Effective Dates: 02/28/2025 - Present Previous | Next

TN 13 (02-25)

DI 10105.075 When The Five Month Waiting Period Is Not Required

A. Policy

Disability insurance benefit (DIB) claimants will not have to serve a waiting period if they have:

  • •

    A diagnosis of Amyotrophic Lateral Sclerosis (ALS) within the five month waiting period and the Notice of Award date is on or after 07/23/2020 (see DI 11036.001), or

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    a prior period of disability (PPD) (see DI 10105.001 - Period of Disability) that terminated within 5 years (60 months) before the current period of disability began.

REMINDER: There is no 5-month waiting period for childhood disability benefits (CDB) or disabled adult child (DAC) entitlement. For more information on CDB, see DI 10115.001. For disabled widow(er) benefits (DWB) entitlement, supplement security income (SSI) eligibility months may be credited toward both the 5-month waiting period for payments and the 24-month qualifying period for Medicare coverage. For more information on DWB, see DI 10110.001.

NOTE: 

If a Medicare for Qualified Government Employment (MQGE) beneficiary subsequently becomes insured for DIB, the MQGE period is not treated as a prior period of DIB. The deemed waiting period in the MQGE entitlement does not satisfy the requirement for a DIB waiting period, even if MQGE entitlement is continuing when a period of DIB is established. For more information on the DIB waiting period, see DI 10105.070.

B. Entitlement date

When the DIB waiting period does not apply, eligibility for benefits begins with the first month within the effective life of the application:

  • •

    throughout which the claimant is under a disability, and

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    has DIB insured status.

If the claimant does not have DIB insured status in the month the current disability begins, the claimant will not be eligible for a DIB until the first month thereafter in which insured status exists. In these situations, the first day of the first month of the first quarter in which the claimant has insured status for the current period of disability will become the established onset date (EOD).

For more information on DIB insured status requirements, see RS 00301.120. For information on how a period of disability affects insured status, see RS 00301.122.

C. Prior period of disability (PPD) cases

 

1. Beginning date of 60–month period

The 60–month period begins with the month in which DIB terminated or the prior freeze ceased, i.e., the month after the last month of entitlement. The T8 month on the MBR History line or the DBC entry on the DIB line is the first month counted for the 60–month period. For example, if the last payment was for 11/2006. the 60–month period would be 12/2006 through 11/2011.

2. Ending date of 60-month period

The ending date of the 60-month period is the last day of the 60th calendar month after the end of the prior DIB entitlement or the end of the prior freeze period. If a new period of disability is established within the 60–month period mentioned above, the period ends with the month before the first month throughout all of which the NH is under a disability.

Where the current disability begins on the first day of a month, the period will end with the preceding month. If it begins on a day other than the first day of a month, the period will end with the month in which the current disability began.

EXAMPLE: A claimant’s period of disability terminated 11/30/2015 (12/2015 is the T8 month on the MBR History line and the DBC entry on the DIB line) as he was no longer disabled. The 60-month period would be 12/2015 through 11/2020. The claimant filed for a new period of disability on 2/18/2021. The DDS established the claimant was disabled on 8/14/2020. The claimant does not have to serve a waiting period because his new period of disability, the date of onset, falls within the 60-month period. The claimant’s entitlement date would be 09/2020.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0410105075
DI 10105.075 - When The Five Month Waiting Period Is Not Required - 02/28/2025
Batch run: 02/28/2025
Rev:02/28/2025