What does date last insured mean for disability?
Ask the Advocate
October 26, 2019
Question: I am a 57-year-old woman with Multiple Sclerosis. MS forced me to stop working seven years ago but I was able to manage my symptoms most of the time. I have had MS since I was in my late 20s. Right now, I have cramping, difficulty walking, inability to rapidly change motions, involuntary movements, muscle paralysis, muscle rigidity, muscle weakness, problems with coordination, stiff muscles, clumsiness, muscle spasms and sometimes overactive reflexes. There are times I have to use a walker or a wheelchair. I take medications, but I am losing my mobility.
I applied for Social Security Disability Insurance. Social Security sent me a letter stating that I did not qualify for Disability Insurance because I didn't have enough work credits! How can that be? I have worked since I was 17 and now I can't. I thought disability benefits were for people that can't work. Please help!
Answer: Social Security Disability Insurance (SSDI) is funded by payroll FICA deductions (or taxes if you are self-employed). SSDI is like any other insurance program; you pay in and it pays out if you become disabled. SSDI is also like any other insurance program in that once you stop paying in, it expires.
To be fully insured for SSDI you must have 20 quarters of coverage in the 40-quarter period prior to the onset of the disability. For uninterrupted work history in Social Security covered employment, the claimant must have worked 5 out of the 10 years prior to the onset of disability.
SSDI expires 5 years after you stop paying in. So, if you alleged you became disabled any time after that five-year period Social Security would say you did not have enough quarters in the right time period. If that is the case, you might want to make sure Social Security has the date your disability began as the last day you worked. That should correct the "quarter" issues.
Next, look at the evidence you have from seven years ago. Listing 11.09 for MS states you must have: disorganization of motor function in two extremities, resulting in an extreme limitation in the ability to stand up from a seated position, balance while standing or walking, or use the upper extremities.
Disorganization of motor function means interference, due to your neurological disorder, with movement of two extremities; i.e., the lower extremities or upper extremities (including fingers, wrists, hands, arms, and shoulders). By two extremities we mean both lower extremities, or both upper extremities, or one upper extremity and one lower extremity.
Extreme limitation means the inability to stand up from a seated position, maintain balance in a standing position and while walking, or to use your upper extremities to independently initiate, sustain and complete work-related activities. The assessment of motor function depends on the degree of interference with standing up, balancing while standing or walking, or using the upper extremities (including fingers, hands, arms and shoulders).
If a person does not specifically meet or equal the listing criteria and severity of the MS impairment listing, they may still be approved for disability benefits. Social Security has another method of approving individuals for disability. If a person is unable to work because of the limitations of MS, they may be approved for disability through a medical vocational allowance.
Social Security disability examiners are able to consider a person's residual functional capacity (what they are able to do in spite of limitations), age, education, past work activity and their ability to perform other types of work when their limitations are considered. If the disability examiner finds that their residual functional capacity is so restrictive it precludes their past work or jobs or any other work, they may be approved for disability benefits.
An Accredited Disability Representative with more than 20 years experience, Diana Wade believes her clientele can be comfortable knowing that she is recognized by SSA and is a charter member of NADR. To contact Ms. Wade call (661) 821-0494, email [email protected] or visit http://www.CaliforniaDisability.net.