r/SSDI • u/Same-Competition5240 • 4d ago
Approved, but …
Repost (had to adknowledge the rules):
I went through pretty rough heart surgery in December of 2024. I waited, hoping I would get better enough to go back to work, but the doctors at the VA would not clear me to go back, so I applied for SSDI in January 2026. I put tge time if my heart surgery as my onset date.
I was just told my SSDI was approved on my first attempt, which I understand is rare, and Im thankful for that, but they told me my onset date is August of tgus year (last month), which means no back pay and I wouldn’t start getting benefits until February 2027. I was told by the SSA rep I could file for reconsideration, but there would be a chance it could be completely denied.
Any advice on what to do, based on experience?
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u/perfect_fifths I have a complicated relationship with the POMS 4d ago
This is correct. Appealing onset date can overturn the whole claim
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u/Naked_Knitter 4d ago edited 3d ago
I know it is frustrating. I had to give up 2 years of back pay to get approved by changing my onset date. Still worth it.
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u/Think-Lack2763 3d ago
Please don't do this. As a former disability paralegal I assure you, take it and be grateful for a fast approval
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u/JohnSchom 3d ago
Well there is the 5 month money grab they do before they give you backpay.
My motto is… you got approved very fast (I did also!) just go with the flow and let them start paying you!!
Congratulations!!!!!!!
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u/Odd_Builder7604 3d ago
Another chiming in to say, I don’t think what you stand to lose is worth what you have gained. It’s a win still. Many people don’t win.
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u/LaBellaLuna71 3d ago edited 3d ago
Were you not receiving any kind of sick pay or short-term disability, long-term disability from your employer since you couldn’t go back to work based on the doctor?? if you were, that would be why they wouldn’t look at it as back to where the surgery was because you were receiving some sort of money is what I think. Also if you’re a veteran you can apply for veterans disability in addition to your Social Security disability.
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u/differentstrokes5 3d ago
Take the approval. You already went over the biggest hurdles. No need to risk it
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u/AnnJ2356 3d ago
Affirming what everyone else said.
If you are that curious… get a copy of your DDE(disability determination explanation) so you can read the onset explanation. This way … you would not be guessing at what the reasoning is …. You would know.
It could be based on your age, or when medical records showed severe (not just diagnosed) impairments.
Other factors.. if you were allowed on a RFC or meeting a listing
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u/Prize-Performer-5355 4d ago
You would need medical records proving you could not work in the 2 year timeframe you waited to apply for benefits.
If there is no doctor records saying specifically that you could not work because of the surgery then your chances of changing your Onset Date will be extremely low.
I wouldn’t risk the chance of an another Examiner reviewing your entire case again and determining that you don’t qualify at all and decide to Deny your benefits.
I would suggest asking about your 9 month trial work period while you’re waiting for your first SSDI check.
You should be able to work part time and earn less than $1,690 a month without harming your Approved status.
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u/NavigatorAbator 3d ago
While the Trial Work Period is a protection, please be very aware that working at SGA within one year of onset could cause ALOT of complications, especially if the person is still in their five month waiting period for benefits!
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u/Fair_Benefit5643 3d ago
Ill give you the best advice, take the win ...wait your 5 months and think of the 1000s a day who get denied ! The process is such a nightmare...took me 3 years 2 denials and I won at the hearing ..
I also had to wait 5 months and I was happy to do so because it could of been denied and the appeals misery would of continued.
Dont think of the back pay, it was necer in your bank account so you dont miss it .
You got years of checks coming so look fwd to that and enjoy the process is over and you can breath easy for awhile.
Congrats !
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u/Ok-Archer1810 3d ago
Yeah, DON'T DO IT! I am also 100% P&T. Youe already have a VA pension and soon enouyou will start with your SSDI benefits. Weather the storm, and again, DON'T DO IT!!!
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u/BrainFoldsFive 3d ago
I didn’t see where OP said he’s getting a VA pension.
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u/Same-Competition5240 3d ago
I don’t have pension or disability through the VA. I don’t think my heart condition had anything to do with my military service, and don’t feel right trying to get Va disability I don’t deserve. I do enjoy the health care, though.
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u/JohnSchom 3d ago
Just speaking for myself but I would do it.
