Why does the online claim form for Supplemental Security Income disability benefits used internally by Social Security request the date that disability began? You can't get benefits until the month after the month you file the claim. An alleged onset date prior to the date of the claim is meaningless. Yes, I suppose an alleged onset date before a prior denial is an implied request to reopen but the claimant can always make an express request to reopen. I keep getting Administrative Law Judges being concerned about an SSI alleged onset date that goes back several years and I have to keep saying we regard that as of no consequence, that we'll amend to the date of the claim since it makes no difference. But why does the form even request an alleged onset date? The paper form, which is rarely used these days, doesn't request an alleged onset date so why should the computer based form?
Somewhere in POMS you will find current policy which is that the agency will not initiate extra development to determine whether a SSI applicant was disabled prior to the month of application, but will establish an earlier onset date if supported by the evidence already in the file. This may save effort in the future. As one example, a 25 year with healthy working parents applies for SSI alleging that he became disability at age 21. 50 years later a parent dies or retires and the SSI recipient applies for CDB. It sure would be convenient if the agency had determined 50 years ago that he had been disabled since age 21.
ReplyDeleteIt was probably easier to write a single line of code than to have to do two sets. Or they simply didn't think about it when they were generating the program.
ReplyDeleteI don't know why the ALJs get so worked up about it. It's not a difficult concept to wrap your head around. It never bothers me if someone amends or doesn't amend.
An even bigger brain teaser: In the Title II application, why doesn't the agency straightforwardly ask when the claimant alleges they became disabled, rather than simply asking when they stopped working, and imputing an alleged onset date based on the response, regardless of the claimant's reported reasons for stopping work on the given date?
ReplyDeleteCouldn't an earlier EOD from SSA on a XVI disability claim entitle the claimant something from other sources of benefits? Medicaid, Medicare, SNAP, state benefits of some sort? Otherwise, I'm with you.
ReplyDeleteI’ve always wondered that as well! Many people stop working for reasons unrelated to disability and then become disabled at a later date. Many ALJs then use the day they stop working to discredit them.
ReplyDelete@10:42
ReplyDeleteAlso, many people continue to work with accommodations (reduced hours, workplace restructuring, etc.) to allow them to work despite being disabled.
Tying disability to the last date of actual work is a bad idea.
8:09 - it would be wonderful if a claimant could get info about an earlier application, or even earlier receipt, of benefits. It's pretty impossible, though. I can't say how many times people have come to me who used to receive benefits, as a child or otherwise, and they just can't understand why SSA can't use earlier information. Trying to get an old file is all but impossible.
ReplyDelete"An alleged onset date prior to the date of the claim is meaningless." My client was terribly bed-ridden 4/14.... and hospitalized when she became dehydrated in 9/14 finding out she had 30% fibroid liver, Hep-C, and it took another 3 months to determine what course of action to take. She was to start on interferon..but complications (and no insurance) caused her to wait until 5/15. She had interactions with her meds for DM II, PTSD, and Bipolar III. She had applied 2/15 for SSI and DDS said in 7/15 that she was getting better and disability was not expected to last 12 months...
ReplyDelete...but it had already lasted 12 months although she could only be paid for a few of those months..
In some cases, it may be meaningless for the Social Security Administration to ask the onset in the first SSI disability benefits application, but not meaningless in subsequent claims when it directs prior claim reopening (POMS § 27501.005B.1.a) and many claimants are serial filers. (Of course, I am assuming that the new claim is filed within the reopening period and there is an adequate reason for reopening the prior claim some of which I outlined in a paper I last updated in 2012.)
ReplyDeleteIt also is useful in younger individual claimants when there is a future Adult Disabled Child claim that cannot be filed now as the parents or grandparents are neither dead nor receiving Social Security insurance (Title II) benefits under their own earnings record. Collateral estoppel is how you use the prior Supplementary Security Income claim to establish a later Adult Disabled Child claim.
Also, an onset prior to filing the Supplementary Security Income claim may establish entitlement to additional months of retroactive Medicaid benefits (currently as far back “as the first day of the third month preceding the month an [Supplementary Security Income] application … is effectively filed”). POMS § SI 01730.010A.3.
SSR 83-20 states:
ReplyDeleteThere may be instances where it is necessary to establish that disability has existed for several consecutive months (possibly up to 12 months) immediately prior to the date of filing in order to assure that the severity/blindness requirements of the law are met. (There is no duration requirement for a finding of statutory blindness in title XVI cases.) This situation may occur where: (1) the duration requirement is not met as of the application date, even though the requisite level of severity is established as of the date of filing, e.g., disability ceases shortly after application date but prior to adjudication; (2) medical recovery is expected within 12 months of filing but onset occurred within the 12 months prior to application; (3) the claimant begins work at an SGA level on or after the date of filing but met the severity/duration requirement prior to returning to work (in which case the claimant may be afforded the protection of a trial work period); or (4) medical documentation prior to application date is relevant to an assessment of severity/duration in the impairment category involved, e.g., myocardial infarction, cirrhosis, certain mental conditions, or for some dual title II-XVI claims where an earlier onset must be established for the title II claim.
AODs are always kind of a work in progress. Nothing is exact. But I pick an AOD before the SSI app because I want the ALJ to look at records back to that date.
ReplyDeleteFeel like if I amend always to the SSI app date then the ALJ will just be lazy. A claimant can allege any onset date if the records warrant it.
As I believe at least one responder indicated, an onset prior to filing can be important in some instances in meeting the duration requirement.
ReplyDeleteStrat from the POMS. https://secure.ssa.gov/poms.nsf/lnx/0425501370
ReplyDeleteIt does have to do with duration, and the form you linked does in fact ask for an onset date (see page 2, question 7b).
ReplyDeleteBecause if they didn't have it they would get sued by some lawyer.
ReplyDeleteIt could be because when you file for SSI you must file for all benefits for which you are entitled. So, they may want to know your actual alleged onset date for possible eligibility to SSDI of to childhood disability on the record of a parent.
ReplyDeleteIt can make a difference in whether or not a Collateral Estoppel adoption can apply if a claim is filed later for a different title. Unless there are lag earnings or some other technical issue where the DFI is before the T16 onset date, a subsequent Title 2 claim can be an easy adoption. If the time periods don't overlap, neither FO or DDS can adopt and a substative medical decision has to be made. DDS almost always uses the T16 filing date for onset. But, if it's a clear case of a traumatic onset due to stroke, TBI or injury, DDS can and should use that date as the onset date if there is medical evidence that supports it.
ReplyDeleteIn Kentucky there are advantages with regards to Medicaid benefits if you can get an onset three months prior to filing. I'm not sure how that works in other states, which is why I guess they leave room for flexibility here.
ReplyDeleteAlso an application for SSI is an implied application for. DIB... Possiible DIB benefits need to be ruled out even
ReplyDeleteIf DLI well in the pas