# Social Security Disability Insurance (SSDI): The Five-Month Waiting Period for Benefits

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URL: https://www.frixlaw.com/law-library/documents/crs%3ARS22220

## Record

- **Collection:** Congressional research report
- **Document type:** CRS Report
- **Published:** January 24, 2014
- **Citation:** RS22220

## Text

Social Security Disability Insurance (SSDI):
The Five-Month Waiting Period for Benefits
(name redacted)
Analyst in Income Security
January 24, 2014

Congressional Research Service
7-....
www.crs.gov
RS22220

Social Security Disability Insurance (SSDI): The Five-Month Waiting Period for Benefits

Summary
Social Security Disability Insurance (SSDI) is authorized by Title II of the Social Security Act
and provides income replacement for eligible individuals who are unable to work due to a longterm injury or illness that is expected to last at least one year or result in death. Current eligibility
requirements include (1) verification of an applicant’s disability, (2) filing a claim, (3) a “recent
work” and “duration of work” test, (4) verification that an individual has not reached normal
retirement age, and (5) a five-month waiting period from disability-onset.
In implementing the five-month waiting period for SSDI benefits, Congress sought to set a time
frame that would be long enough for a short-term injury or illness to be corrected, but would also
deter individuals who can work from applying for benefits. The first month counted as part of the
waiting period can be no more than 17 months before the month of application, and benefits can
be applied retroactively for up to 12 months. The Social Security Administration (SSA)
encourages eligible individuals to apply for benefits as soon as possible after the onset of a
disabling condition.
The waiting period does not apply to individuals who have been previous recipients of SSDI in
the five years prior to any current disability. Several other programs, such as Supplemental
Security Income (SSI), temporary disability insurance, workers’ compensation, unemployment
compensation, and private disability insurance, can provide funds for eligible SSDI applicants
facing financial hardship during the five-month wait period.

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Social Security Disability Insurance (SSDI): The Five-Month Waiting Period for Benefits

Contents
The Five-Month Waiting Period for Social Security Disability Insurance Benefits ........................ 1
The Five-Month Waiting Period ................................................................................................ 1
Retroactive Benefits .................................................................................................................. 2
Exception to the Five-Month Waiting Period ............................................................................ 2
Legislative History of the SSDI Waiting Period .............................................................................. 2
Congress’s Justification for Instituting a Waiting Period .......................................................... 2
Changes to the SSDI Waiting Period ......................................................................................... 3
Potential Income Supports During the Five-Month Waiting Period ................................................ 4
Supplemental Security Income .................................................................................................. 4
Temporary Disability Insurance ................................................................................................ 4
Workers’ Compensation............................................................................................................. 5
Unemployment Compensation .................................................................................................. 5
Private Disability Insurance....................................................................................................... 6
Impact of the Five-Month SSDI Waiting Period ............................................................................. 6

Contacts
Author Contact Information............................................................................................................. 7
Acknowledgments ........................................................................................................................... 7

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Social Security Disability Insurance (SSDI): The Five-Month Waiting Period for Benefits

The Five-Month Waiting Period for Social Security
Disability Insurance Benefits
Title II of the Social Security Act provides that certain individuals may be entitled to Social
Security Disability Insurance (SSDI) benefits under the federal Old Age, Survivors, and
Disability Insurance (OASDI) program if they meet the following statutory requirements:1
•

The individual’s medical condition meets the definition of disability as specified
in Section 216 of the act;2

•

The individual has filed a claim for disability benefits;

•

The individual is insured, generally requiring either a work history or the work
history of a parent or spouse, as specified in Section 214 of the act;3

•

The individual has not reached normal retirement age as provided in Section 216
of the act;4 and

•

The individual has completed a five-month waiting period.

The Five-Month Waiting Period
The waiting period for SSDI benefits consists of five consecutive calendar months beginning with
the first full calendar month in which a covered individual satisfied the test of disability. If an
individual’s disabling condition began before he or she met the insurance requirements, the
waiting period would begin with the first full calendar month after insured status was gained.
During this waiting period, SSDI benefits cannot be paid. It is important to note that this waiting
period begins at the onset of the disabling condition and is not affected by the date a worker
applies for SSDI benefits. Workers are encouraged by the Social Security Administration (SSA)
to apply for benefits at the onset of their disability. The first month counted as part of the waiting
period can be no more than 17 months before the month of application and thus, retroactive
benefits are limited to 12 months from the date of application.

