Timing and deadlines, part two: Key dates in an SSD claim

by | Apr 16, 2020 | Firm News

In the last post, I went into some detail on the Date Last Insured, a key date in a claim for Title II/SSD benefits.  Let’s see how that date fits in more generally with the overall claims process.  

The DLI is a function of your tax history, so unless you return to work, that date is going to essentially be frozen in time from the day you stop working.  What next?

The first date that is going to matter in a Title II/SSD claim is what we call the Alleged Onset Date, or AOD.  The AOD is the date that you are claiming marks when you became disabled under the law.  For most people, this will be the day you stopped working (last day on the job) because of your medical condition, but there are some variations.  If you became disabled due to a clear medical event, such as an accident or acute attack of some sort, but went back to work for a little while after the medical event, we may use the date of the medical event as your AOD, if we believe that the work after that date doesn’t count for some reason (and there are several, which we will get into in a later post).  

Sometimes we don’t know the correct date, so we will estimate in some way.  Sometimes that’s just because of forgetting or losing information, especially if a long time has passed.  Some people wait years before filing and don’t keep clear records, so we may only know for certain what year the work stopped.  In cases like that, it’s okay to just use our best guess, so we may just pick a date like January 1, or the first day of the first month in which we’re sure you didn’t work.  Estimated dates are fine as long as we can come up with medical support for them.  

This date is very important in determining your eligibility for benefits.  For Title II claims, this date has to be prior to the DLI (see prior post) for the person to be eligible for benefits.  It also determined, in conjunction with the filing date, how far back benefits can be paid.  

We mentioned the DLI and did a full post about it earlier.  The DLI is the date on which your financial eligibility for SSD would end if you are not determined disabled by then.  

The next key date is the filing date.  This is the date on which the application is considered submitted.  The government is supposed to use the earliest date that you informed them of your intent to file for benefits, with certain constraints.  Even just calling SSA on the phone to ask for information about benefits can be construed as your filing date, as long as it’s not more than about six months before the application is completely filed.  For SSD claims, the filing date will be the date when you start your online application.  For SSI claims, it will usually be the date when you call to make the appointment to file, as opposed to when they call you back to complete the application.  

The filing date and AOD together will determine how far back your eligibility for benefits will go when your claim is finally granted.  This is your Date of Entitlement, or DOE.  This is another one where it gets a little weird.  It’s the later of two dates: either the first day of the sixth full calendar month after the AOD, or the first day of the twelfth month before the filing date.  Basically you can get up to a year of backpay before you filed, but you can’t get benefits within five full calendar months of becoming disabled.  This is called the Waiting Period.  

Between the waiting period and the retroactive entitlement, we can see an imaginary deadline that isn’t really written down anywhere and doesn’t have a name, but it’s the date by which you have to apply before you start losing benefits due to waiting too long.  That’s going to be the first day of the eighteenth calendar month after your AOD.  Confusing, right?  It’s because we take five full calendar months after the AOD for the waiting period, and add the twelve months retroactive that can be paid after that date, to come to an imaginary deadline to file your claim.  There’s no formal penalty for waiting longer than that, but because benefits are only paid 12 months back, you would lose a month of benefits for every month you wait after that to file.  

If you’ve been out of work for over a year, it’s time to start considering that as an approaching deadline.  

Now here’s a question, why wait so long in the first place to file?  Believe it or not it’s not always a bad idea to wait rather than filing right away when you stop working.  We have another kind of backwards deadline called the “duration requirement.”  The duration requirement is embedded in the five-step disability evaluation process at step 2, where we look at “severe impairments.”  The law says that for an impairment to count as disabling, it has to last or be expected to last either a year or the rest of your life, whichever is shorter.  It’s not uncommon when people apply right away for the government to deny them solely on the basis that the condition hasn’t lasted a year yet.  For this reason, it sometimes makes sense to wait a year to apply, but not always; this is a conversation you should have with an attorney because there are other factors to consider, relating to the likelihood of the claim being granted versus if further appeals are expected.  If the odds of being granted are low, it makes more sense to apply ASAP since it’s going to be a long process.  

Those are all the key dates you need to know about at the filing stage of a claim.  After this, you will need to start thinking about the dates and deadlines that come up along the way pursuing a claim.