THE DATE LAST INSURED AND DISABILITY BENEFITS
WHAT DOES THE “DLI” STAND FOR?
The “Date Last Insured” is the last day you were insured for SSDI benefits. You may wonder what that means. After all, you probably didn’t realize that the SSD program is an insurance program. But, it is.
For example, you pay your insurance “premiums” by paying your taxes when you work. Therefore, by working, you pay your taxes and buy insurance. In other words, you become “insured” and eligible for disability benefits.
If you are thinking about filing for Social Security benefits, then you need to know that important date. The reason you need to know your “Date Last Insured” (DLI) is that the DLI may determine whether or not you qualify for SSD benefits.
With luck, your date last insured will be in the future. Most people who stop working within one year or less of applying for disability benefits are still insured. The DLI typically becomes an issue if you wait many years after you stop working to apply for benefits.
For example, if you stop working in 2015 and wait to apply for benefits until 2021, then you probably have a DLI problem. In other words, your DLI has expired. Contact our law firm for questions about your insurance status.
WHAT IS THE “DATE LAST INSURED”?
When the Social Security Administration refers to your Date Last Insured, they are referring to the last work quarter in which you met the SSD insured status requirements. In order to be win benefits, you must have enough work credits to qualify.
In most cases, individuals will qualify for Social Security Disability benefits if they had worked five out of the past ten years before their disability begins. Regardless of your medical condition, your date last insured is one of the first things Social Security looks at when deciding your claim. Learn more information about SSA’s definition of work.
SSA’S SYSTEM FOR QUARTERS OF INSURANCE COVERAGE
If an individual works for ten years, then they have worked forty quarters. There are four quarters for each year. In order for each quarter to qualify for insurance coverage, the person must earn a certain amount of money. For example, in 2021, you must earn $1470 in one quarter for that quarter to count for insurance coverage. Likewise, in 2022, you must earn $1510 in one quarter to have a quarter of coverage. Learn more about your earnings record here.
If an individual stops working on January 1st, they start losing quarters of coverage. This is true even if they worked for the past 10 years. After one year of not working, the worker will have 36 quarters of coverage. Each additional year of not working is another four quarters of lost coverage.
Typically, a full-time worker remains insured for up to five years after they stop working. After the fifth year of not working, that person is no longer insured for benefits. However, depending on your earnings, that period of insurance can be less than five years.
HOW DOES THE SSA DETERMINE YOUR DLI?
The SSA calculates your date last insured based on how many quarters of coverage you earned during your working life. They also look at when you stopped working and your age. The method for calculating this date is termed the “20/40” test.
The SSA will look at your earnings record and count back 20 covered quarters. Then, the SSA will count forward 40 quarters (both covered and uncovered). For a person who works full time, the DLI is approximately five years after they stop working.
The DLI only applies to the applications for SSDI. It does not apply to applications for Supplemental Security Income benefits. Supplemental Security Income or SSI benefits comes with Medicaid. Medicaid benefits, like SSI, start from the date of application. Learn more information about Medicaid benefits.
Social Security Disability benefits, however, come with Medicare benefits. There is a five month waiting period for SSD benefits. The five month waiting period begins after the onset date of your disability. Additionally, there is a 24 month waiting period, after the five month waiting period, for Medicare benefits. Learn more information about Medicare benefits.
SUPPLEMENTAL SECURITY INCOME
If you are filing for SSI benefits only, then you do not need to concern yourself over the date last insured. However, for applicants with concurrent claims, meaning both an SSDI and SSI claim, the DLI still applies. Find out more about the amount of your monthly SSD benefit.
The DLI doesn’t apply to SSI cases. The reason the DLI does not apply in SSI cases is because an SSI claimant does not have enough quarters of coverage through the disability program. SSI is a benefit that is usually given to children, who normally have no work history. Find out more about children’s SSI benefits.
SSI is also for adults who have no work history or have very little work history. This could be, for example, an adult who struggles with mental illness throughout their life. Or, it could be an adult with Down syndrome. It could also just be a person who has never worked. Additionally, SSI is available for those who have a work history, but whose earnings have been low.
WHY DOES THE DATE LAST INSURED MATTER?
