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SSDI application at 63 with long-term disability - Medicare waiting period question

My brother-in-law has been paralyzed from the waist down since a construction accident 20 years ago. Despite this, he's worked as a software engineer this whole time (amazing guy, seriously). He's now 63 and 4 months old and just found out his company is downsizing and he'll be laid off next month. He never applied for SSDI because he was able to work, but now he's concerned about healthcare coverage. Two big questions: First, if he applies for SSDI now, will he still face the 24-month Medicare waiting period, or would his disability onset date from 20 years ago mean he could get Medicare right away? He's worried about being 'penalized' for choosing to work all these years. Second, can he file for regular Social Security retirement benefits while his SSDI application is being processed? COBRA from his employer would cost almost $1,900/month which is just not feasible on a fixed income. Any insights from those who've navigated this would be so helpful!

Emily Thompson

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He can definitely file for both regular retirement benefits and SSDI simultaneously - that's called a "concurrent claim." SSA will process both. If approved for SSDI, he might get a higher benefit amount since disability benefits aren't reduced for early filing like retirement benefits are. As for the Medicare waiting period, unfortunately I believe the 24-month period starts from when he's first entitled to receive SSDI payments, not from when the disability began. The original onset date might be 20 years ago, but since he never filed and received payments, the clock wouldn't have started.

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Jacob Lee

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Thanks for confirming about the concurrent claim! That's a relief. The Medicare waiting period is disappointing though. Do you know if there are any exceptions to that 24-month rule? It seems unfair that someone who chose to work despite disability would now have to wait 2 years for Medicare, while if he had just taken benefits back then, he'd already have coverage.

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Actually the Medicare waiting period does have some exceptions, but they're pretty specific. ALS patients get Medicare immediately. End-stage renal disease has special rules too. But for paraplegia, I don't think there's an exception. One thing your brother-in-law should consider - when he applies for SSDI, he can request an "onset date" from when his disability began (20 years ago). HOWEVER, SSA will only pay retroactive benefits for 12 months before application date. So even with an established onset date 20 years ago, the 24-month Medicare waiting period would still apply from when he starts receiving SSDI now.

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Daniela Rossi

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my husband is in similer situation nd we were told the waiting perod starts when u get approved not from the onset date. its really unfair bcause he could of been on medicare for years but wanted to work!!!

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Ryan Kim

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I helped my cousin through this last year when she got laid off at 61. She had MS for 15+ years but kept working. Here's what we learned: 1) The 24-month Medicare waiting period DOES start from when you begin receiving SSDI benefits, NOT from onset date. It's completely unfair to people who choose to work despite disability!! 2) You can ABSOLUTELY file for both retirement and SSDI at the same time. She did this! 3) Important: If he gets approved for SSDI, they'll convert his retirement to disability benefits which are paid at the FULL retirement amount even though he's only 63! That's about 13% more money each month! 4) Make sure he has VERY detailed medical records from when his disability started, continuing to present. The more documentation, the better! Hope this helps with your brother-in-law's situation!

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Zoe Walker

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Good advice but I thought the 24 month waiting period for Medicare DOES start from established onset date, not approval date? Anyone know for sure which is correct?

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Elijah Brown

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I just went through this situation with my wife who has MS and worked for 14 years after diagnosis before needing to stop. Let me clear up a few technical points: 1. Medicare waiting period: The 24-month waiting period begins from when you start receiving SSDI payments, not from your established onset date (EOD). The exception is if your EOD is established to be more than 29 months before your application date - then some of that time can count toward the 24 months. 2. Concurrent filing: Yes, he should definitely file for both retirement and SSDI concurrently. If SSDI is approved, he'll receive the higher of the two benefit amounts. 3. Important benefit: If approved for SSDI, his benefits will be paid at his full retirement age amount even though he's only 63. This is a significant advantage. 4. Retroactivity: SSDI can be paid retroactively for up to 12 months before application date (if he meets the criteria during that time). 5. Healthcare gap: The tough period will be between losing employer coverage and either SSDI approval + 24 months or reaching 65. COBRA is expensive but may be necessary for some portion.

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Jacob Lee

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This is incredibly detailed and helpful, thank you! The 29-month lookback for the Medicare waiting period is something I hadn't heard about - but I assume that wouldn't help in his case since the disability started 20 years ago but he never applied for SSDI during that time. So it sounds like he'll definitely face that 24-month waiting period regardless of his long-standing disability, which is disappointing.

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Zoe Walker

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Have u looked into marketplace insurance? Might be cheaper than COBRA until medicare kicks in. Also check if your state has any disability health programs.

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Jacob Lee

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That's a good idea - he's in Ohio and I'm not sure what programs they might have, but we'll definitely check the ACA marketplace options. His medications alone cost several hundred dollars a month, so he definitely needs some kind of coverage during that gap.

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Maria Gonzalez

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Getting through to SSA to even ask these questions can be a NIGHTMARE. I spent 3 weeks trying to reach someone about my disability application. Finally used a service called Claimyr (claimyr.com) that got me through to an agent in 20 minutes after weeks of failed attempts. They have a video showing how it works here: https://youtu.be/Z-BRbJw3puU Made a huge difference for me since I needed specific answers about my situation that weren't on the website. Your brother-in-law's situation is complex enough that speaking directly with an SSA rep would be really helpful.

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Jacob Lee

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Thanks for this tip! He's already tried calling a few times and keeps getting disconnected after waiting on hold for 45+ minutes. It's so frustrating. I'll pass this along to him - at this point, getting clear answers directly from SSA would be worth it.

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Daniela Rossi

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My freind works at SS and she says apply RIGHT AWAY bcause the processing time for SSDI is like 6-8 months sometimes even longer!!! He should get retirement benefits started while waiting for SSDI decision. That way he gets some income at least!!

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Elijah Brown

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This is solid advice. The processing time for initial SSDI applications is averaging 6+ months in many offices, and even longer if it requires appeals. Starting retirement benefits immediately provides income during that waiting period. If SSDI is ultimately approved, SSA will adjust payments accordingly.

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Ryan Kim

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One thing nobody's mentioned - if he gets approved for SSDI with an onset date from 20 years ago, does he qualify for any back payments? Seems like the system should compensate him for all those years he could have collected but chose to work instead.

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Emily Thompson

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Unfortunately, SSDI back payments are limited to 12 months prior to application date, regardless of when the disability began. It's one of those policies that can feel really unfair, especially to people who tried to keep working despite qualifying disabilities. The system doesn't really have a mechanism to compensate people who chose work over benefits historically.

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This is actually a common misunderstanding about SSDI and Medicare. The 24-month waiting period for Medicare begins when you become entitled to SSDI benefits, which is typically 5 months after your established onset date (due to the SSDI 5-month waiting period). However, since your brother-in-law has been disabled for 20 years but never applied, his entitlement date would begin 5 months after he applies and gets approved (assuming they establish his onset date as recent). If he can prove he met the disability criteria continuously for the past 20 years, the onset date might be set far back, but SSA will only pay benefits 12 months retroactively from application date. The Medicare clock would still start from his first SSDI entitlement, not from the onset date 20 years ago. Only time actually receiving SSDI benefits counts toward the Medicare waiting period.

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Zoe Walker

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This is so confusing! So basically he gets punished for working instead of taking benefits. The system is backwards.

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