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alleged onset date

How to Choose the Right Onset Date for Your Disability Claim

alleged onset dateWhen you apply for disability benefits, one of the first questions that Social Security will ask you is “when did you become disabled?” or “what onset date do you want to use?”  Social Security calls this date your alleged onset date and it will be used throughout the course of your disability claim.

Interestingly, many of my clients tell me that this question caught them off guard – what date should they choose? Sometimes, as we approach a hearing date I may discover that we have to change, or amend, the onset date. But, as you will see, it is much better to choose the right onset date early on as opposed to changing it later.

What is the “Best” Onset Date for Your Disability Claim?

Social Security will find that you are disabled if the symptoms arising from your medical problems make it impossible for you to work. Thus, your onset date ought to be the day when you could no longer perform the duties of any type of work even a simple, entry-level job. Continue reading →

Is it Possible to Recover Past Due Benefits for a Disabiling Condition that Began 20 Years Ago

how far back can I go to collect disabilityI recently received an email from a blog reader who tells me that she has recently been approved for SSDI based on a stroke.  However, she was diagnosed with another disabling medication condition 20 years ago but never applied.  Is there anything she can do about the older medical condition and recovering 20 years worth of past due benefits.

Here is my analysis: first, this is a difficult question to answer because I do not have all of the facts.  For example there are circumstances where an informal communication with Social Security could be considered an application.  There are also cases where even an unintentional misstatement by a Social Security employee could toll the statute of limitations.  Continue reading →

Past Due Benefits Paid Up to One Year Prior to Application Date Only

onset date vs. application dateQuestions related to onset dates, application dates and the date of first payment continue to be one of the more confusing elements of Social Security disability.  A recent question from a blog reader incorporates all of these issues so I thought it might be helpful to use this question as the basis of a blog post:

I STOPPED WORKING IN 2009 I KNOW THIS WILL BE MY ONSET DATE, MY QUESTION IS MY ONSET DATE OF 2009, HOW WILL THIS AFFECT ME WHEN I APPLY FOR SSI BENEFITS SOON, SINCE I DON’T HAVE AN EARLIER ONSET DATE. WILL SOCIAL SECURITY BACK PAY ME FOR 2009 IF I WIN MY DECISION.

Let’s first discuss the question of what is Robert’s onset date.  Generally, most claimants choose as their onset date the date that they last worked, and that is a reasonable choice.  However, your onset date should be the date that you became unable to work.  If, for example, Robert was laid off in May, 2009, and he suffered a major heart attack in October, 2009, the October date would be more appropriate.  In theory, you can choose an onset date prior to your last day of work, but doing so is an uphill battle and judges are reluctant to approve a claimant for disability for a time period when he was working full or close to full time.

Generally I advise my clients to choose the earliest possible onset date when their medical condition prevented full time work.  Your disability onset should be a date prior to the date that your SSDI insurance runs out. Continue reading →

Appeals Court Awards Claimant 30 Years Worth of Past Due Benefits

Frusher Social Security appealA federal circuit court of appeals has awarded a widow 30 years worth of past due benefits on her late husband’s claim.  The case involved the claim of Dr. Richard Frusher, a Rhode Island resident who applied for benefits based on mental illness in 1975.

Social Security denied his claim in 1975 and again in 1978.  Disheartened, Dr. Frusher and his family gave up.

Fast forward to 2003, Dr. Frusher was approaching age 62 and he applied again, although this time for SSI only since he had long ago run out of SSDI credits.   Noting that there was evidence in the file confirming that his mental health issues dated back to the early 1970’s, Dr. Frusher’s lawyer filed an appeal to the Appeals Council arguing that “good cause” existed for the Appeals Council to reopen his 1978 application on the grounds that Dr. Frusher’s schizophrenic condition prevented him from understanding his appeal rights, and that those rights were still available to him. Continue reading →

SSI is Different than SSDI

SSDI vs. SSI mistakeI regularly get phone calls or emails from potential clients who tell me that they “want to apply for SSI.”  In some respects “filing for SSI” has become a shorthand phrase for someone who wants to file for disability, but, in truth, there is a huge difference between SSI and SSDI.

SSDI stands for “Social Security Disability Insurance” and refers to benefits payable to claimants who have enough credit hours to be considered “insured” for disability.  The monthly payment is a function of what you have paid in to the system.  In my practice the average SSDI monthly payment is around $1,50o.

SSI stands for “Supplemental Security Income” and refers to welfare benefits payable to claimants who do not have enough credits to be insured for disability.  The maximum monthly payment is set out in the law – and for 2011 is $674 per month for an individual.

Last week, for example, I received a long email from a concerned woman who was writing on behalf of her father.   Apparently, her father had worked at a very physical job for over 20 years before suffering a stroke in 2002.   This gentleman filed for Social Security disability in 2002 and was denied at a hearing, which I will assume was held at some point in 2003.

After being denied, this gentleman did not file anything else.  He remained at home, unable to work because of the ongoing complications from the stroke as well as depression and anxiety. Continue reading →

Multiple Sclerosis Patient Seeks Strategy to Win SSDI Case Early

Here is a question I received from a multiple sclerosis patient who is preparing to apply for Social Security disability and is hoping to win her case early.

