Social Security Disability Insurance: The Five-Month Waiting Period for SSDI Benefits
Social Security Disability Insurance: The
Five-Month Waiting Period for SSDI Benefits
Scott Szymendera
Analyst in Disability Policy
Domestic Social Policy Division
Summary
Current law requires that a person wait five months from the onset of a qualifying
disability before receiving Social Security benefits. This report explains the five-month
waiting period and its legislative history. This report also provides information on other
programs that provide income support during this waiting period. It also briefly
describes legislation introduced in the 110th Congress that would reduce or eliminate
the five-month Social Security Disability Insurance (SSDI) waiting period (H.R. 69,
H.R. 2713, and S. 2050). This report will be updated to reflect legislative activity.
The Five-Month Waiting Period for
Disability Insurance Benefits
Title II of the Social Security Act (the 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 as2
specified in Section 216 of the act, 42 U.S.C. 416;
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 April Grady and Julie Whittaker. (Hereafter cited as CRS Report RL32279.)
2 A person is disabled under the terms of the act if he or she is unable to engage in any substantial
gainful activity (SGA, for 2008 earnings of $940 per month for non-blind persons and $1,570
per month for blind persons) because of a medically determinable physical or mental impairment.
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
(continued...)
!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 42 U.S.C. 414;
!The individual has not reached normal retirement age as provided in
Section 216 of the act,4 42 U.S.C. 416; 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.
Retroactive Benefits. Section 223 of the act, 42 U.S.C. 423, provides for
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.
Exception to the Five-Month Waiting Period. Section 223 of the act, 42
U.S.C. 423, provides one exception to the five-month waiting period. 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. This exception was part of the Social Security Amendments of 1960, P.L. 86-
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. The Social Security Amendments of 1954, P.L.
83-761, 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
2 (...continued)
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 A detailed explanation of the insurance requirements can be found on the SSA website at
[http://www.ssa.gov/dibplan/dqualify3.htm] and in CRS Report RL32279.
4 A detailed explanation of the normal retirement age can be found on the SSA website at
[http://www.ssa.gov/OACT/ProgData/nra.html] and in CRS Report RL32279.
benefits.5 Two years later, Congress passed the Social Security Amendments of 1956,
P.L. 84-880, which authorized the payment of SSDI benefits to persons over the age of
Congressional Reasoning for the Waiting Period. In 1955, the House
Committee on Ways and Means Report recommending passage of the proposed Social
Security Amendments discussed the rationale for a six-month waiting period between the
onset of disability and eligibility for federal benefits. This report cited the unique nature
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” then the disability
definitions commonly used by commercial insurance carriers at the time, many of which
had their own six-month waiting periods. In addition, the Committee felt that the six-
month waiting period was “long enough to permit most temporary conditions to be
corrected or to show definite signs of probably recovery” and would be of sufficient6
length to make it “unprofitable for a person who can work not to do so.”
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, the Social Security Amendments of 1960, P.L. 86-778, 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.
In order 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.
In their reports to the House and Senate on the 1960 Amendments, the Ways and
Means and Finance Committees saw the six-month waiting period for those with previous
disabilities as a possible barrier to return to work efforts stating:
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 real7
bar to any further work attempts.
5 This measure found in the 1954 Amendments 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.
6 U.S. Congress, House Committee on Ways and Means, The Social Security Amendments of
1995), pp. 5-6. The Senate Finance Committee did not include a provision for disability benefits
in its report.
7 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: GOP, 1960), pp. 13-14, and
U.S. Congress, Senate Committee on Finance, The Social Security Amendments of 1960, reportthnd
to accompany H.R. 12580, 86 Cong., 2 sess., S.Rept. 1856 (Washington: GPO, 1960), p. 17.
The second change to the SSDI waiting period reduced the waiting period from six
to five months as part of the Social Security Amendments of 1972, P.L. 92-603. The
intent of this change was to reduce the financial burden on applicants and in its report the
Committee on Ways and Means wrote 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.”8 The Senate Finance Committee went further than the House and
recommended reducing the waiting period to four months.9
The SSA is in the process of implementing several demonstration projects that will
alter the benefit structure of the SSDI program.10 However, none of these demonstration
projects will change the existing five-month waiting period between the onset of disability
and eligibility for SSDI 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 that meet the statutory test of disability or
are over the age of 65 and who fall below specific income and asset thresholds.11 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 for12
SSI benefits. 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. SSI13
benefits are not available to residents of Puerto Rico, Guam, or the U.S. Virgin Islands.
