“Date last insured” (DLI) is a term with which every applicant for Social Security Disability benefits (SSDI), quickly becomes familiar. This has meaning only in a Title II DIB case, or SSDI claim. It has no meaning in a SSI case (Title XVI).
The DLI is the last date that an individual is eligible to receive SSDI. Again, this term does not apply to those who are only applying for Supplemental Security Income (SSI). The interpretation and calculation of DLI is complicated and definitely confusing. If “date last insured” is an issue in your disability case, the assistance of an attorney knowledgeable and experienced in Social Security disability law is crucial to receiving benefits.
In order to receive SSDI, an individual must pass a two part test. First, the individual must have 40 quarters of coverage over his or her life (10 years of work credits); and Second, what some call the “recent work” test. The second prong requires that you must have worked 20 of the last 40 quarters, more simply stated, work five of the past ten years. Social Security will typically look back ten years from the date an applicant filed a disability claim to determine his or her DLI. This requirement is flexible in that for younger workers who have had years to pay into the SSA system, less quarters are required. The calculation can get burdensome, so we usually let the SSA calculate the date last insured.
For individuals that have worked their entire life and then stopped at a certain date, the DLI depends on the date you stopped working (at a job that pays into the Social Security system through FICA taxes- working for cash DOES NOT COUNT). In a simple conceptual approach, if the date you stopped work was exactly five years ago, your DLI would be today. If this date was four years ago, your DLI would be one year into the future. If you stopped working six years ago, your five year window has expired, your DLI would be one year ago. In reality, the SSA works on quarters (not days) and the DLI’s always expire on the last day of a quarter.
Once the DLI has passed (expired), the Social Security Administration (SSA) has to analyze the case carefully. You can literally file a first SSDI application at any time, but you must always prove you became disabled BEFORE your DLI expires. For example you stop work 7 years ago (say 12/3/2009). In general, your DLI expires five years after you stop work, or 12/31/14. You can file this claim today, but you must prove you were disabled on or before the date your DLI expires, which in this case is 12/31/14. I have had clients who have had a terrible accident after their DLI expired. They are clearly disabled from the accident date forward. However, since the compelling medical proof comes from a traumatic incident AFTER the DLI expired, they have no case.
Sometimes the medical proof is equivocal. Many disabilities lack a traumatic origin. If someone is clearly disabled before their DLI expires, yet the medical proof lacks something that points to a very particular date of disablity, we must infer the date to award benefits. Here an ALJ will look your ADL’s, the date of a MRI, the date you first complained of something to a doctor, etc. The ALJ is just trying to find something that makes sense in terms of a date your disability began (for SSA purposes- what onset date makes sense to you may not be what the ALJ sees as a compelling date).
I had a client who was almost bedridden. We had no real proof that demonstrated why she was so impaired. The law requires objective proof. We lacked it and lost. Her DLI was expired. A month or two after the ALJ denial, she gets insurance and gets a MRI. She has a large spinal tumor. We got a letter from a doctor saying that the tumor was the source of her symptoms, and had obviously been there for many months. We won that case on an appeal. The ALJ was able to take solid medical proof from a time frame AFTER the DLI, and use it to make sense of the other evidence BEFORE the DLI, and establish a date of disability for this woman while she was still insured.
Because date last insured doesn’t apply to eligibility for Supplemental Security Income benefits, if you have a disability claim after the date of your DLI has passed, and you can’t establish that your disability onset date was before your DLI, you may apply for SSI if you have sufficiently low assets and income.
One of the best ways to make sure you understand all of your options associated with applying for disability benefits is to retain the services of an experienced, knowledgeable, and qualified Social Security Disability attorney. Contact Sullivan Law Office today. We offer free consultations, so there is absolutely nothing to lose! Call 888-587-0228 or visit us online today!
