CAN YOU FILE A CLAIM ON AN OLD WORK RECORD?

Social Security disability is a mandatory insurance policy. It is sold by the US Government and paid for by deductions from each of your payroll checks, matched by contributions from your employer. Like all other insurance, it has a starting point and an ending point. The ending point occurs about 4 to 5 years after you stop working and stop paying the FICA withholding tax. That ending point is called the "Date Last Insured" or DLI.

Here's an example to help us understand this mess. Rebecca worked for 14 years and paid FICA tax out of each paycheck. She accumulated sufficient "quarters of coverage" to have insured status for Social Security disability. However, Rebecca stopped working when her first child was born in 2007. She continued to be "insured" until 12/31/12. So, her Date Last Insured was 12/31/12. After that date, she is not covered for any NEW disability that starts after 12/31/12.

On 4/1/16, Rebecca began having severe back pain. Her doctor did an MRI and found two bulging cervical discs and a fairly severe case of degenerative disc disease in the lumbar spine. Since Rebecca is no longer insured by Social Security, can she file a claim?

The answer is, Yes. Rebecca is entitled to file one claim AFTER her Date Last Insured (that is, after 12/31/12). However, she must prove that she became disabled before 12/31/12. In short, she must prove that she became disabled while she was still insured. So, Rebecca will need objective medical evidence to show disability beginning prior to 12/31/12. Since her bulging discs were not diagnosed until April of 2016, she will have a very hard time claiming disability before her Social Security coverage expired.

This requires older medical records. Doctors and other providers often destroy medical records after a period of time. So, the longer a claimant waits to file a claim, the more roadblocks there are likely to be in proving the disability. The moral of the story: As soon as you feel you may have a disability that will last for at least 12 consecutive months, file the claim right away. Delaying for a few months or a few years may make it impossible to qualify for benefits because of the "date last insured" rule.