Jonathan,
First, I want to thank you for putting valuable information about the SSDI process online. I was diagnosed with MS in 1993. I recently left work on an early disability retirement after a 24 year career with the State of ABC.  My question is this – if I have MS and my medical records document cognitive dysfunction, isn’t it feasible that I would be approved with my initial application to SS? Although I did very well in the beginning of the journey, as I have gotten older, (I’m only 44), my disease has started progressing over the last few years. Will the fact that I have taken an early disability retirement from the state weigh favorably towards my case?

Here are my thoughts: the first question I would ask is “are you insured for Title II Social Security disability?”  In some states, employees do not contribute into the Social Security system- instead, they contribute to a state disability program.  For example, I sometimes get calls from teachers who may have worked for years, but who are not insured for Title II Cognitive dysfunction associated with multiple sclerosisdisability because their school system opted out of Social Security.  If you cannot tell from looking at an old paystub, I would advise you to contact your human resources office to confirm that you have been making payments into the Social Security system.    You can also call Social Security at 800-772-1213 to inquire as to whether you have been earning credits.  You can also request an earnings and benefit statement (Form 7004) from Social Security directly.

If you are not insured for Title II SSDI, then you might still be eligible for SSI, but that will depend on household income and the value of assets that you own.

Assuming you are eligible for Title II disability, your best chance at an early approval would be to request help from your treating doctor to show that you meet or equal the multiple sclerosis listing, which is found at  Listing 11.09.   When you read this listing, it does refer to cognitive issues by referring to Listing 12.02 which describes “organic mental disorders.”

I would print out the entire Multiple Sclerosis listing and the listings referenced in 11.09 and take the printout to your doctor’s office.  If your doctor or someone in his office is willing to write a narrative report describing your symptoms, course of treatment and state that your symptoms meet or equal what is contained in the listing, you greatly improve your chances at an early decision.  Your doctor should track the language of the listing as closely as possible, using the language of the listing wherever possible.   Further, since the disabling symptom you describe has to do with cognitive dysfunction, you may need to have a psychiatrist or a neuropsychologist evaluate you and write a narrative report that tracks Listing 12.02.

I take a similar approach when I am representing an MS client – although instead of a narrative report, I create a checklist for the doctor to complete and submit that to the Social Security judge along with copies of all medical records.  Often times, by the way, Social Security will provide the neuropsychological exam as a “consultative evaluation” that they pay for, however, if you can provide your own, you obviously  have more control of the process. Continue reading →

More on Compassionate Allowances and Quick Determinations

Compassionate allowances and quick disability determinationsOn October 13, 2010, SSA announced new rules effective on November 12, 2010 that will allow SSA personnel to fast track disability claims.   Now there are two programs that will allow SSA personnel to quickly approve cases there the medical evidence for disability is overwhelming.

The first program is called the “compassionate allowance” program, and it identifies specific diseases that produce work activity limitations that meet SSA’s definition of disability – in other words, if someone has one of these medical conditions, they would not be able to engage in substantial gainful activity and the symptoms will last 12 consecutive months or result in death.  I discussed the compassionate allowance program in a previous blog post, and you can review the diagnoses on the list by clicking on the link.

The second and newer program is called the Quick Disability Determination (QDD) program.   This program uses a computer program to analyze the electronic claim files to identify “cases where there is a high likelihood that the claimant is disabled” so that a claims representative within Social Security can approve a case without the need to review the claim with a medical or psychological consultant.  In a regular claim adjudication the claims rep, or “Adjudicator” must get a medical or psychological consultant to sign off on an approval, a process that takes time and can yield inconsistent results. Continue reading →

Can Child Claim Auxiliary Benefits if Disabled Parent Refuses to Apply?

I regularly receive questions about auxiliary Social Security disability benefits.   Often these questions are from divorced persons who are struggling with the cost of raising a child, while the disabled, non-custodial parent has not been cooperative with regard to auxiliary benefits.

Recently I received the following question:

i have a 15 yr old son. my ex husband is dying of cancer. he has not applied for ss , so i was told by ss that i cannot apply until my ex does. in the meantime we r struggling. help. -S

Here is my response:  unfortunately, there is nothing that S can do unless and until her ex-husband applies for disability benefits.  Cancer is a listing level impairment and my experience has been that SSA adjudicators and judges are more likely than not willing to grant benefits.   Further, some cancers are included in Social Security’s compassionate allowance program.  Even if the cancer is treatable, the treatment protocol often lasts 12 months or longer, so a cancer claimant can usually get a closed period even if on-going benefits are not awarded. Continue reading →

How Can Waiting to Apply for Benefits Cost You Money?

Recently, I came across a very relevant blog post written by New York Social Security disability lawyer Lew Insler entitled Waiting to Apply for Social Security Disability Can Cost You Money.  Attorney Insler comments “I still don’t understand why some people wait years before even filing their claims. Not only do claimants lose out on years of potential benefits, but the longer a person waits to apply, the harder it may be to obtain the medical records necessary to show disability while they are still covered for benefits.

I think that Mr. Insler’s point is very well taken.  When you apply for Title II disability benefits, you can only get paid up to one year prior to your application date, even if your disability began two, three or more years ago.  In a Title XVI SSI case you can only get paid as of the date of application.

Another problem that can arise if you want relates to your insured status for Title II Disability.  Unlike retirement benefits, which are calculated based on your lifetime earnings, Disability benefits look at your earnings during the 10 years prior to the onset of your disability.  Generally you have to show that you worked for 5 out of the past 10 years.   When you stop working, your coverage will therefore remain in force for the next 4 to 5 years.  You need to show that you became disabled while you were covered. Continue reading →

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