Continuing Benefits During an SSDI Appeal:  Do You Still Receive Your Benefits?

Navigating the Social Security Disability Insurance (SSDI) system can be overwhelming, particularly when facing a denial or dealing with the appeals process. One of the most pressing concerns for many beneficiaries is whether they can continue receiving benefits while their SSDI appeal is pending. The answer depends on several factors, including the type of decision being appealed and the specific circumstances of your case.

Understanding the SSDI Appeal Process

Before diving into benefit continuation, it’s important to understand how the SSDI appeal process works. When the Social Security Administration (SSA) makes an unfavorable decision regarding your disability claim, you have the right to appeal. The appeals process consists of four levels: reconsideration, hearing before an administrative law judge, review by the Appeals Council, and federal court review.

The timeline for these appeals can be lengthy, sometimes taking months or even years to reach a final decision. This extended waiting period makes the question of ongoing benefits particularly crucial for individuals who depend on SSDI payments to cover essential living expenses.

Initial Application Denials

If you’re appealing an initial denial of your SSDI application, you cannot continue receiving benefits for the simple reason that you were never approved to receive them in the first place. This situation applies to individuals who have filed for SSDI but were denied at the initial application stage or reconsideration level.

During this type of SSDI appeal, you’ll need to rely on other sources of income or support while you wait for a decision. Many applicants face significant financial hardship during this period, which can last anywhere from several months to over a year, depending on which stage of appeal you’re at.

Cessation of Benefits Appeals

The situation differs significantly when you’re already receiving SSDI benefits and the SSA has determined that you’re no longer disabled. This is known as a cessation or termination of benefits. In these cases, you may be able to continue receiving benefits during your appeal, but only if you act quickly and meet certain requirements.

When the SSA notifies you that your benefits will stop because they’ve determined you’re no longer disabled, you typically have 10 days from the date you receive the notice to request that your benefits continue during the appeal. This is called requesting “benefit continuation” or “payment pending appeal.” If you file your appeal within this 10-day window and specifically request that your benefits continue, the SSA will generally keep paying you while your case is under review.

However, there’s an important caveat: if you ultimately lose your appeal and the decision to terminate your benefits is upheld, you may be required to repay any benefits you received during the appeal period. This is because those payments would be considered an overpayment once the final decision confirms that you were no longer eligible for benefits during that time.

The 10-Day Window

The 10-day deadline for requesting benefit continuation is strictly enforced. The clock starts ticking from the date you receive the notice, not from the date the notice was mailed. The SSA typically assumes you received the notice five days after it was mailed unless you can prove otherwise.

Missing this deadline doesn’t mean you can’t appeal the decision to terminate your benefits. You still have 60 days from receiving the notice to file an appeal. However, if you miss the 10-day window, your benefits will stop while your appeal is pending, and they will only be reinstated if you win your appeal.

Types of Benefit Continuation Requests

When appealing a cessation decision, you can request benefit continuation at three levels of appeal: reconsideration, hearing before an administrative law judge, and Appeals Council review. You cannot request benefit continuation at the federal court level.

At each level, you must file your appeal within the specified timeframe and explicitly request that your benefits continue. Simply filing an appeal isn’t enough. You need to indicate on your appeal paperwork that you want your benefits to continue during the review process.

Medical Improvement and Continuing Disability Reviews

The SSA conducts periodic continuing disability reviews (CDRs) to determine whether beneficiaries remain disabled under their guidelines. If your benefits are being terminated following a CDR, and the SSA has determined that medical improvement has occurred, you have the right to appeal and request benefit continuation.

The burden of proof in these cases falls on the SSA to demonstrate that medical improvement has occurred and that you’re now able to engage in substantial gainful activity. If you disagree with their assessment, requesting benefit continuation while you appeal can provide crucial financial stability as you gather medical evidence and prepare your case.

Financial Implications of Benefit Continuation

While receiving continued benefits during an SSDI appeal can provide essential financial support, it’s important to carefully consider the potential consequences. If you lose your appeal, you’ll be responsible for repaying all benefits received during the appeal period. For some individuals, this can amount to thousands or even tens of thousands of dollars.

The SSA may recover this overpayment by withholding your future benefits if they’re later reinstated, by billing you directly, or through other collection methods. However, you can request a waiver of overpayment recovery if you can demonstrate that the overpayment wasn’t your fault and that repaying it would cause financial hardship or be unfair for other reasons.

Note on Supplemental Security Income Considerations

It’s worth noting that Supplemental Security Income (SSI), which is a needs-based program separate from SSDI, has different rules regarding benefit continuation. SSI recipients generally cannot continue receiving benefits during an appeal of a cessation decision. The rules discussed in this article apply specifically to SSDI, which is based on work credits earned through employment.

Making an Informed Decision

Deciding whether to request benefit continuation during an SSDI appeal requires careful consideration of your circumstances. If you have strong medical evidence supporting your continued disability and you would face severe financial hardship without benefits, requesting continuation may be the right choice. However, if your case is weak or you have other sources of income, you might want to forgo continuation to avoid the risk of owing a substantial overpayment.

Speaking to an experienced disability benefits attorney with Bross Frankel PA can help you make an informed decision. A knowledgeable SSDI benefits lawyer can evaluate the strength of your case, explain the risks and benefits of continuing payments, and guide you through the SSDI appeal process.

Have Questions? Contact Bross Frankel PA Today to Discuss Your SSDI Appeal Rights

Whether you are able to continue receiving benefits during an SSDI appeal will depend on your specific situation. For example, if you’re appealing an initial denial, continuation isn’t an option because you weren’t receiving benefits to begin with. However, if your existing benefits are being terminated and you file an appeal within 10 days requesting benefit continuation, you can typically keep receiving payments while your case is reviewed, though you may need to repay them if your appeal is unsuccessful.

If you have questions or need guidance related to an SSDI appeal, then now is the time to contact Bross Frankel PA. Our disability benefits law firm has helped thousands of people get Social Security disability and other types of disability benefits. Our experienced and knowledgeable SSDI attorneys possess decades of combined experience advocating for people with disabilities in New Jersey and Pennsylvania. To learn more or to schedule a free claim review with a Cherry Hill disability attorney, give us a call at 856-795-8880 or fill out our online contact form.