If you have applied for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), you know that waiting for a decision can be a stressful and lengthy process. When the Social Security Administration (SSA) finally issues a determination, you might expect a simple “approved” or “denied.” However, there is a third possibility that many applicants encounter: a partially favorable decision.
A partially favorable decision means that the SSA agrees you are disabled and entitled to benefits, but they disagree with you on certain key details—most commonly the exact date your disability began. Understanding what this decision means, how it affects your benefits, and whether you should appeal is critical to protecting your rights.
Fully Favorable vs. Partially Favorable Decisions
To understand a partially favorable decision, it helps to first understand what it means to win your claim completely.
A fully favorable decision means the SSA agrees with every part of your application. They agree that you meet the strict medical requirements for disability, and they agree with your alleged onset date (AOD). Your alleged onset date is the date you stated your disability became severe enough to prevent you from working. When you receive a fully favorable decision, your retroactive back pay is calculated based on this original date.
A partially favorable decision, on the other hand, means the SSA has found you disabled, but they have established an established onset date (EOD) that is later than your alleged onset date. In other words, the SSA agrees you cannot work now, but they believe your disability started more recently than you claimed.
Alternatively, a partially favorable decision can also mean the SSA determined you were disabled for a specific period in the past, but they believe your medical condition has improved and you are no longer disabled (a closed period of disability).
Why Did the SSA Change My Onset Date?
The SSA relies heavily on medical evidence and work history to determine when a disability began. There are several common reasons an administrative law judge (ALJ) or disability examiner might issue a partially favorable decision by pushing your onset date forward:
- Lack of Early Medical Evidence: The SSA needs objective medical records to prove your condition was disabling on your alleged onset date. If you stopped working in January but did not start seeing a doctor or receiving specialized treatment until June, the SSA may decide your disability did not officially begin until June when the medical evidence supports it.
- Age Milestones: The SSA’s “grid rules” make it easier to get approved for disability as you get older, particularly when you reach age 50 or 55. If you applied at age 49 but turned 50 while waiting for a hearing, the judge might approve your claim starting on your 50th birthday because that is when you officially met the requirements under the grid rules.
- Work Activity: If you attempted to work after your alleged onset date and earned more than the Substantial Gainful Activity (SGA) limit, the SSA will not consider you disabled during that time. They may move your onset date to the day after your unsuccessful work attempt ended.
- Date of a Specific Medical Event: If your condition worsened over time, the SSA might pinpoint a specific event—such as a major surgery, a severe MRI result, or a specific doctor’s diagnosis—as the date your condition officially became disabling.
How a Partially Favorable Decision Affects Your Benefits
The primary impact of a partially favorable decision is financial. Because your established onset date is later than your alleged onset date, you will receive less retroactive back pay than you originally anticipated.
For SSDI claims, there is a mandatory five-month waiting period after your onset date before benefits begin. If the SSA pushes your onset date forward by six months, you lose six months of back pay. If they push it forward by several years, you could lose tens of thousands of dollars in retroactive benefits.
Additionally, moving the onset date forward delays your eligibility for Medicare. SSDI recipients become eligible for Medicare 24 months after their first month of benefit entitlement. A later onset date means a later Medicare start date.
Should You Appeal a Partially Favorable Decision?
When you receive a partially favorable decision, you have the right to appeal the established onset date to the Appeals Council. You must request this appeal in writing within 60 days of receiving your notice.
However, appealing a partially favorable decision carries a significant risk. When you appeal, you are not just appealing the onset date—you are appealing the entire decision. This means the Appeals Council will review your whole case, and they have the authority to overturn the judge’s decision entirely. You could go from being approved for benefits with a later onset date to being completely denied. Furthermore, while your appeal is pending, your monthly benefit payments will be delayed.
Because of this risk, the decision to appeal a partially favorable determination should never be taken lightly. It requires a careful legal analysis of your medical records to determine if there is strong, undeniable evidence supporting your original onset date, and whether the potential increase in back pay is worth the risk of losing your benefits altogether.
Get Help From a Mankato Social Security Disability Lawyer
Navigating the Social Security Disability system is complex, and understanding the nuances of a partially favorable decision can be overwhelming. If you have received a partially favorable decision and are unsure whether you should appeal, it is highly recommended that you consult with an experienced disability attorney before the 60-day deadline expires.
At Harvey & Carpenter, Attorneys at Law, we exclusively practice workers’ compensation and Social Security disability law. We understand how the SSA evaluates onset dates and can help you weigh the risks and benefits of an appeal based on the specific facts of your case.
Contact our Mankato office today to schedule a free consultation. We can review your decision notice, examine your medical evidence, and help you determine the best path forward to secure the benefits you deserve.