1
For more information on the SSDI program, see CRS Report RL32279, Primer on Disability Benefits: Social Security
Disability Insurance (SSDI) and Supplemental Security Income (SSI), by (name redacted).
2
42 U.S.C. §416(i). A person is disabled under the terms of the act if he or she is unable to engage in any substantial
gainful activity (SGA) because of a medically determinable physical or mental impairment. The SGA thresholds for
2014 are earnings of $1,070 per month for non-blind persons and $1,800 per month for blind persons. This impairment
must be expected to result in the impaired person’s death, or be expected to last at least 12 consecutive months. In
addition, this impairment must prevent a person from engaging in their previous work or in any other work that exists
in the national economy. The Supreme Court held in Barnhart v. Thomas 124 S. Ct. 376 (2003) that the previous work
test does not require that an individual’s prior job exist in the national economy.
3
42 U.S.C. §414. For a detailed explanation of the insurance requirements, see “Disability Planner—How Many
Credits You Need,” at http://www.ssa.gov/dibplan/dqualify3.htm.
4
42 U.S.C. §416(l). For a table of retirement ages by year of birth, see “Social Security Benefits—Normal Retirement
Age,” at http://www.ssa.gov/OACT/ProgData/nra.html.

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Social Security Disability Insurance (SSDI): The Five-Month Waiting Period for Benefits

Retroactive Benefits
SSA provides retroactive SSDI benefits when the onset of disability occurred before an
application for benefits was filed. In such cases, a beneficiary is entitled to benefits retroactive to
five months after the date of disability onset provided that this date is within one year of the date
of application.5

Exception to the Five-Month Waiting Period
Section 223 of the act provides one exception to the five-month waiting period.6 A person who, in
the five years immediately preceding the onset of a current disability, had either received SSDI
benefits or had a disabling condition that met the requirements set forth in Section 216 of the act
(42 U.S.C. §416), is entitled to immediate benefits paid from the onset of disability.

Legislative History of the SSDI Waiting Period
A waiting period from the onset of disability to eligibility for benefits has been part of the SSDI
program from its inception. In 1954, Congress made the first provisions for loss of work due to
disability and included language that exempted a period of disability from being counted when
determining retirement benefits.7 Two years later, Congress authorized the payment of SSDI
benefits to persons over the age of 50 after a six-month waiting period.8 The age requirement was
removed in 1960. In recent years, Congress has introduced a variety of legislative initiatives to
reduce or eliminate the five-month waiting period.9

Congress’s Justification for Instituting a Waiting Period
In 1955, the House Ways and Means Committee recommended passage of the proposed Social
Security Amendments and discussed the rationale for a six-month waiting period between the
onset of disability and eligibility for federal benefits. A committee report cited the unique nature
5

42 U.S.C. §423.
Ibid. P.L. 86-778. This exception was part of the Social Security Amendments of 1960.
7
P.L. 83-761. This measure, found in the Social Security Amendments of 1954, is commonly referred to as the
“Disability Freeze,” For more information, see Edward D. Berkowitz, “Supporting Disability: An Historical
Perspective,” American Rehabilitation, vol. 25, no. 1, (1999), pp. 2-8.
8
P.L. 84-880, Social Security Amendments of 1956.
9
For example, H.R. 2263, introduced as the Disability Equity Act by Rep. Betty Sutton in the 111th Congress, sought to
eliminate the waiting periods for people with disabilities for entitlement to disability benefits and Medicare. H.R. 723
and S. 366, concurrently introduced in the 111th Congress as the Social Security and Medicare Improved Burn Injury
Treatment Access Act of 2009, attempted to eliminate the waiting periods for DI and Medicare benefits in the cases of
individuals with disabling burn injuries. H.R. 160, introduced as the Fairness for the Terminally Ill Act of 2011 by Rep.
Heath Shuler in the 112th Congress, sought to eliminate the waiting period in the DI program for those individuals
determined to be terminally ill by a physician (i.e., a life expectancy of 6 months or less). S. 1311, introduced as the
Expedited Disability Insurance Payments for Terminally Ill Individuals Act of 2013 by Sen. John Barrasso in the 113th
Congress, attempted to provide phased-in SSDI payments during the waiting period for individuals with terminal
illnesses. H.R. 160, introduced as the Disability Benefits Fairness Act of 2013 by Rep. Mike McIntyre in the 113th
Congress, sought to eliminate the five-month waiting period for an individual to be eligible for benefits based on
disability.
6

