A technicality that surprises many Social Security Disability claimants is a rule called the “date last insured” (DLI). This date is the last date you are eligible to receive Social Security Disability Insurance (SSDI). While there are many factors involved, your DLI generally expires around five years after you stop working.
Regardless of your disabling condition, your date last insured is one of the first things Social Security looks at when evaluating your claim.
Before you can apply for disability under the Social Security Disability Insurance program, you must meet the minimum contribution requirements set forth by SSA. Date last insured is Social Security’s way of making sure you meet those requirements.
“Date Last Insured” Explained
Compare SSDI to private insurance. With private insurance, you pay premiums to an insurance company. As long as you pay for it, you receive insurance coverage from the insurer. Stop paying, and the coverage stops.
Social Security Disability is also a form of insurance that we “buy.” As working adults, we pay into Social Security through FICA taxes withheld from our paychecks. Those withholdings go into federal Social Security and Medicare coffers, and part of that money is for Social Security Disability Insurance.
Like other insurance programs, your SSDI coverage begins on a certain date. When you stop paying into FICA, your coverage will end on a certain date (date last insured).
However, unlike private insurance, to qualify for benefits under Social Security, you must build up coverage. You have to pay enough into the Social Security program on a continual basis and for a set period of time, in order to be eligible to submit an application for disability benefits.
Once you stop working at a job that pays into the Social Security system, you have a window of about 5 years after you’ve ceased employment—and the end of that 5-year period is called your “date last insured.” In other words, if you have worked full time for ten years or more, your DLI is typically five years after you left your last job.
Thus, in your application for benefits, you must be able to prove that your disability began before your date last insured. And, once Social Security approves your claim, the date last insured becomes unimportant because your benefits will continue.
That’s the big picture. Here are the pieces of the puzzle.
Social Security Credits and DLI
To qualify for SSDI benefits, you must have earned sufficient “credits” before you became disabled. A credit (or work credit) is the unit which SSA uses to measure your insured status under the SSDI program.
Credits are also known as Quarters of Coverage (QC), meaning there are four 3-month quarters of coverage per year. You can earn up to four work credits in one year by working all year at the required earnings level.
The number of credits you need to be eligible for disability benefits depends on your age at the time you become disabled, your employment activity and how much you earn.
For most people, the minimum number is 40 credits. If you stop working before you have enough credits to qualify for benefits, your credits will stay on your record. If you return to work later, more credits will be added.
Many people earn more credits than the requirements call for, but extra credits will not increase your amount of payable benefits.
In addition, you must be working at the required earnings level to earn a credit. To qualify for one credit in 2019, you need to make at least $1,360; to get the annual maximum of 4 work credits, you need to make at least $5440. These amounts continually change.
How Does SSA Calculate Your Date Last Insured?
SSA’s policy for calculating DLI is based on the number of credits you earned throughout your history of employment, and the date you stopped working.
To be eligible to apply for disability benefits, you must prove that you have worked long enough and have therefore earned enough work credits to qualify.
Claimants 31 years and older: The number of work credits needed for SSDI depends on your age when you become disabled. As a rule, you need 40 credits, 20 of which being earned in the last 10 years ending with the year you become disabled.
Fewer quarters are required for younger applicants.
Examples of Date Last Insured
With such complicated rules, DLI makes a difficult process more confusing. For better understanding, let’s look at one example from three different angles:
You have earned enough credits to technically qualify for SSDI. You worked five out of the last ten years and your coverage starts when you stopped work in December of 2013. Social Security notifies you that your eligibility for SSDI coverage expires December 31, 2018. That is your date last insured (five years after you left your last job).
What does that mean for you? Do you run out of benefits on December 31, 2018, or are you insured?
You have not worked in those entire five years. If you became disabled in December 2013, and you apply for SSDI at any time, as long as you can demonstrate your disability began before your late last insured, which in our example is December 31, 2018, you qualify.
Suppose you stopped working (while you were healthy) in December 2013. In this case, you did not work for most of the years 2014-2018. In September 2018 you go back to work full time. A week later you sustain serious injuries in an accident and stop working.
As you recover, you undergo months of rehabilitation and occupational therapy. Time goes by and it becomes clear you need to apply for SSDI benefits. It is now July 2019. Right off the bat, Social Security will ask for the date you became disabled. You answer that your accident occurred in September 2018. You have the medical records to support this.
Are you are eligible for SSDI? Yes, because the onset of disability is prior to the December 31, 2018 date last insured.
Here’s where many claimants stumble. Using the same example: You stopped working (while you were healthy) in December 2013. Your date last insured is on December 31, 2018. This time, it is November 2018 when you go back to work. You suffer a disabling illness on January 1, 2019. You apply for SSDI, with proof that you became disabled on January 1, 2019.
Will you qualify for disability benefits based on your earnings? No, because you are outside the “5 year window” of insurance coverage based on work credits. In this harsh outcome, SSDI eligibility stopped on December 31, 2018, and your disability application is based on medical records beginning January 1, 2019.
Will Date Last Insured Impact your Claim?
Many technical and medical denials of Social Security Disability benefits are based on date last insured issues. Social Security may have decided that you have not worked recently enough or long enough to qualify for benefits.
Interpreting and calculating DLI are complicated tasks. If “date last insured” is a problem in your disability case, help from attorneys who are board certified in Social Security Disability law can be vital to receiving benefits. Many times we are able to appeal these denials upon further review and investigation. [Link to SSDI practice area landing]
Sometimes medical proof is questionable; disabilities often lack a traumatic origin. Further investigation of a case may help clarify what was previously an incorrect or unclear date of disability onset, or invalid determination that you became disabled before your date last insured expired.
Given the importance of these issues, we welcome your call today at 800-562-9830.