Determining the Onset of Disability for Social Security Purposes

 Posted on January 05, 2016 in Social Security Disability Medical Conditions

An important part of any Social Security Disability insurance case is establishing precisely when the applicant's disability began. Social Security regulations require agency officials to consider three factors when determining “the onset date of disabilities of a nontraumatic origin.” First and foremost, there is the onset date claimed by the applicant. Second, there is the applicant's work history. Finally, there are medical records and “all other relevant evidence.”

While medical records weigh most heavily with Social Security officials, it is often difficult to ascertain an exact onset date from such evidence alone. In those cases, Social Security may “infer” an onset date. If such an inference is not possible, Social Security must “explore other sources of documentation,” such as testimony from family members of co-workers. However, Social Security must not infer an onset date that actually conflicts with the available medical evidence.

Social Security Claims Man's Brain Tumor Appeared “Suddenly”

Despite these regulations, Social Security administrative law judges (ALJs) often reach illogical conclusions with respect to onset dates. Here is a recent example from here in Illinois. The applicant in this case last worked in 2004. In the following years, the applicant's family noticed “his personality changed.” Eventually, he “turned into what might be described as a homeless person with psychological issues,” according to a federal magistrate's description of the record.

It turned out the applicant's problems had an ascertainable medical cause—he had a “giant tumor” in his brain. This tumor was discovered during a medical examination on May 20, 2010. While doctors were able to remove the tumor, the applicant “was still left with some residual issues like depression and memory loss.”

Accordingly, the applicant filed for Social Security Disability insurance benefits. Under Social Security regulations, a person is only eligible for benefits if the onset of the disability occurs within five years of the “last insured date,” that is, when the applicant last worked and paid into the system. Since the applicant here last worked in 2004, he had to prove an onset date on or before 2009. But the ALJ who reviewed the applicant's case denied benefits, holding the onset of his disability did not occur until May 20, 2010, the day he was diagnosed with his brain tumor.

On appeal, a federal magistrate ordered Social Security to reconsider the applicant's claim. Put simply, the magistrate found it absurd to claim the applicant's disability—his tumor—began the day it was discovered by doctors. “Surely, the [brain tumor] did not suddenly appear, 'giant'-sized, on May 20, 2010,” the magistrate said, adding, “Even Athena had a gestation period before springing fully grown and armored from Zeus's head.”

The magistrate said the ALJ failed to consider a plethora of medical and additional evidence regarding the “slow growing” nature of the applicant's symptoms. Several witnesses testified as to the applicant's degenerating mental condition dating back as far as 2006. That Social Security uniformly disregarded this evidence was “unfathomable,” according to the magistrate.

Get Help From a Disability Lawyer

As the case above illustrates, there are many times a person may become disabled over a long period of time. It is not always possible to determine the date of disability's onset from medical records alone. That is why, if you are in such a position, it is imperative you work with an experienced Chicago Social Security Disability attorney who understands the system and can make sure officials follow their own rules. Contact Pearson Disability Law, LLC, if you need to speak with a lawyer right away.

Source:

http://www.leagle.com/decision/In%20FDCO%2020151210F11/MACK%20v.%20COLVIN