Determining onset date for disability claims

The Social Security Administration (SSA) has issued a new ruling about determining the onset date for Social Security Disability and Supplemental Security Income claims.  The established onset date is the earliest date that the claimant meets the both the definition of disability and the non-medical requirements for benefits eligibility.

SSA first determines the potential onset date, which is the earliest date that the claimant meets non-disability requirements.  If the claimant meets the statutory definition of disability on the potential onset date, that date is used as the established onset date.

For impairments that result from a traumatic injury or other traumatic event, the onset date is the date of the traumatic event even if the claimant worked on that date.

Non-traumatic impairments are impairments that are not expected to change in severity over time, impairments that are expected to improve over time, or impairments that are expected to worsen over time.  For non-traumatic or exacerbating and remitting impairments, SSA determines the first date that the claimant meets the definition of disability.  SSA reviews the evidence and considers the nature of the impairment, the severity of signs, symptoms and laboratory findings, the longitudinal history and course of treatment, the length of the impairments exacerbations and remissions if applicable, and any statements by the claimant.  The onset date can predate the earliest recorded medical examination.

SSA considers evidence from other non-medical sources such as family, friends or former employers only if SSA cannot obtain other medical evidence and SSA cannot reasonably infer the onset date from the medical evidence in the file.

At the hearing level, the Administrative Law Judge (ALJ) may call upon a medical expert but the decision to call a medical expert is entirely in the ALJ’s discretion.  The claimant cannot require the ALJ to call a Medical Expert.

If the claimant has both a traumatic and non-traumatic impairments, SSA considers all of the impairments in combination when determining the onset date.

Generally, the claimant’s established onset date is not before the last day the claimant performs substantial gainful activity.  However, SSA can determine the established onset date to be before or during an unsuccessful work attempt.

The established onset date can be in a previously adjudicated period if the claimant meets the definition of disability and applicable non-medical requirements during the previously adjudicated period.  However, it is in the adjudicator’s discretion whether to reopen a prior claim.  (SSR 18-01p, October 2, 2018.)

Posted in SSI