Thursday, October 15, 2015

CONFUSING DISABILITY TERMS: WHAT DO THEY REALLY MEAN?




Some important terms stand out in Social Security disability regulations.  Here is what they mean.

Alleged Onset Date (AOD).  This is the date the claimant alleges to have first become disabled.  If it becomes the Established Onset Date (EOD), meaning that the Social Security Administration agrees that the claimant did indeed become disabled on that date, benefits may be paid back to that date.  So the AOD/EOD affects how many months of back pay or past due benefits the claimant is entitled to receive.

Waiting Period.  The waiting period for all Title 2 (regular disability) claims is 5 full calendar months.  This is really an elimination period.  5 months of benefits will be subtracted from the Established Onset Date.  For example, if you are found to have become disabled on March 15th, your waiting period will include the months of April –August and your first benefit payment eligibility will be for the month of September.  This does not necessarily mean you would have to wait 5 months to get a benefit. It depends on when hour established onset date was. 

Duration Requirement.  Social Security regulations require a claimant to be disabled for at least 12 consecutive months in order to receive disability benefits.  And the 12 months must be from the same impairment(s).  For example, if a person is disabled for 5 months because of a heart attack, then becomes disabled again for 7 months because of back surgery, the two impairments cannot be combined to satisfy the 12 month duration requirement.  A claimant does not necessarily have to wait 12 months before filing an application for disability benefits, however.  If he/she expects to be disabled for a period of 12 consecutive months by the same condition or combination of conditions, the application can be filed immediately.  The requirement is that the claimant provides medical documentation that he/she can reasonably be expected to be disabled for at least 12 consecutive months.  Disability expected to last less than 12 consecutive months are not covered by Social Security.  Benefits may be awarded before the 12 month period expires.  The duration requirement is intended to eliminate benefits for impairments that are expected to last less than 12 months.

Date Last Insured (DLI).  This is the date the claimant’s Social Security disability insurance expires.  Yes, disability insurance does expire if you stop working and stop paying FICA taxes.  If your DLI is 12/31/17, for instance, you must file a disability claim before 12/31/17 or prove that you became disabled prior to 12/31/17.  Otherwise, you lose the right to file a new claim after 12/31/17.  If you are receiving disability benefits from Social Security, this date has nothing to do with when your payments will stop, when your case will be reviewed again, etc.  It simply means that there was a point in time beyond which you could not file a new disability claim.  That date is called The Date Last insured (DLI).  If you are receiving disability benefits, you obviously filed a claim prior to the DLI, so the date means nothing to you at this point.

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