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Thursday, September 19, 2013

What is the Date Last Insured, and Why Does it Matter?

Today's post comes from guest author Susan C. Andrews, from Causey Law Firm.

A person who has been out of the labor market for quite some time before he applies for Social Security Disability (SSD) may find that his application for benefits is rejected because he cannot prove he became disabled before his date last insured.  

In order to qualify for benefits in the first place, a person must pay Social Security taxes long enough to have insured status. When the individual stops working and therefore stops paying into the system, eventually he will hit his date last insured and lose his insured status. It is a little like a private insurance policy: when you stop paying the premiums, you no longer are covered by the policy.  For a person who has work steadily in his lifetime, the date last insured is arrived at and insured status lapses about five years after stopping work.
 The Social Security Administration has another program for the medically disabled called Supplemental Security Income (SSI) where there is no date last insured rule, but there are other program requirements and limitations. In a future article, we will explore the differences between the Social Security Disability (SSD) and Supplemental Security Income (SSI) programs.   
     As an example of how the date last insured issue can prevent a person from getting Social Security Disability (SSD) benefits, consider the case of a 35 year-old woman who has worked steadily since her late teens. She and her husband have twins when she is in her mid-30s. There are a lot of late night feedings and diapers to change! She stays home to take care of the twins while her husband continues to work to support the family. When the twins turn five, she begins to think about returning to work, perhaps when they go into first grade a year or so later. Five years has passed, and she reaches her date last insured. She loses her insured status and has not yet returned to work. When the twins turn six, she gears up her job search, but has not yet re-entered the labor market. Then medical catastrophe strikes: she has a very disabling stroke – unusual in a person this young, but not unheard of. She clearly cannot work. She applies for Social Security Disability and is turned down because she did not become disabled before her date last insured. Unlike the Social Security Retirement program, where it is possible to collect Social Security Retirement (SSR) benefits on the earnings record of one’s spouse, the Social Security Disability program only allows for benefits to be paid on the basis of one’s own earnings record.

     Consider another scenario with this family of four. When the twins are three, mom is diagnosed with Multiple Sclerosis. This condition can progress slowly or more quickly. In her case, she suffers a fairly quick progression of symptoms. By the time the twins are six and going into first grade, she is ready to return to work, except that she is suffering a variety of MS symptoms, including the profound fatigue that is experienced by many with this disease. Her combination of symptoms prevents her from working, so she applies for Social Security Disability. She passed her date last insured when the twins turned five. Will she get benefits? That depends. She certainly can apply for benefits after her date last insured, but she must be able to show that her symptoms had become sufficiently severe to prevent her from working before her date last insured. We have handled many cases where the individual is out past his or her date last insured. The key is to obtain all of the medical records that help to document the seriousness of the medical condition before that date last insured. Sometimes these can be buttressed with statements from family members or close friends who were in a position to observe at close range how seriously the person’s medical condition was affecting her functioning prior to the date last insured. In the case above, a statement from the husband likely would be helpful.

     The Social Security Administration has another program for the medically disabled called Supplemental Security Income (SSI) where there is no date last insured rule, but there are other program requirements and limitations. In a future article, we will explore the differences between the Social Security Disability (SSD) and Supplemental Security Income (SSI) programs. 

Photo credit: Đˆerry / Foter.com / CC BY