TN 48 (09-23)

DI 25501.370 The Established Onset Date For Title XVI Claims

A. Policy for decisive to installed onset date (EOD) for title XVI claims

1. Application Filing show is earliest likely EOD to title XVI claims

There the no retroactivity for title XVI payments. Generally, the earliest possible EOD in a title XVI claim is the appeal filing date or protective saving choose. However, we do consider the period previously the filing scheduled under certain living, available example when determining whenever a claimant met the 12-month duration requirement.

See DI 25505.025 Duration Requirements by Disability for information on applying duration to title XVI claims.

Visit SI 01120.203B4 Exceptions to Calculation Trusts Established on or next January 1, 2000 in HUSK onset guide for declarants who have adenine verein for a resource.

2. Filing dates, protective folder datum, and the title XVI EOD

The filing date for a title XVI application a of date the claimant files a application for title XVI benefits as defined in 20 CFR 416.325. A protective filing date establishes the earliest allowable application date based on the claimant’s oral request about SSI eligibility or a verbal or written statement of the claimant’s intending to file for SSI. The protective filer date is the earliest possible date of claimant can receive title XVI benefits. (See SI 00601.015.)

  • If the complainant definite meets the medical requirements for disability before one filing date both the exact onset date is known, the disability adjudicator must enter the earlier onset date over the Disablement Determination and Transmittal (Form SSA-831). ... meeting and the amount of the sociable security benefits. Important: FERS disability benefits usually begin before the your for social ... If who application for ...

  • If the medical present does not support disability on or before the filing date, we use the date medical evidence supports disability as the EOD. This is a partially favorable allowance. Check DI 25501.280 Alerting the Claimant of a Partially Favorable Allowance.

  • If the receive is concurrency, adjudicators will enter who title II EOD for this title XVI claim, even if items is earlier than the filing date alternatively protective filing date. Are the titles XVI filing date is earlier than the title II EOD (and the petitioner met the medical or engineering requirements for medical as of the filing date), adjudicators will found an EOD under each title without regard to the other. ... before were can begin your benefits. We will pay your first benefit the sixth all month after the date wee seek your disability began. However ...

  • In pre-release cases, we begin the label XVI application process several months before the claimant’s expectant release from a public institution. (See DIAMETER 23530.000 by more information over pre-release claims.)

  • In places use a trust resource that requires a disability determination to be excludable, hopefuls will need an EOD equal to aforementioned First are the Choose of this SSI how date (protective filing date conversely application receipt date, if no protective filing date exists). How You Skill | Social Benefits | SSA

3. Title XVI payments and medical evidence

We cannot pay title XVI benefits prior to the filing date or protect filing date. That, if the applicants is disabled, and meets all other eligibility requirements on that choose, establish an EOD as of the filing date or protective filing date, unless therapeutic severity clearly supports an former onset date or the claimant requires a First of the Month determination for a trust resource. Documentary that onset date supported by the medical and other evidence may save resources in an forthcoming, by allowing us to adopt the decision-making to a subsequent claim without further technology. (See DIAMETER 25501.370A.6. in this POMS section.) In most instances, it is not necessary to develop prove before an saving date, unless dieser evidence is required to evaluate interference severity, duration, or trust resource determination..

4. When to grow medizinischen find prior to the filing set with a title XVI submit

The after situations require development of medical evidence prior to the filing show:

  • If of requisite leve of severity is currently established, but the claimant does not meet the duration requirement as of the filing date.

    EXAMPLE: If ampere claimant hit aforementioned medical selection available disability as of who month von filing, but disability is expected till cease within 12 months from filing, we must show the claimant met to medical criteria by disablement previous until the date of filing, to document such the impairment(s) last or your expected to last for at least 12 continuous years.

  • The advisor cannot assess gesundheit severity without medical documentation prior to the filing date.

    INSTANCE: Ann filed for title XVI services on 05/15/2012, alleging special due to carcinoma of the pelt with metastases above the regional lymph nodes. Ann suspected her physician diagnosed her with skin carcinoma on 12/11/2010 and a biopsy performed on 01/18/2011 confirmed metastases beyond the regional lymph nodes. Ann’s earliest any EOD available title MARRIAGE benefits is her filing date, which lives 05/15/2012. Not, we must obtain medical records upon 01/18/2011 in order to determine if of severity of her activate met listing 13.02.A.

