other government benefits, such as workers' compensation, public disability benefits, or pensions based on work not covered by Social Security (e.g., some government or foreign employment), the Social Security benefits payable to you and your family may be reduced.

How Long Will It Take to Appeal the SSA’s Decision?

Each case is unique, so the time that it will take to successfully appeal the SSA’s decision will vary on a case-by-case basis.

How long does it take to get a Social Security disability appeal?

This process—requesting the review and waiting for the results of the review—can add another six months to two years on to the appeals process. This process is different for every state and would be handled differently than for example, how a Social Security Disability Attorney in Lake Oswego, OR would treat it.

How long does it take to appeal a disability claim?

The SSA must receive your written request to appeal within 60 days from the date you received their decision. If you miss this deadline, you will lose the right to file an appeal.

What is SSDI disability?

Legal Posts. The Social Security Administration (SSA) provides Social Security Disability Insurance (SSDI) benefits to eligible disabled individuals who are unable to work as a result of their physical or mental condition. Many people rely on these benefits to make ends meet when they can no longer work due to their disability.

What is the first step in the process of a claim?

The first stage of the process is reconsideration, which is a complete review of your claim by someone who was not involved in the initial review of your claim. The person who reviews your claim will look at evidence submitted with your initial application and any new evidence you have submitted since your claim was denied.

How long does it take to get a hearing?

Then, you will need to wait for a hearing date to be scheduled. This can take anywhere from several months to over a year, depending on your location. After the hearing, you will need to wait another several weeks or months for the judge’s decision. On average, the process of getting a hearing, attending the hearing, and waiting for the judge’s decision takes about two years.

How long do you have to wait to get a copy of a court decision?

The administrative law judge will not reveal their decision right away. Instead, you must wait to receive a copy of their decision in the weeks or months following your hearing.

How long does it take for SSA to approve a claim?

First-time applicants win approval in 3-5 months, on average. In 2020, the SSA approved a little more than 1 in 5 first-time applicants. Most claimants have to appeal their initial denials, especially if they don’t have a lawyer handling their cases.

How long do you have to wait to file a disability claim?

That’s why many applicants find that they wait six months to two years before finally receiving benefits. Here’s what you need to know about various types of claims and a brief overview of the four stages of application and appeals:

How to appeal a disability claim?

Appealed disability claims have four steps before you should attempt to reapply for benefits. The SSA may approve your claim at any point in this process: 1 Reconsideration 2 A hearing with an Administrative Law Judge (ALJ) 3 An appeals council review 4 Federal court

How many steps are there to reapply for disability?

Appealed disability claims have four steps before you should attempt to reapply for benefits. The SSA may approve your claim at any point in this process:

How long does it take to get a federal appeals approval?

The amount of time it takes for you to win approval depends on which level of appeal your claim must go through. For example, some applicants who have their claim approved after reconsideration may be approved within six months. Applicants who take their claim to the appeals council for review may experience a wait time of two years. Appealing to a Federal court may take more than a year after the appeals council.

What is the first step in the long claims process?

According to Tim Moore, a former disability examiner for the SSA, the first step in the long claims approval process is to send your Social Security disability benefits application to a state disability agency, which is also called Disability Determination Services (DDS).

What is the second criteria for being fast tracked?

The second criteria for being fast-tracked is that the condition is on the Compassionate Allowance List (CAL). People with a condition on CAL always meet the SSA’s definition of “disabled” and are often approved. If you’re eligible for an expedited claim, you may be approved as little as 30 days.

How long does it take for Social Security to do a medical review?

Most people who fill out the mailer and send it in will get a letter from Social Security after one to three months saying that Social Security does not need to do a medical review at this time. This means you do not have to go through a CDR at this point and your CDR is deferred until your next periodic review.

How long do you have to wait to get Social Security?

Recipients in this category have to wait the longest to find out whether they get to keep their benefits— five to six months, sometimes more.

How often does Social Security reset your medical reexamination diary?

Social Security will reset your periodic review interval, which it calls your " medical reexamination diary ," at the same interval it was before you received the mailer. For instance, if Social Security designated you as "medical improvement possible" and gave you a three-year diary when you were approved for benefits, you'll be sent another mailer or long-form report in three years. (For more information, read our article on how frequently your disability case will be reviewed .)

What happens if you go through a full medical review?

Those who go through a full medical review will have their benefits terminated if the claims examiner finds that their condition has improved since they were approved for benefits. This happens in relatively few adult cases, although the percentage of adults whose benefits are terminated has been increasing over the last few years. In 2013, 13% of adults were terminated after a full medical review, while in 2017, over 16% of adults had their benefits ceased after a full medical review. (The fact that there was an extensive backlog of CDRs that Social Security tackled in the last three years may have helped this increase—claimants who are long overdue for CDRs may be more likely to have improved or started to work.) But the good news for this 16% whose benefits were ceased is that about half of CDR benefit denials are reversed on appeal.

How long does it take for a disability to be reviewed?

The average time for DDS to process a reconsideration was 101 days in 2017, but this review can take anywhere from three to five months.

What is a SSA 454?

If you receive Form SSA-454, called the Continuing Disability Review Report, means that you're getting a CDR. You need to fill out this form in full and send it in.

What is the short form for Social Security?

Most disability recipients receive the short-form Form SSA-455 —what the agency calls a "mailer"—with just six questions, whose answers Social Security can scan into its computers. Other disability recipients receive the long-form Form SSA-454. How long the review takes depends on whether you receive the mailer, the long-form report, or both.

How long does it take to get a Social Security card?

A social security card. Social Security recommends applying for retirement benefits three months before you want them to begin, because processing can take two months or longer. In most cases, you can apply as early as four months in advance.

How to get verification of Social Security benefits?

You can get faster verification online. Log on to My Social Security or open an account to check on your application status. After your benefits are approved, you can view and print your verification letter.

How to get faster service for Social Security?

However, you'll receive faster service if you apply online at My Social Security or by telephone. To avoid delays, complete the application properly, sign up for direct deposit and supply all the required supporting documents, such as tax returns.

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