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HAVE YOU WAITED TOO LONG (TO FILE FOR DISABILITY)?

Yes, there are deadlines to apply for Social Security disability.  Have you waited too long?

 

The Many Adventures of a Disney

Social Security uses a thing called "Date Last Insured" or DLI.  In the simplest terms, DLI is the last date on which you can file a new application for disability based on your work record.  The DLI is based on the date you last worked and paid FICA from your payroll checks.  The DLI is usually about 4 to 5 years after you stopped working and paying FICA.

So, for many workers, they would need to file a disability claim within about 4 years after they stop working or risk a problem with Date Last Insured.

Social Security disability coverage is not free.  And it is not paid for from the US general tax budget.  Social Security operates within its own resources and is self sufficient. It takes in and spends its own money. When you work, your employer deducts a percentage of your pay and matches it.  These funds (called FICA* withholding) are sent to the Social Security Administration under your name and SSN.  This purchases a disability insurance plan from the US government, formally called Social Security Disability Insurance (SSDI). When you stop making payroll deductions (or otherwise paying FICA) the countdown towards to your Date Last Insured begins.

You can't accurately determine your Date Last Insured.  The best bet is to call your local Social Security office and ask them for the DLI.  The office will give you the exact date when your SSDI coverage ended, or will end.

There is one exception to an expired DLI.  You are allowed to file one (and only one) disability claim after your Date Last Insured.  However, you must have medical evidence to prove that your disability began prior to your DLI.

For example if your DLI was 12/31/20, you can file one disability claim after that date.  However, the burden is on you to prove that you became disabled (unable to work) on or before 12/31/20. Proving that your disability started after 12/31/2020 will do no good because you were not insured for SSDI at the time your disability began.

I compare this to my automobile insurance.  I could file an accident claim after my auto insurance policy expired.  But the accident must have occurred before my policy expired.  Social Security Disability Insurance (SSDI) is similar.

The longer you wait to file an SSDI claim, the more trouble you could potentially run into.  

Persons sometimes say, "I hope to get better soon and be able to start working again."  This is admirable indeed.  However, if there is a high probability that you may not be able to work within 12 months, I recommend filing for disability.  Later, if you become able to return to work, you can still work and surrender your SSDI benefits or withdraw your application for benefits.  The "Ticket to Work" program at Social Security even permits you to continue receiving SSDI benefits while you transition back into the work force--but there are conditions and stipulations.  You should speak to the local Social Security office before starting back to work after you begin receiving SSDI benefits.

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FICA stands for Federal Insurance Contribution Act.   This 1937 law requires employers to withhold (6.2% of gross pay for Social Security and 1.45% for Medicare.  It is mandatory for most workers, so most people do not get a chance to opt out. It is an "unseen" insurance program that many individuals don't know about.  But not everyone is covered by Social Security Disability Insurance, only those who have worked and paid into the system in recent years.  Coverage does expire at some point after you stop working and stop paying FICA.

 

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