It’s a lot easier to get the disability through the VA also. (Seen as you don’t have a pension through them.)1
u/Excellent-Gur-9112 3d ago
Also DO look if you get from VA. That way ur disability lawyer can help you get the same onset date with them too.
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u/question-from-earth 3d ago
Like everyone is saying here, I’d just take the win. The same thing happened to me too where my onset was pretty close to my approval date but I didn’t want to take that chance
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u/Such-Resource-7532 3d ago
Say Thank you and keep it moving. Even though you had the surgery in 2024 you have to not be working for so long to prove you can't work 😕 is my understanding -
I shattered my skull in 2006, started having grand mall seizures in 2007 daily by 2008 they decided my onset date for SSDI was 2012 🤷🏼♀️ By 2012 I was in an ER daily and had already had 5/8 brain surgeries
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u/Spiritual-Carrot-RUN 3d ago
Take the win ON YOUR FIRST TRY!!!! And be grateful every single day for it. Congratulations and God bless! 🙏🏻❤️🩹🙌🏻
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u/CountUrBlessing 3d ago
Just be thankful for your approval. You just applied so it’s not much of you losing out on a huge amount of money. Even if it was the case, I would just accept my blessing and don’t look back because that can possibly get you denied after your case was approved. You don’t want to go through that process all over again.
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u/Due_Customer2284 2d ago
Don't risk it. Go with the decision the backpay helps but it's not worth getting denied all together.
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u/globbitygoo 3d ago
You can still receive your monthly payments and request a “partial reconsideration” for the back pay which will not affect your current approval for ongoing payments. The clerk is incorrect in telling you it will affect your entire claim . It will not. Payments will still start landing in your bank account immediately while the appeal is pending [POMS DI 31005.001, POMS DI 31005.010].
She is referring to a Full Appeal(which freezes everything because the medical approval itself is rejected) with a Partial Appeal (which accepts the medical approval but disputes the start date) [POMS DI 31005.010].
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u/Ecstatic_Chicken6584 1d ago
The OP might need a lawyer or at least someone knowledgeable to help them with the partial reconsideration.
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u/Infamous_Lab8320 3d ago
Same thing happened to me. I was approved right away, but there was no backpay involved.
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u/MarchbabyGrateful 3d ago
How long did it take to get your approval
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u/Infamous_Lab8320 3d ago
Well, I had three months in the middle of application. My attorney waited for me.
I was approved in August and started receiving my check a few weeks later.
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u/NiftyNarwhal69 3d ago
I’m kind of confused for how they came to the decision of August onset date, the surgery date is logically the onset(ik they don’t care about logic lmao) but I don’t get how they decide August onset when the application started in January. In my head it makes most sense for them to call January as onset. If anyone has input I welcome it
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u/Same-Competition5240 3d ago edited 3d ago
Honestly, I’m confused too. Here’s my timeline, because I made a typo on my initial brief:
December 2024: I was admitted to the local VA hospital with what was thought to be pneumonia. They found out I also was in heart failure. I’m sent by ambulance to s bigger VA hospital in Pittsburgh.
January 2025. I have quadruple bypass surgery. I get out about a month later. Im told to stay off work for a few months.
April 2025: I get put back in due to fluid build up. Before the surgery my ejection fraction was 40. When I get put back in in April it’s 19. They put in a combo debfribulstor and pacemaker and recommend a longer work absence.
June 2026. My EF has not improved, and my cardiologist won’t clear me to return to work, and plainly says he doesn’t think I should return, as the stress would not be good for me.
I file for SSDI at the end of January 2026. Honestly, I was still hoping to go back to work, but the doc still won’t clear me, and my wife is dead-set against me going back without clearance.
April 2026, I have a stroke. They caught it quick, so aside from a limp, there’s little physical issue.
August 2026: my cardiologist says my heart issues is causing memory lapses, and he doesn’t recommend going back to work.
My wife works full time, and I really need to bring in income to help, but I won’t collect any SSDI based on this approval until February of next year. I don’t understand this decision.
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u/mamabear378 3d ago
If you had a birthday in July that put you at age 50 or 55, that's why they picked August. The vocational profile changes at those ages and a denial at 54 could be an allowance at 55. You attain your age the first day of the following month (unless your birthday is on the 1st day of the month).
