Disability Onset Date

My colleague and fellow social security disability lawyer Jonathan Ginsberg has a good post discussing the disability onset date, and the possibility that social security will approve a claim based upon a different and usually later onset date.  http://www.ssdanswers.com/2010/06/23/what-does-it-mean-when-a-judge-wants-to-change-your-onset-date/.  I recommend it for reading for my readers.

As Jonathan points out, administrative law judges will sometimes offer a later onset date at the hearing, and request that we “amend” the onset date – that is, change the date that we allege the claimant became disabled.  This can sometimes feel like “deal cutting” for claimants, like an insurance company offering to pay a claim for 50% on the dollar.  But as Attorney Ginsberg notes, this offer is usually based upon the ALJ’s reading of the medical evidence/record, a specific medical opinion, or a specific medical test.

Here’s an example:

• Claimant was laid off work on January 1, 2009
• He claims disability due to a back impairment.
• He has inconclusive x-rays, but finally on February 3, 2010 he has an MRI showing multiple level disc ruptures, with nerve root impingement.
•  The ALJ requests an amending onset date of February 3, 2010.

ALJ’s may also request an amended onset date based upon your age, not on the medical evidence.  This one is a little harder for claimant’s to understand, but the basis is this.  The vocational guidelines used in determining whether claimants are disabled take age into account when considering whether “other work” is available.  For example, the ages of 50 and 55 are significant.  So, sometimes an ALJ may offer a later onset date based upon age. 

These are the key issues to consider whether to accept an amended onset date:

• As Jonathan points out, never accept an onset date that is AFTER the Date Last Insured
• There is a huge benefit to the claimant in being approved for disability, regardless of the onset date.   In other words, the money the claimant will receive in the future is much greater than the past-due benefits, which is the amount of course impacted by a more recent onset date.
• A later onset date WILL impact the monthly benefit amount where there is a period of non-working from the time of the alleged onset date to the time of the amended onset date:  the monthly benefit will be LESS because it is reduced by the time of no work.

Social Security Disability Deadlines: Real and "Faux"

Like all administrative processes, the social security disability assessment process has lots of deadlines.  Though the system was initially intended to allow claimants to handle their own claims, it did not take long for the process to become very unfriendly for the individual claimant.

In my experience as a social security disability attorney in Dallas Texas for 19 years, I see first-hand the dire consequences of claimants not understanding just how important deadlines really are.  The social security disability assessment process has rigid appeal stages.  If the claimant is denied initially, they have the right to request a reconsideration.  If the reconsideration is denied, the claimant has the right to request an administrative hearing before an Administrative Law Judge.  If the judge turns the claimant down, the claimant may ask the Appeals Council to review the case.  If the Appeals Council refuses to review the claimt, the last step in the process is to take the claim to the US Federal Court.  At each step the claimant has 60 days to appeal the case. Failure to appeal within the 60 days means the claimant must either start all over again, or prove to the Social Security Administration that they had "good cause" for failing to appeal the claim withn the 60 days .  "Good cause" is loosely defined, but typically is confined to proof of non-receipt of the denial letter, a major hospitalization in the 60 day period, etc.  Simply not getting around to dealing with the denial, misreading the denial letter, or misplacing the letter are generally not going to be found to constitute "good cause".  And even more importantly the finding of "good cause" is totally within the discretion of the Social Security Administration.  A claimant cannot appeal a finding by the Social Security Administration that "good cause" for missing a deadline did not exist. So missing an appeal denial is a big deal.

But there are other deadlines in the disability assessment process that Social Security presents as critical that are not in fact as important.  For example, when the Office of Disability Adjudication & Review (ODARS) sends the claimant notice of the hearing, they routinely state that certain forms must be completed and returned within 10 days.  While there is no real reason that the claimant should not do so, there is no major problem if the claimant fails to get those forms back to the judge in 10 days.  The hearing will not be canceled, nor will  the judge automatically deny the claimant. This is an example of what I would call a "faux" deadline ("faux" being French for "false").

Deadlines in the social security disability process are an example of why claimants need competent legal counsel who know when which deadlines are deadly serious, and when they are not.