Think of the DLI as similar to expiring car insurance. If you don’t pay your premium to the insurance company, what do they do? They cancel your car insurance policy. Therefore, if you get into an accident, they don’t have to pay for your car. The DLI is similar.
When you stop working, you stop paying taxes. This is like not paying your car insurance premium. If you don’t pay your car insurance premium, you no longer have insurance.
Similarly, because you are not paying taxes, your “insurance” with the SSA program will eventually expire. The day your insurance runs out is your DLI. Or, the date you were last insured for benefits.
THE DATE LAST INSURED IS AN EXPIRATION DATE
But why does it matter? It matters because your disability must be disabling prior to your insurance running out. If you weren’t disabled, then the SSA doesn’t have to pay. Another way to look at it is this: if your car insurance runs out and then you get into a car accident, the insurance company isn’t liable.
The same is true with Social Security Disability insurance benefits. If you disability begins after your insurance runs out, then the SSA doesn’t have to pay you.
You must prove you have a disability that prevents you from working prior to the date your insurance expires. This applies to everyone who is eligible for SSDI benefits.
If your insurance expires, then there is one thing to remember. If you go back to work and start earning wages at the substantial gainful activity level, then you can become insured again through the SSA program. Find out more here about SSA’s definition of work.
WHAT PROVES DISABILITY PRIOR TO THE DATE LAST INSURED?
If you apply for SSD benefits after your DLI has expired, then you’ll need to prove that the onset of your disability was before your DLI. The medical evidence before your DLI impacts whether or not the Social Security Administration approves your disability.
Your DLI is an important consideration from the medical standpoint of your claim. Medically, you need to show you became disabled before your date last insured. You can file a disability claim even after your DLI expires. But, you will still need to prove your disability began prior to the DLI. Therefore, the most important thing in your SSD case is the medical evidence.
SUBMIT YOUR MEDICAL RECORDS TO THE SSA
You cannot just submit any medical evidence to prove disability. The evidence prior to the DLI must show that your medical condition kept you from working. So, just having progress notes from a doctor prior to the DLI will not do it.
Instead, the medical evidence must discuss why you cannot work. Or, it must show that your residual functional capacity was so limited that you could not work at any job.
Likewise, if your condition is severe enough to meet or equal a listing, then the records prior to the DLI must demonstrate that. Also, please note that if you are blind, your onset date, date last insured, and even earnings for quarters of coverage may be different than those in this article. Please see other SSA information that applies to you if you are blind.
WERE YOUR BENEFITS DENIED BECAUSE OF A DATE LAST INSURED PROBLEM?
If you got a denial in the mail and SSA says they did not find you disabled before a specific date, then chances are the DLI applies to you. SSDI claims are often denied because the individual filing for benefits became disabled after the expiration of their DLI.
Sometimes, medical records will not contain enough evidence to show that the onset date of disability was prior to the DLI. Since most medical condition do not have a single event that causes them, choosing an onset date can be difficult. Your medical evidence must support your onset date. And, your onset date must be prior to the DLI.
If you previously applied for SSD, your lawyer may be able to reopen your old claim for SSD benefits. Especially, if there is evidence of an earlier onset date. Also, if you simply cannot get SSD benefits because of a date last insured problem, then you can apply for SSI benefits.
SSI benefits are available for those who meet the SSI income and asset limitations. You can apply for SSD and SSI benefits online at the Social Security’s website. Learn more information about the future of the SSD benefit program.
DISABILITY PRIOR TO THE DLI AND PROVING ONGOING DISABILITY
Even if you are no longer insured for benefits, you can still file a claim for SSD benefits. However, you will have to prove your medical condition began prior to your DLI in order to win past due SSD benefits. And, you will also have to prove that your medical condition is ongoing.
For example, if a person applies for benefits in 2020 and their DLI was on December 31, 2017. Then, they must prove their disability began prior to the end of 2017. But, they must also prove that the disability continues to the present day.
The difficulty in proving this kind of a claim includes getting the proper medical evidence. Also, you must obtain statements from your current doctors showing your medical condition has been continuous. Many times, hospitals and medical clinics destroy their medical records. Typically, this happens every 5 to 7 years. Remember, medical records are critical to prove your case. If the records no longer exist, then there is no reason for the SSA to pay you benefits.
