Question: For purposes of Disability Insurance Benefits, what is the date last insured of the 43 year old claimant whose earnings record is shown here?
- June 30, 2010
- September 30, 2011
- March 31, 2012
- June 30, 2012
- September 30, 2012
- Never since never fully insured
Answer: September 30, 2012. The claimant needs only one quarter of coverage for each year after turning 21 so is easily fully insured. If you count backwards until you reach the 20th covered quarter, you appear to get to the second quarter of 2002 but quarters of coverage can be moved around within a calendar year (but not stacked). Thus, the 20th covered quarter counting backwards is the fourth quarter of 2002. Counting forward 10 years from there, you reach the third quarter of 2012 and the last day of the quarter is always used.
If you did not know where to start in figuring out the answer to this question, please realize that your expertise in Social Security, which may be considerable, is far from complete.
Update: The results of this quiz dismay me. Confusion about fully insured status! Confusion about everything! This is basic. The earnings record I displayed was plain vanilla. Nothing tricky. If you are working with disability claims, you need to know how to do this. If you rely upon Social Security's computer's you will not know what to do when presented with evidence showing additional earnings that will not be posted for months to come, for instance. If a claimant does not meet the earnings requirement, you need to be able to understand why and be able to sort of explain it. If you represent claimants you need to understand how correcting an earnings record or obtaining additional earnings will affect a claimant who is just short of meeting the earnings requirement. And there are claimants who have off again, on again coverage. No one should rely upon the computers if the claimant had a prior period of disability, especially when the claimant turned 31 soon after going off disability.
Update: The results of this quiz dismay me. Confusion about fully insured status! Confusion about everything! This is basic. The earnings record I displayed was plain vanilla. Nothing tricky. If you are working with disability claims, you need to know how to do this. If you rely upon Social Security's computer's you will not know what to do when presented with evidence showing additional earnings that will not be posted for months to come, for instance. If a claimant does not meet the earnings requirement, you need to be able to understand why and be able to sort of explain it. If you represent claimants you need to understand how correcting an earnings record or obtaining additional earnings will affect a claimant who is just short of meeting the earnings requirement. And there are claimants who have off again, on again coverage. No one should rely upon the computers if the claimant had a prior period of disability, especially when the claimant turned 31 soon after going off disability.
Unreal. Only 1 out of 8 respondents got this correct. More than a quarter had this person uninsured. CLE time. Wow!
ReplyDelete@ 9:04...for those of us who work at SSA, we have a program that calculates the DLI automatically. It's not really pertinent to know how to calculate it manually.
ReplyDeleteFor the times manual calculation is requirted (i.e. once per year), POMS, HALLEX and CFR are easily accesible.
@10:35:
ReplyDeleteI work in an office where we routinely work with earnings records and the DLI that's automatically calculated doesn't always match up. Prior periods of disability are often not entered, for example, and if you put garbage data into the program you get a garbage DLI out.
I always manually calculate the DLI because things have a tendency to blow up spectacularly and expensively if I don't. And then I double- and triple-check.
Anon 11:03,
ReplyDeleteThat is why an option exists to input PPD. But crap inputs will give crap outputs.
Garbage in, garbage out.
ReplyDeleteDisco is hardly the final decision maker on insured status.
ALJs and the attorney decision writes will often indicate one DLI in their decision but the PSC/FO will come up with another. Why? The DLI in the order used earnings that were never reported, proven or later removed and stuck by an outdated DISCO report.
Given the time frame on appeal hearings, earnings will often need to be considered for determining the DLI.
And the problem is not about doing a manual calculation of the DLI, but not knowing insured status requirements for T2 disability benefits. Imagine if even just the 40 respondents were SSA teleservice reps or service reps in the field. That could be 40 possible claimants who lose out on a protective filing date if they do not push to file a claim.
Revised 1:23pm comment;
ReplyDelete"That could be 40 possible claimants..."
That could be 40 possible employees who are costing claimants their protective filing date or incorrectly denying a claim if there is a program exclusion that does not determine the DLI for them.
Apologizes for the rushed remarks.
Many many years ago, employers were required to report earnings for each quarter and employees only received credit for the quarter during which they actually worked. In recent times,employers only report annual earnings and SSA has no idea whether the entire amount was earned in January, in December or is some or all other months. Employees receive quarters of coverage throughout the year based on total earnings. When fewer than four quarters are earned, SSA routinely assigns coverage beginning with the first quarter, but will reassign to whichever quarters are most advantagious to the claimant. Despite knowing all that, I chose the wrong answer because it seemed to me not to matter (at least not now) whether the claimant's insure status extended 6 months into the future or 12 months into the future.
ReplyDeleteI thought this was pretty simple, count 20 C's back and count 40 quarters forward....
ReplyDeleteInsured status is soooo 1992. I have way too much work to do other than calculate a dli into the future. Only attorneys looking for a payday have the time to do that.
ReplyDeleteI do rely on DISCO because it is correct if you put the correct data into the program. However, you should be able to manually calculate it too - it is not difficult if you know the rules. I did pick the correct answer last night and was shocked to be the first with that answer. The number saying not insured at all was shocking to me. Calculate fully insured first, then currently insured.
ReplyDelete