- When Is the Date Last Insured or DLI?
SSDI stands for Social Security Disability Insurance. It's an insurance program. When you worked, premiums were taken out of your pay in the form of FICA withholding and paid to Social Security to fund this insurance. After you stopped working, and no longer paid FICA, the insurance eventually expired and you became uninsured for the SSDI program. You reached your "Date Last Insured." If you try to file a new claim after you reach your DLI, you are filling on an expired policy. You can find out when your DLI will be (or was) by calling the Social Security office and asking. (If the DLI has expired before the disability began, a person may still file for Supplemental Security Income or SSI; however, SSI is limited by financial resources and household income).
- What is the Claimant's Age?
18 - 49 are younger individuals, the hardest to get approved.
49 - 54 are approaching advanced age and may use grid rules.
55 + are persons of advanced age and are more likely to win.
So, if an individual under the age of 50 approaches me about SSDI, I am aware that his or her impairments must be very severe in order to prevail. The question is: What kind of impairments does this young person have that will prevent him/her from performing a simple, sedentary, one step, unskilled, entry level, minimum wage job? If he or she can perform one of these type of jobs, Social Security is going to deny the claim. That's the reality. Older individuals have an easier burden of proof.
- What Are the Claimant's Medical Impairments?
First, there must be at least one severe medical impairment that has lasted for at least 12 straight months, is expected to last for 12 straight months, OR is expected to end in death. You cannot combine different impairments to get 12 months. Most importantly, how do the symptoms of this impairment preclude the capacity for full-time work? We must prove that the medical condition does not permit the claimant to perform full-time work activity or substantial gainful activity.
- What Medical Evidence or Proof Do We Have?
Social Security goes by medical evidence to prove the claimant's allegation of disability. So, I have to ask, What medical evidence do we have to work with? If the claimant hasn't been to the doctor, has no tests or studies and has had little or no treatment, it's a hopeless case. We need to get this individual in for medical treatment someplace. Even if there was treatment but it was 5 or 6 years ago, it's too old for a claim. No proof = no victory.
Other Considerations
There are certainly other things to find out and consider.
- Has the claimant been denied previously? How many times?
- Are there drug or alcohol problems? (Not always disqualifying)
- What kind of work has the claimant been doing for 15 years?
- Is there continuing medical treatment?
My office will conduct a free case evaluation for anyone who calls us, with no obligation. We will explore your case and try to determine if you have a viable case that we can help you with.
Let me admit that I can't always tell who will win disability cases and who will not. I can make educated guesses but even if I don't think a case will win (and therefore I don't agree to represent), someone else may think differently--and the case can still go on to win. So, I never tell someone their case won't win, only that I don't want to accept the case. Sometimes I hear from a colleague that a case I declined to represent has won, and I'm always delighted to hear this. I'm happy for the claimant.
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The Forsythe Firm
Social Security Disability Counselors
7027 Old Madison Pike, Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
Email Your Question: forsythefirm@gmail.com
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