What Can I Do If Social Security Gave Me the Wrong Disability Onset Date?

Because it can take many months, even years, for the Social Security Administration (SSA) to approve a disability claim, most disability applicants will receive "back pay" covering that long wait. How much back pay you'll get depends on:

• the type of disability benefit you're getting (SSDI or SSI)
• your monthly benefit amount (based on your lifetime earnings)
• how long it takes to get your claim approved, and
• your "established onset date" (the date Social Security says you first became disabled).

Your onset date is pivotal to how much back pay you'll receive. If Social Security gets it wrong, you can lose thousands of dollars. But challenging an incorrect established onset date (EOD) for SSDI or SSI isn't without risk. Read on to learn when it might be a good idea to appeal your EOD and what it takes to change it.

What Does Onset Date Mean for Social Security Disability?

Your disability onset date is when you can no longer work full-time or do substantial gainful activity (SGA). Many people report the date they last worked as their onset date. Social Security calls this your "alleged onset date."

But Social Security won't automatically accept your alleged onset date as the date you became disabled. Instead, Social Security considers that date and all the evidence in your file, such as:

• your work and payroll records
• your medical records, including dates of MRIs and surgical procedures, and
• statements about your medical condition and ability to function.

After examining your records, Social Security might agree with your alleged onset date, or the SSA might establish a different disability onset date when approving your claim. If Social Security establishes a disability onset date several months or even years later than it should be—because of an error in your records or an examiner misreading your records—you might want to appeal the EOD.

Challenging Your Established Onset Date for SSDI vs. SSI

The primary reason to appeal your established onset date after your claim has been approved is to increase the back pay you'll receive. But Social Security limits how far back your back pay can go.

The amount of back pay you can receive differs between Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) disability benefits.

With SSDI, Social Security will pay up to 12 months of retroactive benefits for the months you were disabled before you applied for disability. Because of the 5-month waiting period, your established onset date must be at least 17 months before your application date to receive the full 12 months of retroactive benefits. But you can't get more than 12 months of retroactive benefits, no matter how long ago you became disabled.

With SSI disability benefits, you're eligible for back pay covering the period between your application date and your award date—assuming your established onset date is on or before your application date. But you can't get retroactive SSI benefits for the period before your application, even if you were disabled for months before your application date.

Learn more about how much your established onset date affects disability back pay.

When Is Appealing Your EOD Worth the Risk?

Social Security can re-examine your claim whenever you appeal a Social Security decision. If that happens, your initial approval could be reversed and your claim could be denied.

Still, it might be worthwhile to appeal your established onset date if you can show the date you became disabled is many months before the EOD set by Social Security.

But you might find challenging your established onset date is not worth the risk if:

• you stand to gain only an additional few months of back pay
• both your EOD and your AOD are on or before your SSI application date
• both your EOD and your AOD are more than 17 months before you applied for SSDI, or
• you lack evidence that a clear mistake was made in using your medical or employment records to establish your onset date.

Difference Between Your Onset Date and Your Entitlement Date

Again, your disability onset date isn't always the same as the day you become entitled to disability payments. For instance, no matter how long you've qualified as disabled, you're not entitled to SSI disability benefits for any months before your application date.

And because of SSDI's five-month waiting period, Social Security will set your disability onset date up to five months before your benefit entitlement date. That means your EOD, for the purposes of payment, won't be earlier than 17 months before the date you apply for SSDI benefits.

When Social Security Uses an Older Onset Date to Deny Your Claim

Social Security uses a concept called the "date last insured" (DLI) to refer to the last quarter in which you met the work credit requirements to qualify for SSDI. To qualify for SSDI, you need to have earned 20 work credits in the last 40 quarters—that roughly means you have to have worked five of the last ten years. If you haven't worked recently, the point at which you had worked five of the last ten years would be your last date insured.

If Social Security gives you a disability onset date that's after your date last insured, you won't qualify for SSDI even if you're disabled now.

The date last insured most frequently becomes an issue when applicants wait years after becoming unable to work to apply for disability benefits. If you apply for SSDI after your date last insured has expired, you'll need proof that your disability onset date was before your DLI.

Your medical records from before your DLI are key to establishing that you were disabled prior to that point. Social Security frequently denies claims when it establishes the applicant's disability onset date to be a date after the applicant's DLI has expired because it didn't have enough evidence that the applicant's condition was disabling before the date last insured.

If you have an older disability application that was denied, you may be able to reopen that disability claim so that Social Security can use it for evidence that you had an onset date before your DLI.

How to Challenge Your Established Onset Date

You can appeal if you disagree with Social Security's established onset date. To win your appeal, you'll need proof like one of the following:

• clear evidence that Social Security made a mistake in reading your medical or employment records
• clear evidence of an error in your medical or employment records (like an incorrect surgery date in your file), or
• new medical evidence that shows you became disabled earlier than the date set by Social Security.

The award notice you receive from Social Security will tell you what you need to do to file an appeal and how long you have to do so. (Learn more about the Social Security appeals process).

If you're considering challenging your established onset date for SSDI or SSI, you might benefit by talking with a disability lawyer. An experienced attorney can review your situation and help you weigh the risks and potential benefits of appealing a partially favorable decision. (Learn more about working with a disability lawyer.)