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Social Security Disability Insurance (SSDI): The Five-Month Waiting Period for Benefits

of the federal definition of disability and called its requirement that a disabling condition be
expected to result in either death or long duration “more exacting” than the disability definitions
commonly used by commercial insurance carriers at the time, many of which had their own sixmonth waiting periods. In addition, the Ways and Means Committee expressed that the six-month
waiting period was “long enough to permit most temporary conditions to be corrected or to show
definite signs of probable recovery” and would be of sufficient length to make it “unprofitable for
a person who can work not to do so.”10

Changes to the SSDI Waiting Period
Two significant changes to the original six-month waiting period have been passed as part of the
creation of the SSDI program. The first change eliminated the waiting period for disabled
workers who were previous SSDI recipients or who had a previous disabling condition in the five
years prior to the onset of their current disability. To be exempted from the waiting period, the
previous disabling condition must have met the statutory definition of disability as provided in
Title II of the act.11
In their reports to the House and Senate on the 1960 Amendments, the Ways and Means and
Finance Committees affirmed that the six-month waiting period for those with previous
disabilities as a possible barrier to return to work efforts, stating that
Most disability insurance beneficiaries who return to work do so despite severe impairments.
Where a disabled person becomes employed without any improvement of his condition, a
more or less slight change in his situation can result in the loss of his job and make him once
again eligible for disability insurance benefits. Other disabled persons, whose medical
conditions may improve sufficiently to require termination of benefits, may subsequently
grow worse again and become reentitled to benefits. A new six-month qualifying period
during which they receive neither earnings nor benefits imposes a hardship on them and their
families, and may be a real bar to any further work attempts.12

The second change to the SSDI waiting period reduced the waiting period from six to five
months.13 The intent of this change was to reduce the financial burden on applicants, and the
Ways and Means Committee reported that “reducing the waiting period from six months to five
months would diminish the financial hardships faced by those workers who have little or no
savings or other resources to fall back on during the early months of long-term disability.”14 The
Senate Finance Committee went further than the House and recommended reducing the waiting
period to four months.15
10

U.S. Congress, House Committee on Ways and Means, The Social Security Amendments of 1955, report to
accompany H.R. 7225, 84th Cong., 1st sess., H.Rept. 1189 (Washington: GPO, 1995), pp. 5-6. The Senate Finance
Committee did not include a provision for disability benefits in its report.
11
P.L. 86-778, the Social Security Amendments of 1960.
12
U.S. Congress, House Committee on Ways and Means, The Social Security Amendments of 1960, report to
accompany H.R. 12580, H.Rept. 1799 (Washington: GPO, 1960), pp. 13-14, and U.S. Congress, Senate Committee on
Finance, The Social Security Amendments of 1960, report to accompany H.R. 12580, 86th Cong., 2nd sess., S.Rept. 1856
(Washington: GPO, 1960), p. 17.
13
P.L. 92-603. The Social Security Amendments of 1972.
14
U.S. Congress, House Committee on Ways and Means, The Social Security Amendments of 1971, report to
accompany H.R. 1, 92nd Cong., 1st sess., H.Rept. 92-231 (Washington: GPO, 1971), p. 56.
15
U.S. Congress, Senate Committee on Finance, The Social Security Amendments of 1972, report to accompany H.R. 1,
(continued...)

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Social Security Disability Insurance (SSDI): The Five-Month Waiting Period for Benefits

Potential Income Supports During the Five-Month
Waiting Period
Supplemental Security Income
Title XVI of the act authorizes Supplemental Security Income (SSI) benefits for individuals who
meet the statutory test of disability or are over the age of 65 and who fall below specific income
and asset thresholds.16 SSI beneficiaries need not have any prior work history or meet the
insurance requirements of SSDI, and there is no waiting period between the onset of a disability
and eligibility for SSI benefits. In December 2012, of the 8.4 million disabled-worker
beneficiaries aged 18-64 receiving SSDI benefits, 1.1 million or 13.1% also received federally
administered SSI benefits.17 Thus, SSI can be used by some disabled workers to lessen the
economic hardship faced by the lack of earnings and benefits during the SSDI waiting period. SSI
benefits are not available to residents of Puerto Rico, Guam, or the U.S. Virgin Islands.18
The maximum federal SSI payment, referred to as the federal benefit rate, is $721 per month for
an individual living independently and $1,082 for a couple living independently in 2014. Fortyfour states and the District of Columbia add a supplement to this benefit for their residents. The
amount of the federal benefit, plus any state supplement, may be reduced or offset by some
earned and unearned income.19 Since most SSI recipients have other income, the average monthly
SSI payment is less than the federal benefit rate. In December 2013, the average federally
administered SSI payment was $546.38 for adults aged 18 to 64.20 Thirty-nine states, the District
of Columbia, and the Commonwealth of the Northern Mariana Islands grant Medicaid eligibility
to all SSI recipients or have Medicaid eligibility rules that are the same as those of the SSI
program.