WHAT SHOULD YOU DO IF YOUR BENEFITS WERE DENIED DUE TO YOUR DLI?
The SSA may deny your application for benefits if they do not agree with your onset date or if your severe medical condition began after your DLI. If the SSA denies your claim, then you should file an appeal. As part of the appeal process, you can submit additional medical evidence to help prove exactly when you became unable to work.
If you don’t have medical evidence prior to your DLI , then another option is to apply for Supplemental Security Income. The SSI program is intended for low income individuals who have a medical condition that keeps them from working. With SSI benefits, your work history is not a factor. However, you will still need to meet the income and asset rules for the SSI program.
THERE IS NO ATTORNEY FEE UNTIL YOU WIN BENEFITS
We will use our skills to help you figure out if you have a date last insured issue in your case. Also, if you do have a DLI issue, we will try to solve that problem. We want to win your benefits. But, it also our goal to make the process easier for you. Therefore, we offer a free review of your case. Even if we don’t accept your case, we will still try to help you.
Hiring us doesn’t cost you any upfront money. Why? Because we don’t charge you money to become our client. Instead, you only pay us an attorney fee if we win your case.
This means if we win, then you pay us an attorney fee out of your back benefits. If you do not win, then you do not pay an attorney fee. How much is the fee? It is 25% of your back benefit. Also, the fee is capped at $7200. And, 25% is usually less than the $7200 cap. You will pay the lesser amount between 25% and the fee cap.
If there are costs in your case, then you pay those costs. But the costs in most cases are usually less than $100. You must also pay to obtain a copy of your medical records. The cost of your medical records is whatever your doctor charges for them.
You owe costs whether we win or lose your case. But, to hire most lawyers, you have to also pay a fee upfront. Not with us. You only pay an attorney fee to us when we win your SSD and SSI case. Learn more about attorney fees in SSD cases.
WE OFFER A FREE REVIEW OF YOUR SSD BENEFITS
If you have a severe medical condition, then our law firm offers clients a free review of their case. But, what does this mean?
For most people who want to become clients, it means we will talk to you about your case over the phone. We will not charge you to examine the merits of your case, including questions about unemployment benefits. Most lawyers do charge an attorney fee to review your case. We do not.
Please understand, however, that giving you a free review of your case is not the same thing as becoming your attorney. We examine the merits of your case. Our understanding is based upon what you tell us.
Sometimes, in order to get a better understanding of your case, we will request that you send us your medical records. Or, we may ask for you to send us a copy of your SSA paperwork. We do this so we can understand the details of your case. Even if we ask for more information, it does not mean we accept your case or that we are your attorney.
You will know if you hire our legal team because we will send you our contract and other SSA paperwork to fill out. Return your paperwork to us as soon as possible. If you do not sign and send the paperwork back, then we are not your attorney. We will send you a stamped envelope to send the paperwork back to us.
WE CAN HELP PROVE YOU DESERVE SSD BENEFITS
Cannon Disability Law is one of the best Social Security firms in the country. Also, we are listed as one of the best Social Security firms in Las Vegas, Nevada. The lawyers at our law firm are also members of the National Organization of Social Security Claimant’s Representatives. Learn more about Utah SSD benefits.
Nevada SSD and SSI Information can also be found on this website. Learn more about how to file for SSD benefits in Nevada. If you are from California, then you can learn more about California SSD information. You can also learn more about Idaho SSD benefit information. However, we can represent you no matter where you live.
There are many technical issues with the law that apply to SSD claims. The main example you need to know are any issues with your date last insured. You need a lawyer who understands those issues. You also need a lawyer who knows the law. We would like to be your legal team. Hire us for our experience. Over the last 30 years, we have won over 20,000 SSDI and SSI claims.
Additionally, we have won millions of dollars in SSD and SSI benefits for our clients. Don’t file your claim without help. If you need help with SSA’s forms, then ask us. Also, do not go to your hearing without a lawyer who has the experience to win your case.
Those who go to the hearing without an attorney usually do not win benefits. You should hire an attorney with many years of experience in Social Security law. Contact Cannon Disability Law. We have the experience you need to win your benefits. Also, we can help you with any issues you have with regard to your date last insured.
