"Date Law Insured" Can Make or Break a Disability Case | Florida ...

The ?Date Last Insured? (or DLI) is a simple concept that is sometimes difficult to calculate.? However, understanding when it will occur can make a significant difference on whether?a Social Security Disability claim will be approved or denied.

In simple terms, the DLI is the date on which a working individual?s coverage under social security disability insurance terminates.? For an illness or injury to qualify as a valid payable claim under disability insurance, then the illness or injury must pre-date the DLI.? Put a different way, if you are injured after your DLI expires, then you will be denied social security disability benefits for that injury.? But note that the DLI only applies to?the date of occurrence of injury, and not to the date of when you apply for disability. In fact, many disability applications are submitted after the DLI has passed.? Calculating a correct DLI can be complicated, and often requires a copy of an individual?s earnings report from Social Security to be accurate.

In order to create a period of disability insurance coverage, a claimant must have worked at least 20 quarters (20 Qs) within a 40 quarter (40 Qs)?time period.? And each year has only 4 quarters. How quarters are earned goes beyond the current subject, but suffice it to say that 20 Qs out of 40 Qs is roughly 5 out of 10 years.? If a claimant has worked for 5 years in a 10 year period then the DLI would be in the?10th year after the first quarter of the last?20 Qs?that you have worked.? To put it another way, the DLI can be calculated by doing this: start with the last?quarter?you earned before you stopped working, count backwards over the years until you have reached a total of 20 Qs, then count forward from that date until you reach 40 Qs.? That is your DLI (give or take).??If you have a steady work record, then you DLI will most likely?occur about 5 years after you stop working.? In order to be approved for disability, you must show that your injury dates back to some time before this DLI.

So, what happens if your injuries occur over a period of time during which the DLI expires? Let?s take an unlikely example.? Assume a?claimant falls and hits their head in 1999 suffering memory loss.? DLI expires in 2000. Claimant has a heart attack in 2001 and suffers partial paralysis. Claimant has a stroke in 2002 due to the prior 1999 fall and suffers a slight vision impairment.?Assuming all other conditions are met, the 1999 fall would obviously be covered by disability because it occurred before DLI. The heart condition and paralysis would probably not be considered for disability because?they occurred after the DLI expired. However, it is likely?that the stroke in 2002 with?vision impairment would be considered for disability because?even though it occurred in 2002, the event relates back to the 1999 head injury and?occurred close in time to the fall.

So, what does all this mean for my disability claim? Using the example above, it becomes more clear (hopefully) as to why some disability applicants do not understand why they are denied benefits when they are clearly disabled.? In the above hypothetical, the claimant has memory loss, paralysis, and slight vision impairment.? Let?s further assume that in 2003 the claimant goes to a judicial hearing on their social security disability claim. Under a strict interpretation, it is possible that only the memory loss and vision loss would be considered for disability purposes, while the paralysis would be completely ignored. In other words, the disability decision would be based on whether the memory and vision loss would be sufficiently severe to prevent the claimant from working, while the obvious paralysis would not come into play at all. Furthermore, if the memory and vision loss are not severe, then the paralyzed claimant could be denied disability on the basis that they are not disabled and are capable of working.

This is a harsh outcome, but I used an extreme example to underscore the importance of understanding how the DLI can affect a disability claim.? Knowing the nature of your claim and what you need to prove is essential to winning a social security disability case.? If you are unsure of where you stand, then?it is probably worth seeking a consultation with a disability attorney in order to uncover the possible pitfalls of your case.

Source: http://jtmlawfirm.com/blog/2012/12/knowing-the-date-last-insured-can-mean-the-difference-between-winning-or-losing-your-disability-case/

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