Date of Onset: Starting and Ending Points for SSDI Claims

Date of Onset for Social Security Disability Insurance (SSDI) Claims

Understanding the Difference Between Alleged and Established Onset Dates of Disability

The law is full of unusual terms and phrases.

Social Security disability law is no different.

Two of the most important terms when seeking Social Security disability insurance (SSDI) benefits or Supplemental Security Income (SSI) are the alleged onset date of disability and the established onset date.

This article explains how to choose your alleged onset date, when to consider moving for or accepting an amended date, and what it means when the Social Security Administration finds an established onset disability date.

Keep reading to learn more about the alleged and established onset dates for disability.

If you have questions or want a top-ranked disability attorney to consider representing you, call (804) 251-1620 or complete this form.

What is the Alleged Onset Date of Disability?

Social Security’s Program Operations Manual System (POMS) DI 25501.210 defines the alleged onset date as the date you tell Social Security you became unable to work because of your medical impairments.

Where Can I Find My Alleged Onset Date?

Your alleged disability onset date should appear in many places in your Social Security file.

For example, you can usually confirm the alleged onset date at one of these locations:

• • Your disability application

• • The case date section of the electronic disability folder created by the Social Security Administration

• • Form SSA-3368

• • I also recommend writing the alleged onset date in the remarks section of the Adult Disability Function Report (Form SSA-3373-BK)

You can also confirm the alleged onset date when reading decisions from the Disability Determination Services (DDS) at the initial and reconsideration stages of the disability appeals process.

What is the Established Onset Date of Disability?

The Social Security Administration determines your established onset date of disability after you file an application and prove you meet the statutory definition of disability and the applicable non-medical requirements for the program whose benefits you seek.

Your established onset date is the first day you meet the definition of disability or blindness under the Social Security Act and regulations and satisfy the non-medical eligibility factors for SSDI.

Why is the Alleged Onset Date Important for Your SSDI Claim?

Your alleged onset date is significant because Social Security considers it “the starting point in establishing the established onset date (EOD).” And the established onset date determines how much SSI or SSDI back pay you will receive.

In addition, Social Security must generally develop your complete medical history for at least 12 months before the month you say your disability began. It meets this obligation by requesting your medical reports.

If you choose an incorrect date, you risk Social Security not requesting and receiving significant medical evidence to prove your claim, which can be the difference between winning or losing.

Further, Social Security may adopt your alleged onset date as the established onset date if your medical records, doctor disability letters about residual functional capacity (RFC), consultative examinations (CEs), or other evidence support the date you pick.

How Do I Choose an Alleged Onset Date?

I recommend choosing the earliest possible date as your alleged onset date of disability.

For example, in SSDI claims, I recommend choosing the earliest of these dates, if applicable:

• • The date of your occupational injury if you have a workers compensation case and no treating physician has released you to return to work without restrictions since

• • The date of your motor vehicle accident (car crash, truck crash, pedestrian accident, etc.) if that collision resulted in the injuries that prevent you from working

• • The date you last worked full-time consistently (i.e., when you stopped performing substantial gainful activity (SGA) under Social Security’s rules and regulations).

• • The first date a doctor disabled you from work.

• • The date of a significant surgery, such as spinal fusion or total knee replacement.

• • The date you had an MRI showing osteoarthritis, degenerative disc disease, or a herniated disc.

• • When your employer provides accommodations at work.

And in SSI claims, I recommend choosing the date you apply for SSI as the onset date due to back pay rules specific to this program.

What Happens if I Choose the Wrong Alleged Onset Date?

Generally, choosing an unsupported alleged onset date will not harm your SSDI case if the date given is earlier than the evidence supports.

But there is an exception.

Eligibility for SSDI depends on earned work credits. You accrue credits for each quarter you work and pay federal taxes.

When you stop working, you stop accruing work credits. After a while, you no longer have coverage under the SSDI program.

This last date of SSDI coverage is known as the date last insured (DLI). Usually your DLI is five years after the date you last worked at the substantial gainful activity (SGA) level.

If you choose an alleged onset date of disability after your DLI, then Social Security will deny your SSDI claim. You must prove that you are disabled before your DLI to receive benefits.

Can Social Security Choose an Established Onset Date that Differs from My Alleged Onset Date?

Yes.

Social Security may find you have an established disability onset date later than your alleged onset date. When this happens, you have an amended onset date.

An amended onset date typically corresponds with turning 50, 55, or 60. These ages are significant under Social Security’s Medical-Vocational Guidelines (the “Grid Rules”); the older you are, the easier it is to win an SSDI case.

In other situations, the amended onset date may be when you attended a consultative examination that found significant limitations or underwent a joint replacement surgery or an MRI showing degenerative disc disease.

Some administrative law judges (ALJ) like to negotiate onset dates at disability hearings. For example, an ALJ may ask you or your attorney to amend the alleged disability onset date, understanding that the ALJ will allow your case as of that new date.

Agreeing to amend guarantees you win your case. However, the amendment will lower the back pay you will receive.

Do not agree to amend your alleged onset date until you have spoken with an experienced disability attorney and understand the advantages and disadvantages.

What are the Advantages and Disadvantages of Accepting an Amended Onset Date of Disability?

There are advantages to accepting an amended onset date in your SSDI or SSI claim:

• • It is less likely that the Appeals Council will remand or reverse an ALJ’s decision when the claimant moves to amend their onset date.

• • You will leave the hearing knowing the long wait for disability benefits will end on a positive note.

• • You can estimate how much Social Security back pay you will receive.

But there are two disadvantages to moving for or accepting an amended onset date:

• • You are giving up the potential right to additional Social Security back pay by moving your disability onset date forward.

• • You may have to wait longer to qualify for Medicare or Medicaid, meaning you may go longer without the health care you need to improve your quality of life.

Changing your disability onset date is a big decision. Make sure you understand the consequences before agreeing to do so in writing. Depending on the date offered, it may be a great decision and one that helps you start to recover medically and financially.

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