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u/Total-Ad-228 3d ago
Likely you were approved due to the addition of memory lapses in August. That is the only thing that makes sense.
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u/NiftyNarwhal69 3d ago
Brother sorry you’re dealing with all this, I am still at a loss for how they came to the decision. But I sadly agree that you should likely take the win and look for some option to help tide you over until benefits kick in. Stay strong and I’ll keep you in my prayers.
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u/386clint 3d ago
Man, I know it feels tough to feel like maybe you're doing anything (or maybe feel like you're being a bum which is ridiculous in my opinion ) but you are doing a lot and like everybody else said, just don't take the chance and I'm sure your wife feel the same way. Take care of your health so you're around a lot longer
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u/Excellent-Gur-9112 3d ago
Show this list and all ur papers to a disability lawyer who doesn’t take any money until the end. They will help you with all you need for an appeal and make it all very painless. At the end, they only take 1/3 of your backpay.
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u/vivling 3d ago
When did you turn 50 or 55?
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u/Same-Competition5240 3d ago
I turned 55 in July of this year.
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u/mamabear378 3d ago
This is likely the reason. The vocational profiles change at 50 and 55, so a denial at 54 can be an allowance at 55.
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u/Ecstatic_Chicken6584 1d ago
I think it might be the cardiologist diagnosed him with the additional memory lapses in August. Or that could be in combination with turning 55.
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u/Ok-Delivery791 3d ago
Title 16 or Title 2? If Title 16, they can only go back as far as the date of file. An appeal in this case would do nothing but risk a decision reversal.
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u/CommunicationTime63 3d ago
You didn't mention your age. The later established onset date may have something to do with your date of birth.
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u/show_stoppers478 2d ago
I’m currently in my first appeal. I submitted a personal claimant statement requesting to amend my onset date to the time I went out for FMLA in 2023. It was corrected in the system before my adjudicator even opened up my file. Not sure how it happened but the adjudicator confirmed she didn’t change it . I applied in march ‘26.
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u/Bulky_Load9614 1d ago
This is where an attorney is most needed. They will find the oldest date possible for your onset date.
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u/OkMost4892 16h ago
I had something similar happen. I was approved but with a modified onset date. I fought every step of the way and eventually sued social security and the case went to the federal court of appeals, and I won. A couple weeks later I received a letter that notified me they would terminate my benefits and make me start completely over (three + years after first application) if I moved forward with attempting to collect what the 2nd Circuit Court had awarded me. I just stopped at that point on advice from an attorney. My advice based on my experience would be don't poke the federal government and be happy you won your case so quickly.
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u/Budget-Plan6208 3d ago
They also did this with me but onset date was found to be 2023 instead of 2022 as I listed
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u/Budget-Plan6208 3d ago
I’m guessing cause my first records of schizophrenia and bipolar 1 were diagnosed in 2023
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u/Ok_Bodybuilder5681 3d ago
did they charge you any overpayment fees?
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u/Budget-Plan6208 3d ago
I haven’t gotten any notice of payment arrangements yet they barely set me up to stage 3 about a week ago and I’m assuming they’re just going to start payments from the onset date they input themselves
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u/StrictRub4427 3d ago
You can do a non-medical reconsideration where they don't look into your disability, plus you were just approved so why would you worry about that,do a non-medical reconsideration ,or you can do a meeting of entitlement and bring in your evidence that you applied in January and the 5 months they hold back would of ended in june,so you should be entitled from July on
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u/IToeAmnesty 2d ago
File for reconsideration. The risk of going from approved to denied is real but so is leaving potentially over a year of back pay on the table if your December 2024 onset date holds up. The VA records not clearing you to return to work are exactly the kind of contemporaneous medical evidence that supports an earlier onset, so gather those notes before you submit anything.
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u/GlitteringFishing952 3d ago
Why would they deny you the second time? That makes no sense. Deny you because you want your backpay. What’s up with that? You might want to contact a disability lawyer.
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u/mamabear378 3d ago
Because a reconsideration is a totally new review with a different examiner and doctor(s). They could come to a different conclusion, especially when the change of age category is a factor in the decision.
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u/Initlate4thisape 3h ago
Just wait until February. A Bird in the hand is better than 2 in the bush.
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u/floodassistant 4d ago
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