CONFUSING DISABIITY 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 15^th, 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.

GETTING SOCIAL SECURITY BENEFITS AT AGE 50 (FIFTY)

If you are age 50 or over, you may qualify for Social Security benefits for any physical or mental condition which prevents you from full-time work.  This actually applies to both veterans and non-veterans.

Yes, younger individuals may also qualify.  However, Social Security uses Medical-Vocational Guidelines which relax the requirements substantially for persons age 50 and over.

In addition to your age, other factors include your past work experience and education.  But being age 50 or more is the greatest single advantage a claimant has in being approved for Social Security benefits.

The Forsythe Firm will provide you with a free case evaluation and local consultation.  If we represent you, you will never pay a fee until you get benefits with back payments.  If you do not win benefits you will never pay us a fee for any service we perform.

Contact us at (256) 799-0297.  We're located across from Bridge Street.

AVOID THESE MISTAKES IN YOUR SOCIAL SECURITY DISABILITY CLAIM

Only about one-fourth of applications for Social Security disability benefits are approved without a hearing.  Below are some of the serious mistakes that claimants make.  If you are filing for Social Security disability, know these mistakes and avoid them for the best chance of winning benefits:

1. Don't forget to ask Social Security for an expedited decision if you have a 100 percent permanent VA disability award.  This can reduce your wait time for a decision by 12 months or more.  Submit your VA award letter with your Social Security application. Also, remember that you may receive full VA benefits + Social Security benefits at the same time.

2.  Don't fail to ask your own doctor to complete a Medical Source Statement.  This is a form which explains what specific limitations you have in performing work related functions, such as sitting, standing, walking, lifting, bending, concentrating, etc.  This is in addition to routine medical records and does not require a special examination.

3.  Filing for disability even if you are still receiving active duty military pay.  If you are still on active duty but are unable to perform your military job, you may apply for Social Security disability benefits now.  You do not have to wait to be discharged or to receive a VA disability to apply for Social Security disability benefits.

4.  You have to prove that your disability will last at least 12 consecutive months (or that it has already lasted that long).  There is no short term disability with Social Security.  12 months is the minimum duration for a qualifying disability.

5. Failing to get medical treatment.  All disability awards must be based on "medically determinable impairments."  You will need your doctor to examine you, diagnose your problems and determine how severe your symptoms are.  Medical doctors and clinical psychologists are "accepted medical sources" with Social Security.  Chiropractors, counselors and nurse practitioners are not.

6.  Failure to get psychological problems diagnosed and treated.  Social Security must consider psychiatric or emotional problems as well as physical problems - but they must be diagnosed by a psychiatrist or clinical psychologist, or at least by your family doctor.

7.  You must apply while you have Social Security coverage.  Not everyone has Social Security disability coverage.  You become covered by working and paying a special tax called FICA tax, which is required to be withheld on every worker.  However, you must earn enough quarters of work to be covered.  Also, when you stop working, you eventually lose your disability coverage with Social Security.  This usually happens after 4 years of no work.  If there are gaps in your work, your coverage may expire in less than 4 years.  The date you stop being covered is called your "date last insured" or DLI.

8.  You have to appeal unfavorable decisions within 60 days.  Being denied is not the exception, it's the rule.  Be prepared to file a request for hearing within 60 days after you receive a denial letter from Social Security.  This 60 day rule is very strict.  If you wait too long you cannot appeal the claim and must start all over.

9.  Avoid trying to represent yourself (pro se representation).  Social Security law is a highly technical and specialized field.  The US disability program is governed by thousands of pages of rules and regulations.  If you don't meet the rules or follow the correct procedures you can be denied and this may cost you thousands--even hundreds of thousands of dollars over the years.  Consider getting a specialist to represent you and arrange a "contingency fee" situation where the representative gets paid only if you win. 

10.  Failure to prepare the vocational (work) aspects of your claim.  There are two important parts of a Social Security disability claim:  the medical aspect is the best known part.  However, there is an equally important vocational aspect to the claim.  Past work will be classified and a vocational expert will be asked to determine whether there are any jobs in the US economy that you could still perform, in spite of your physical and/or mental limitations.  Failure to adequately prepare the vocational aspect of your claim will result in a denial, just like failure to prepare the medical part of the claim will get you denied.

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