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Among the various benefits provided by the Social Security Administration (SSA), individuals who are unable to work due to a medical condition may apply for Social Security Disability Insurance (SSDI), otherwise called “Title II benefits.” in order to qualify for and receive SSDI benefits, the applicant’s disability must begin during a time that they are “insured” under the SSA system.

What Does “Insured” Mean?

An individual is “insured” under the SSA system when they have sufficient work history and have amassed the required number of “credits” in the Social Security system. The amount of credits required to meet insured status is dependent on your age.

For further information on the amount of credits you may need to be eligible for SSDI benefits, visit SSA’s website.

Proving Your Disability in Relation to Date Last Insured

Once you have determined that you have enough work credits to apply for SSDI, it is important to pay attention to your Date Last Insured (DLI or LDI).

If you are fully insured, your DLI is usually five years after you’ve stopped working.

You must prove that your disability began on or before your DLI in order to be eligible for SSDI benefits—this will be much easier if your DLI is a future date.

If your DLI is a date in the past, you must establish that your disability began on or before that date. This will usually be done by obtaining medical records/reports/evaluations/statements from your treating doctors that show that your disability began on or before your DLI.

If those records are not available, it may be much harder to establish that your disability began on or before your DLI. For instance, medical providers and facilities may dispose of medical records after a number of years, as allowed by law.

Another issue arises when the medical provider does not have sufficient memory of your condition to provide a narrative statement. This limits the medical provider’s ability to craft a report about your medical condition and about your inability when you were insured, or last insured, for SSD benefits under the system.

Of course, you should also ensure that SSA has current medical records that support your continued disability.

You should contact the Social Security Administration at 1-800-771-1213 or ssa.gov to find out your Date Last Insured and to confirm that your SSA earnings record is correct.

Other Components in Proving a SSDI Claim

Once you have met the DLI requirement, SSA will determine whether you meet the definition of “disabled” under their rules. “Disabled” under SSA rules means that you are unable to perform substantial gainful activity for at least one year. Not being able to perform “substantial gainful activity” (SGA), means that you are unable to earn more than $1090[1] per month. For individuals who are statutorily blind, SGA is defined as $1820[2] per month or more in earnings. Proof of disability must be supported by medical evidence, such as clinical records, physician reports, and evaluations.

For more information, browse our in-depth guide with advice on winning Social Security Disability benefits.

For Legal Assistance Applying for SSD Benefits, Contact Us

Andalman & Flynn represents clients nationwide in disability claims, and we serve Social Security Disability clients throughout Maryland, Virginia, West Virginia, and Washington, DC. We will help you to thoroughly and accurately complete your claim and represent your best interests through this process, drawing on years of experience. Contact us to request a consultation with a disability attorney on our team.

 

[1] This is the current limit for SGA for 2015.

[2] This is the current limit for SGA for statutorily blind individuals for 2015.