What is an Onset Date for Disability?

Your onset date is defined as the first day that you meet the legal definition of disability when applying for Social Security Disability Insurance (SSDI) benefits. Consulting with a Louisiana Social Security disability lawyer can be a smart idea to accurately determine this date.The process of determining the onset date varies depending on the disability’s nature. In the simplest of terms, it is the first day you are unable to work because of your disability.If the disability results from an accident, establishing the onset date might be straightforward. However, if the disability developed gradually due to a medical condition, pinpointing the exact onset date becomes more complex.

Why is the Date of Onset Important?

The chosen onset date is crucial as it influences the calculation of back benefits. A correctly determined onset date can significantly impact the total benefits received.

The onset date determines when you were first eligible to receive Social Security Disability Insurance (SSDI) benefits and how far back your “back pay” will go.

• SSDI benefits may be paid up to 12 months before the date you file your application.
• Once approved, there is a five-month waiting period after the onset date of your disability during which you are not paid benefits. (For example, if you are found disabled starting on January 1, SSDI does start until your June payment.)

For SSDI, the Social Security Administration (SSA) can retroactively pay benefits as far back as 12 months before your application date if you were disabled before that date, again subject to the 5-month non-payment period.

There is usually little to be gained from alleging an onset date of more than 17 months before your application since you are not eligible for Social Security disability benefits for that time period. Here are some examples:

• You apply on January 1, 2024 stating your onset date was January 1, 2023 and are approved with the AOD. You are entitled to benefits starting June 1, 2023. Why? Although SSA can pay you for one year prior to your application date, your five-month elimination period started on January 1, 2023 and ended on May 31, 2023.
• You apply on January 1, 2024 stating your onset date was January 1, 2022 and are approved with the AOD. You are entitled to benefits starting January 1, 2022. Why? SSA only pays for one year prior to your application date (or January 1, 2023) and your five-month elimination period started on January 1, 2022 and ended on May 31, 2022.
• You apply on January 1, 2024 stating your onset date was January 1, 2024 and are approved with the AOD. You are entitled to benefits starting June 1, 2024. Why? Your five-month elimination period started on January 1, 2024 and ended on May 31, 2024.

The exception to this is if your Date Last Insured (DLI) is more than 17 months before your application date.

*Note: The information about Onset Date and DLI is for SSDI only. For Supplemental Security Income (SSI) claims, SSA can only pay from the date of application OR onset date, whichever is later.

What is an Alleged Onset Date?

The alleged onset date, or AOD, is the date you claim on your Social Security Disability application you became unable to work because of your medical condition.

The onset date may or may not be the same as the date your medical condition was diagnosed or your injury occurred.

A typical AOD is the date last worked.

However, depending on the circumstances and the medical support, the onset date could be after the date last worked.

What is an Established Onset Date?

The date that Social Security determines that you became disabled and unable to work is called the established onset date.

When discussing Social Security disability claims, understanding key terms like “onset date” and “established onset date (EOD)” is essential. The onset date is essentially the day the claimant fulfills the Social Security Act’s requirements for being considered disabled or blind. This date marks when an individual officially meets the medical criteria for disability.

However, identifying the onset date is just the beginning. The established onset date, or EOD, takes this a step further. It’s the specific date when the claimant meets the medical definitions set by the Act and satisfies all necessary eligibility and entitlement conditions to start receiving benefits. This EOD is crucial as it determines from which point the claimant is entitled to receive disability benefits. Therefore, every disability claim must have an EOD clearly defined to process the claim correctly.

To determine your established onset date, the Social Security Administration considers several crucial factors. Firstly, the SSA evaluates the date you list on your SSDI application as your alleged onset date (AOD). Additionally, your work history plays a significant role, particularly focusing on the date you stopped working or only worked in a limited capacity without earning substantial income. Medical evidence is also pivotal; this includes both your physician’s determination of when you became disabled and the details laid out in your medical records.

SSA may agree with your AOD or may select its own onset date.

In addition to affecting your lump sum back payment amount, the established onset date can also determine your eligibility for benefits. You must be unable to work for 12 months to be eligible for disability benefits. If you are expected to recover to the point of being able to work and the judge disagrees with your alleged onset date and moves it back, it could mean that there is no longer a full 12-month period where you are unable to work. Therefore, you are not eligible for benefits at all.

What is the difference between Alleged Onset Date (AOD) and Established Onset Date (EOD)?

Your Alleged Onset Date is only a starting point for the claims examiner reviewing your case. The examiner will review all your records and then establish an Established Onset Date.

Why Would Social Security Change Your Onset Date?

Sometimes, a “partially favorable” decision is issued by SSA or the ALJ.

One potential reason for this partially favorable decision is because SSA or the ALJ agree you are disabled currently but do not agree with your AOD and instead believe you became disabled at a later date.  This can be referred to as an amended onset date.

The impact of such partially favorable decisions is often a person will receive future disability benefits, but the amount of lump sum back payments are reduced or eliminated.

However, it could be that the person is not eligible for benefits if the Amended Onset Date is after the Date Last Insured.

What is the Date Last Insured?

The Date Last Insured (DLI) is the last work quarter for which a claimant is covered under Social Security Disability Insurance.

In most cases, individuals will qualify for Social Security Disability benefits if they had worked five out of the ten past years before the onset of the disability.

The SSA calculates an individual’s DLI based on how many quarters of coverage they earned over their working life and when they stopped working. For a person who worked full-time, the DLI is approximately five years after they stopped working.

You must select an alleged onset date that is BEFORE your date last insured to be eligible for disability payments. If you did not become disabled prior to your DLI, you are likely not eligible for SSDI benefits on your own record.

Think of it like car insurance. If the wreck happened after your coverage expired, then the damages are not covered by the insurance policy.

How do I Select my Alleged Onset Date (AOD)?

Choosing the correct onset date is very important to your chances of obtaining disability benefits and obtaining the maximum back payment you are entitled to receive.

Selecting a specific onset date is difficult since most likely your symptoms and impairments built up over time. Unless you were injured in an accident, it’s not likely that all of your issues began on the same date.

You should pick a date that is supported by evidence in your medical records as well as your work history. If you are having difficulty, consulting with an experienced disability attorney can help.

Often you can tie the onset date to a certain event, either the day you last worked or a major date in your medical history like your date of diagnosis or a date when you were hospitalized.

Other things that can affect your onset date are incarceration, citizenship status, the last day worked, and receipt of or application for unemployment benefits.

Whatever date you choose, make sure the alleged onset date that you select can be supported by medical evidence from around that time period that shows impairments that affect your ability to work.

Understanding these factors is essential as they not only determine the onset date but also significantly influence your financial benefits and overall eligibility for disability support from the SSA. Each component — from your application’s details to the insights from your medical records — contributes to a comprehensive evaluation by the SSA to ensure that all aspects of your situation are considered.