All SSI beneficiaries, regardless of disability or state of residence, receive the
standard benefit of $637 for an individual and $956 for a couple in 2008. Forty-four
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
8 U.S. Congress, House Committee on Ways and Means, The Social Security Amendments of
9 U.S. Congress, Senate Committee on Finance, The Social Security Amendments of 1972, report
to accompany H.R. 1, 92nd Cong., 2nd sess., S.Rept. 92-1230 (Washington: GPO,1972).
10 More information on these demonstration projects can be found on the SSA website at
[http://www.ssa.gov/disabilityresearch/demos.htm] .
11 For more information, see CRS Report RL32279; the SSA publication, Understanding
Supplemental Security Income, available on the SSA website at [http://www.ssa.gov/notices/
supplemental-security-income/text-understanding-ssi.htm]; and 20 C.F.R. § 416.
12 In 2003, 14% of disabled worker beneficiaries jointly received SSI and SSDI benefits. For
more information, see Social Security Administration, Annual Statistical Supplement, 2004, vol.
13 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.
by some earned and unearned income.14 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.15
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 workers with disabilities who are
not receiving SSDI benefits. In addition, 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. The seven 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.16
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. The federal government administers workers’ compensation for its
employees under the Federal Employee’s Compensation Act and the Energy Employee’s
Occupational Illness Compensation Program. 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, the Black Lung Benefits Program, and the Federal Employee’s Liability Act.17
Unemployment Compensation. In each state, workers covered by state
unemployment insurance systems may be eligible to receive partial wage replacement for
up to 26 weeks 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. Unemployment benefits are administered by
the states within federal guidelines under Title III of the act.18
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 2006, 37% of private sector workers were covered
by some form of private short-term disability insurance while 29% of private sector
14 Not all income is counted by SSA when determining a monthly SSI benefit. For more
information, see CRS Report RL32279; the SSA publication, Understanding Supplemental
Security Income; and 20 C.F.R. § 416.
15 A complete list of these states can be found on the SSA website at
[http://www.ssa.gov/work/ ResourcesT oolkit/Health/medicaid.html ].
16 For more information on TDI programs, see Social Security Administration, “Temporary
Disability Insurance,” Social Security Bulletin, vol. 64, no.3, (2003), p.56.
17 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).
18 For more information on unemployment compensation, see CRS Report 95-742,
Unemployment Benefits: Legislative Issues in the 108th Congress, by Julie Whittaker.
workers were covered by long-term disability insurance. 19 It is estimated that up to 20%
of SSDI beneficiaries received payments from private disability insurance policies before
being eligible for federal benefits.20
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 SGA. In addition they are either not receiving monthly benefits to replace lost wages
or are receiving only SSI benefits which are usually lower than SSDI benefits.
One impact that may not be as clear, however, is the role the waiting period plays in
discouraging possible beneficiaries from applying for benefits. This waiting period, and
its accompanying loss of income lessen the overall generosity of the SSDI benefit. One
study estimates that eliminating the waiting period would have the same positive effect
on the number of SSDI applications as a 10% increase in the level of benefits.21
Legislative Activity in the 110th Congress
Three bills have been introduced in the 110th Congress that would alter or eliminate
the current five-month SSDI waiting period:
!H.R. 69, Disability Fairness Act of 2007, would eliminate the five-month
waiting period;
!H.R. 2713, Joseph H. Seall Act of 2007, would allow the Commissioner
of Social Security to waive the five-month waiting period if a person is
terminally ill and if the application of the waiting period would present
an undue hardship for that person; and
!S. 2050, Arthur Woolweaver, Jr. Act of 2007, would waive the five-
month waiting period for terminally ill persons.
19 Department of Labor, Bureau of Labor Statistics, National Compensation Survey: Employee
Benefits in Private Industry in the United States, March 2006, (Washington: GPO 2006), Table
20 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.
21 Brent Kreider, “Social Security Disability Insurance: Applications, Awards, and Lifetime
Income Flows,” Journal of Labor Economics, vol. 17, no.4, ( 1999), pp. 784-827.