What is the "date last insured," and why is it so important for Social Security Disability Insurance claims?

Social Security Disability Insurance is Just That:  Disability Insurance

Social Security Disability Insurance is nothing more than a disability insurance policy.  The only difference is that the federal government is the insurer, not some private insurance company.

When a person earns income, whether as an employee or business owner, contributions out of gross income are made to the Social Security program.  This is like a premium that a person pays to an insurance company.  So, what does it take to be insured?

Being Insured

Under the Social Security Disability program, a worker is insured if they make the required amount of contributions from wage withholdings over the required amount of time.  Social Security looks at earnings made each quarter of a year.  If you earn enough in a quarter of a year, than that quarter counts as a quarter of coverage.

Generally, to be insured for disability benefits, a worker must have at least twenty quarters of coverage in the last forty quarters.  Stated another way, you must have at least five years of insurance paid in over the last ten years.  There are exceptions for workers under the age of 31.

The Date Last Insured

If someone works for ten years and earns enough quarters, then they have forty quarters of coverage.  But if they stop working on January 1st, they start losing quarters of coverage.  After one year of no work, the worker will have 36 quarters of coverage.  Each additional year of no work is four quarters of coverage lost.  This worker will remain insured for five years after they stopped working.  The day after the fifth year has passed that person is no longer insured for benefits.

How does this affect a disability claim?

The Alleged Onset Date and Continuous Disability

Even if the worker is no longer insured for disability benefits, she may be able to make a successful claim for benefits if she can prove that her disability began prior to the date she was last insured for benefits, and that the disability has been continuous.  So if a person applies for benefits in 2018, and was last insured on December 31, 2015, they must prove that their disability began prior to the end of 2015, and has continued to the present.

The common challenges in proving this kind of a claim include finding supporting medical evidence, and showing that the disability has been continuous.  Many times, hospitals and medical clinics purge their medical records after so many years, and medical records are critical to prove disability.  Other times, the worker attempted to go back to work, and if they worked long enough, it breaks the chain of continuous disability.

Questions?

We have reviewed many cases involving a remote date last insured.  Sometimes, we can dig and find supporting evidence.  If you have a question about Social Security Disability claims involving a date last insured, contact us to find out where you stand.

Joe Di Bartolomeo
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Top-rated Personal Injury Lawyer Helping Oregon and Washington Families