The ALMIGHTY ‘Date Last Insured’ Mystery: What the hell is a DLI??
Ok, of the almost 9 years of practicing Social Security Disability law, this question is one that I usually have to take a minute to really explain. Most people don’t even know what it is until they get a letter from SSA during the disability process telling them about it. When they get a letter that talks about it, it will usually say one of two things:
1) You are ineligible for Social Security Disability because you don’t have enough quarters of coverage.
2) You have provided insufficient evidence to demonstrate you became disabled before this date ____________.
If you get either of these two types of responses in a letter from Social Security, this usually means that you have a “Date Last Insured” issue or what is referred to as a DLI.
For those of you who have seen this phrase but don’t know what it means, I’m going to give you the technical definition and then the REEVES explanation.
Technical Definition:
DLI is the last day in the last quarter when disability insured status is met. As of the DLI the individual must be fully insured or deemed fully insured, and must meet the appropriate disability insured test. A per has DIB insured status if he or she:
- Has at least 20 QC’s during a 40 quarter period ending with the quarter the waiting period begins; and
- Is fully insured in that quarter.
Onset development can be curtailed if:
- The DIB claimant clearly does not meet disability insured status as of the AOD or later; or
- The DIB claimant does not meet disability insured status based on information on the earnings record and any lag wages;
Social Security Administration Programs Operation Manual System
REEVES explanation:
Ok, i’m sure alot of you are reading the technical portion and are having a ‘Scooby Doo’ moment!! ARROOO??? Let me make it a little easier. When you work, you pay into Social Security. This payment is more than just retirement. This payment insures that you have disability coverage in the event you can’t work due to your disability. Now, in order to be fully covered, you have to worked for a certain dollar amount. Once you have achieved this dollar amount, you are covered for a period of time (Even if you stop working). So it’s like this, let’s say that you worked for 5 years and stopped in December 31, 2003, according to SSA (and this is a ROUGH approximation), your COVERAGE would extend to December 31, 2008. Now, here’s where it gets tricky. Using the example I just provided, here’s a few questions that pop up:
a) I became disabled on January 1, 2009. What does that mean and what should I do??
This situation is the one that comes up ALOT. You get the letter that says that they don’t have any evidence to demonstrate that you are disabled before DLI (In this example, 12/31/2008). As such, you have three options. The first is to amend your onset date to before 12/31/2008 and try and obtain evidence BEFORE 12/31/2008. The second is to drop your claim for DIB. The third is to try and convince SSA to relate back.
b) I became disabled on December 1, 2008 but my first medical evidence isn’t until Feb. 1, 2009. What do I do??
This situation is the typical “relating” back situation. This situation is tough because you are literally asking the SSA to ASSUME that your condition is bad as it was at the time you started getting medical treatment. Unfortunately, this answer is not simple. Sometimes, a doctor can complete a statement indicating that you were disabled in the past and give statements to support that opinion. If your condition is one that could reasonably be expected to have been disabling in the past (i.e. IQ), a judge may be able to make that assumption. Sometimes, a medical expert may be called in by SSA to review your records to determine if they can go back.
c) I became disabled on December 30, 2008. Am I covered?
Of course, if you are able to demonstrate that your condition became disabling BEFORE 12/30/2008, then you should be covered by the Social Security Administration.
d) If I am disabled on December 30, 2008, will be disability END on December 31, 2008?
So for those of you who are freaking out and thinking that you will only get a DAY of benefits, this is not true. By demonstrating that you were disabled before the ending of your insurance status, you will not be eligible for disability benefits going forward (Unless SSA determines an end date for a closed period but that’s another post)
e) What if I get disability, get better and get off of disability but then I need to go back on it again. Am I stuck?
Most people don’t realize that your disability insurance status literally FREEZES. As such, this status takes into account the possibility that the person may get better. It’s important that if you are receiving benefits and you get better, ask SSA when your new DLI would be if you stop receiving disability benefits.
Ok, now I have spent alot of time talking about what happens if you have issues with the DLI. Now, what happens if you DON’T have a DLI. This situation usually comes up when you didn’t even know that you hadn’t the requirements. This situation gets goofy because it usually falls under two scenarios:
1) You didn’t have enough quarters
Unfortunately, this situation is pretty much a lock because you either Have them or you don’t.
2) Some of your earnings were not reported.
This situation provides a little more wiggle room. Sometimes, you may be aware that you have coverage but some body didn’t report the information or didn’t report your earnings. If this situation arises, you need to notify SSA to possibly correct this information.
I know this post was kind of long but I can’t tell you how many people have found themselves frustrated because they didn’t know that their disability status was affected by their earnings. I hope this clears up a few things.
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