Temporary Disability Insurance
California, Hawaii, New Jersey, New York, Puerto Rico, and Rhode Island currently administer
Temporary Disability Insurance (TDI) programs that provide either state or private benefits to
(...continued)
92nd Cong., 2nd sess., S.Rept. 92-1230 (Washington: GPO,1972).
16
20 C.F.R. §416. For more information, see CRS Report 94-486, Supplemental Security Income (SSI), by (name redac
ted). See also “Understanding Supplemental Secur ity Income” at http://www.socialsecurity.gov/ssi/textunderstanding-ssi.htm.
17
Social Security Administration, Annual Statistical Report on the Social Security Disability Insurance Program, 2012,
Table 66, November 2013, http://www.ssa.gov/policy/docs/statcomps/di_asr/ (hereinafter cited as “SSDI Annual
Report 2012”).
18
Residents of these jurisdictions are eligible to receive federal benefits from their commonwealth or territorial
government under the provisions of Title XIV and Title XVI of the act. These benefits are administered by the
Department of Health and Human Services.
19
Certain income sources are not counted by SSA when determining a monthly SSI benefit. For more information, see
CRS Report RS20294, Supplemental Security Income (SSI): Income/Resource Limits and Accounts Exempt from
Benefit Determinations, by (name redacted).
20
Social Security Administration, Monthly Statistical Snapshot, December 2013, January 2014, Table 3,
http://www.ssa.gov/policy/docs/quickfacts/stat_snapshot/.

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Social Security Disability Insurance (SSDI): The Five-Month Waiting Period for Benefits

workers with disabilities who are not receiving SSDI benefits. The six TDI programs provide
temporary benefits, with maximum durations of between 26 and 52 weeks, for those with an
earnings history who are unable to work because of a disability and who are not receiving
workers’ compensation or SSDI benefits.21 In addition to state TDI, employees of the railroad
industry in all states are eligible for TDI benefits administered by the federal Railroad Retirement
Board in accordance with provisions of the Railroad Unemployment Insurance Act.22

Workers’ Compensation
Workers’ compensation systems in each state provide wage replacement and medical benefits to
workers unable to work because of an employment-related illness or injury and may be able to
pay benefits during the SSDI waiting period.23 The federal government administers workers’
compensation for its employees under the Federal Employees’ Compensation Act.24 The federal
government also administers workers’ compensation systems for some private sector employees
in the maritime, mining, and railroad industries through the Longshore and Harbor Workers
Compensation Program,25 the Black Lung Benefits Program, and the Energy Employees’
Occupational Illness Compensation Program.26

Unemployment Compensation
In each state, workers covered by state unemployment insurance (UI) systems may be eligible to
receive partial wage replacement in the event of a job separation. The states, however, require that
those receiving unemployment compensation be able and willing to work, a condition that may
exclude many waiting for SSDI eligibility (especially an individual who would earn in excess of
the substantial gainful activity), since it is assumed that the individual is unable to work.
Unemployment benefits are administered by the states within federal guidelines under Title III of
the act, and unemployment compensation provisions for individuals who are ill or disabled vary
by state.27

21

For more information on TDI programs, see Social Security Administration, Annual Statistical Supplement to the
Social Security Bulletin, 2013, scheduled release date: February 2014, http://www.ssa.gov/policy/docs/statcomps/
supplement/2013/tempdisability.html.
22
For more information on railroad disability benefits, see CRS Report RS22350, Railroad Retirement Board:
Retirement, Survivor, Disability, Unemployment, and Sickness Benefits, by (name redacted)
23
For more information on workers’ compensation, see Social Security Administration, Annual Statistical Supplement
to the Social Security Bulletin, 2013, scheduled release date: February 2014, http://www.ssa.gov/policy/docs/statcomps/
supplement/2013/workerscomp.html.
24
See CRS Report R42107, The Federal Employees’ Compensation Act (FECA): Workers’ Compensation for Federal
Employees, by (name redacted)
25
See CRS Report R41506, The Longshore and Harbor Workers’ Compensation Act (LHWCA): Overview of Workers’
Compensation for Certain Private-Sector Maritime Workers, by (name redacted)
26
For more information on state and federal workers’ compensation programs, see Charles B. Lewis, Workers’
Compensation Law and Strategy Guide (New York: Aspen Publishers, 2005).
27
For more information on unemployment compensation, see CRS Report RL33362, Unemployment Insurance:
Programs and Benefits, by (name redacted) a nd (name redacted) and 2012 Comparison of State Unemployment
Insurance Laws at http://workforcesecurity.doleta.gov/unemploy/comparison2012.asp.

