Q: Claimant retired at 48 with 120+ work credits. What qualifies as permanent fully insured & does it ever expire?
Claimant worked 30 yrs as a skills trade journeymen & retired in Aug 2008 at age 48. In Nov 2008, claimant was admitted for heart failure & received a heart implant Feb 2009. Claimant tried limited subcontracting for his wife's company, but applied for SSDI Nov 2014 under medical advice after health continued to decline. ALJ determined he was not disabled due to date last insured expiring on Dec 31, 2014. The onset of condition would be Nov 2008 & the SSDI application was submitted Nov 2014. How is this ruling correct under DIL rules? Claimant passed from the condition & his family members have been unable to receive survivors benefits. Please help us understand this & can we have the claim reopened, even if it's only for the closed period?
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A:
To be permanently fully insured for Social Security Disability Insurance (SSDI), the claimant must have earned a sufficient number of work credits, which he did by working 30 years. However, SSDI eligibility also depends on whether the claimant is still insured on the date they become disabled. In this case, the claimant's date last insured (DLI) was December 31, 2014, which is crucial.
The Administrative Law Judge (ALJ) ruled that the claimant was not disabled by the DLI despite the SSDI application being filed in November 2014. The onset of the condition was in November 2008, but the ALJ determined there was insufficient evidence to prove the claimant was disabled before the DLI expired. For SSDI, the claimant must show they were unable to work due to a disability before the DLI.
You may request to have the claim reopened if new, substantial evidence supporting the disability onset date before the DLI is available. Additionally, consider exploring other survivor benefits options through Social Security for the claimant’s family. It may be helpful to consult with a legal advisor who can guide you through the appeal process and ensure all relevant medical documentation is considered.
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