Why is Date Last Insured Important for Disability Benefits?
Why is my Date Last Insured (DLI) vital in a Social Security Disability Case?
Social Security Disability Insurance (SSDI) offers benefits for covered employees who become unable to work due to a serious medical condition. When you work, a portion of the taxes that are deducted from your paycheck goes toward Social Security, retirement and disability.
As long as you work and pay Federal Insurance Contributions Act (FICA) taxes, you're covered under SSDI. Think of it like car insurance. If you stop paying your car insurance premiums, your coverage will expire at the end of the month. So if you were to get into a car accident the following month, you won't be covered.
SSDI works in a similar way, but the good thing is that there is a longer grace period where you can maintain insurance without paying your "premium". If you stop working and can't return to work, your coverage will eventually expire. But it could expire up to 5 years down the road. The date you stop being covered is called the date last insured (DLI). So think of the DLI as the expiration date for SSDI benefits.
How Does Social Security Calculate Your DLI?
When you file an application for disability benefits, Social Security will calculate your DLI by reviewing your earnings history for the last 10 years prior to the date that you filed your application for disability benefits. The agency is looking to see that you've paid your "insurance premiums" by working at least 5 out of those last 10 years. Basically, Social Security uses a system of work credits to determine eligibility for SSDI. In 2023, for every $1,640 you earn, you get one credit. You can have up to 4 credits per year. To qualify for SSDI, you'll need to have 20 work credits over the past 10 years.
How Does the DLI Affect My SSDI Claim?
Your "date last insured" is the last date you're eligible to qualify for SSDI. You'll need to establish that you became disabled before your DLI expires in order to receive monthly SSDI benefits. Generally speaking, your DLI will be about 5 years after you last worked. For example, if you last worked in 2020, and lets say you worked at least 5 full years leading up to 2020, then your date last insured should be December 31, 2025. So as long as you establish you were disabled prior to December 31, 2025, you are eligible for SSDI benefits.
How Do I Find My DLI?
Social Security divides DLIs based on yearly quarters (three-month periods.) Your DLI will be on one of the following dates: March 31, June 30, September 30, or December 31. To find out the exact date and year of your DLI, you can contact your local SSA office. Or you can create a login on MySSA.gov and see what your date last insured is there.
Normally, you don't have a time limit on when you can file for SSDI benefits. As long as you have medical records dating back prior to your DLI that support a finding that you're disabled. This means that the only medical records that are relevant, are records that existed prior to the expiration of your DLI. However, the longer you wait to file for SSDI, the more likely your date last insured will pass without a disability determination. For example, lets say you last worked in 2010, and your date last insured in 2015, since we are in 2023 now, your DLI is remote. You can still file for SSDI, but you have to prove that you were disabled prior to 2015. So, for example, if your medical condition got worse in 2021, the records in 2021 would not matter or play a factor in your SSDI case, as your DLI expired in 2015. So, once again, the only records that are relevant in this scenario, are records that existed prior to the end of 2015.
Having a remote DLI limits your options because the agency doesn't usually look at any medical treatment you've received after your DLI. So if you have a nerve conduction study in 2021 showing carpal tunnel syndrome but your DLI is in 2015, Social Security isn't likely to use the 2021 test to find that you qualified for SSDI in 2015. You are out of luck at this point.
What Happens When You Apply for SSDI After Your DLI Has Passed?
In order to qualify for SSDI after your DLI has passed, you'll need to show that your alleged onset date of disability was before your DLI. Your alleged onset date (AOD) is the date you became disabled, but it must have some medical significance. Such as the date you last worked because of your condition, or maybe the date of a major injury, illness, or hospitalization.
Depending on how far back your DLI is, getting the medical evidence to show that your disability existed prior to your DLI can be a challenge. For example, getting records from your doctors from last year should be fairly easy to do, but trying to get records from 10 years ago from a doctor that has retired, could be very challenging. Make sure that you notify SSA about any and all medical providers you saw prior to your DLI. Even if you have a gap in treatment, you might be able to convince Social Security to approve your disability claim based on an earlier medical records that fall within your SSDI coverage period.
If you only started receiving medical treatment after your DLI, the agency may, butnot always, agree that you were disabled prior to the expiration of your DLI. For example, if your DLI is September 30, 2021, and you saw a rheumatologist on October 15, 2021, who diagnosed you with severe rheumatoid arthritis, Social Security may then infer that you were likely disabled prior your DLI. This is because its reasonable to assume that your arthritis did not begin right on October 15, 2021 but that it existed prior to that.
Its always best to consult with a social security lawyer to assist as they can better explain whether you qualify for social security disability benefits.