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Social Security Disability Insurance (SSDI): The Five-Month Waiting Period for Benefits

The Government Accountability Office (GAO) found that 117,000 individuals (less than 1.0% of
all SSDI beneficiaries) received concurrent SSDI and UI cash benefits in fiscal year (FY) 2010.28
SSA’s Office of the Chief Actuary estimated that 0.4% of disabled-worker beneficiaries would be
in receipt of both SSDI and UI benefits in 2014.29

Private Disability Insurance
Private disability insurance programs offered by employers can be used to provide wage
replacement benefits during the five-month waiting period for SSDI benefits. In March 2013,
39% of private-sector workers participated in some form of short-term disability insurance plan
while 32% of private-sector workers were covered by long-term disability insurance.30 It has been
estimated that up to 20% of SSDI beneficiaries have received payments from private disability
insurance policies before being eligible for federal benefits.31

Impact of the Five-Month SSDI Waiting Period
The five-month waiting period between the onset of disability and eligibility for SSDI may have a
negative impact on the income of those seeking to enter the program. During this waiting period,
persons with disabilities are either not working or earning less than the substantial gainful activity
(SGA) threshold. In addition, claimants are either not receiving monthly benefits to replace lost
wages or are receiving only SSI benefits, which are usually lower than SSDI benefits. A July
2012 analysis by the Congressional Budget Office (CBO) estimated that the elimination of the
five-month waiting period would increase outlays to SSDI by approximately $8.0 billion dollars
in 2022 (about 4% of program outlays).32
One impact that may not be as clear, however, is the role that the waiting period plays in
discouraging possible beneficiaries from applying for benefits.33 This waiting period, and its
accompanying loss of income, lessen the overall generosity of the SSDI benefit.34
28

U.S. Government Accountability Office, Overlapping Disability and Unemployment Benefits Should be Evaluated
for Potential Savings, GAO-12-764, July 2012, http://www.gao.gov/assets/600/593203.pdf. GAO defined concurrent
receipt of SSDI and UI benefits as receipt of SSDI benefits in all three months of the quarter for which they received UI
benefits in FY2010.
29
Letter from Stephen C. Goss, Chief Actuary, to the Honorable Sam Johnson, Chairman, Subcommittee on Social
Security, January 7, 2014, http://www.socialsecurity.gov/OACT/solvency/SJohnson_20140107.pdf.
30
U.S. Bureau of Labor Statistics, Table 16. Insurance benefits: Access, participation, and take-up rates,1 private
industry workers, National Compensation, March 2013, http://www.bls.gov/ncs/ebs/benefits/2013/ownership/private/
table12a.htm. In March 2013, the median duration of benefit receipt on short-term disability insurance for all workers
in private industry was 26 weeks. Long-term disability (LTD) insurance benefits can last anywhere from a year to a
beneficiary’s full retirement age. Once a beneficiary is in receipt of SSDI, insurers generally offset LTD benefits by the
amount of SSDI benefits.
31
Todd C. Honeycutt, “Program and Benefit Paths to the Social Security Disability Insurance Program,” Journal of
Vocational Rehabilitation, vol. 21, no.2 (2004), pp. 83-94.
32
Congressional Budget Office, Policy Options for the Social Security Disability Insurance Program, July 2012,
http://www.cbo.gov/sites/default/files/cbofiles/attachments/43421-DisabilityInsurance_print.pdf.
33
Although the same analysis conducted by the CBO posited that an extension of the waiting period from five to
twelve months might deter claimants from applying for benefits, the CBO chose not to speculate as to the number of
possibly discouraged applicants.
34
One study estimated that eliminating the waiting period would have the same positive effect on the number of SSDI
(continued...)

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Social Security Disability Insurance (SSDI): The Five-Month Waiting Period for Benefits

Author Contact Information
(name redacted)
Analyst in Income Security
/redacted/@crs.loc.gov, 7-....

Acknowledgments
This report was originally written by Scott Szymendera and updated by (name redacted). All questions
should be directed to the current author.

(...continued)
applicants as a 10% increase in the level of benefits. For additional information, see Brent Kreider, “Social Security
Disability Insurance: Applications, Awards, and Lifetime Income Flows,” Journal of Labor Economics, vol. 17, no. 4
(1999), pp. 784-827.

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Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/crs%3ARS22220. Public record. Not legal advice.