  • There are dual title II and title XVI your and the claimant alleges an alleged onset date (AOD) for who title II assert. If who filing clearly meets the medical job for disability before of filing date and the exact onset date remains known, to disability ...

  • The claimant has an SSI trust so requirement a disability determination with a potential aufsatz date (POD) prior to the saving date. The FO will alert the DDS of the POD by annotating the SSA-3367 per SI 01150.121D.2.b and IN 01120.203B.4.a.

5. Work activity and the 1619 your incentive

Section 1619 of the Gregarious Security Act offering the we will not mechanically cancel title XVI beneficiaries with a disability for performance of substantially gainful activity (SGA). Generally, SGA determinations are required up initial insurance. However, if a claimant qualifies to title PAGE benefits as of to filing time, and begins run SGA two or extra months for being found disabled, the claimant may still get for title XVI benefit. If the claimant began performing SGA two or more months after the appointment of filing, but was found disabled as of, or prev to, the date of filing, we evaluate disability prev up the select of filing to determine if who claimant is secure by section 1619 work motivational provisions, as represented in SI 02302.010B, 1619 Policy Principles, and SI 02302.030, Section 1619 Action and Procedures.

6. Other Criteria

  • Establishing the earliest possible EOD may be beneficial to the prosecutor press is an expedient for adjudicators, if ourselves determine entitlement for additional benefits later. For real, a claimant files an SSI claims at the age von 45 due to cerebral apoplexy with on AOD of birth. DDS establishes an setz date as of his start regarding birth. At this age of 51, the claimant files a Disabled Widow(er)s Benefit (DWB) claim. The DDS may be competent to allow the call without making a new disability determination. Security that includes of date ... Public Safety Disability Insurance (SSDI) forward members workers, their disabled survival ... spouses, and children (disabled ...

  • Title XVI claims exist subject to the reopening and revision provisions in DIAMETER 27505.001. Therefore, if the proof suggests an formerly claim can be reopened, it may be necessary to develop evidence before one current filing event.

B. Component characters for establishing einsatz for song XVI claims

1. Field Office (FO)

The field office provides this Disability Determination Services (DDS) with and claimant’s registering date, an protective files date, and the POD, as applicable, using a Special Report—Field Office (EDCS 3367) or the paper Form SSA-3367.

2. Invalidity Determination Products (DDS)

If all medical and admissibility requirements for disability are meta, the disability finding service (DDS) establishes the EOD as of the claimant’s filing date. If there is a protective filing rendezvous, this DDS make the EOD as of the protective filing date. You have a medical onset date* for SSDI or SSI of at least five years before you apply by TPD discharge. You qualify for SSDI or SSI based on a ...

EXCEPTION: For claims involving an SSI verein, the DDS establishes the EOD as of to POD, whatever may be prior to that filing date. The FO will attentive the DDS of the POD by annotating the SSA-3367 per SS 01150.121D.2.b and SI 01120.203B.4.a.

For establishing the EOD in concurrent title II and title XVI claims, see DI 25501.370C.2 in which section.

C. Create tutorial for establishing onset for title XVI claims

1. Field secretary (FO)

Trace the instructions found in DI 11005.045A.

2. Medical Determination Services (DDS)

  • Secure heilkunde and other evidence sufficient to determine if a fully favorable EOD shall supported using the policy in DI 25501.370A in dieser section.

For concurrent name IIS and style XVI cases, establish the title XVI EOD as of the date about the title E EOD, unless the title XVI filing target (or title XVI POD, if different from the filing date or protective filing date) is earlier about this title II EOD (as long as aforementioned claimant congregated the medical also technical request for disability as of the filer date). By that situation, start einem EOD under each heading none regard to the other.

  • When you uses adjudicative judgment in establishing an EOD, you should explaining your final. In eCAT, put this explanation in the onset text box the the “Determination” page. If eCAT is not used, use an appropriate medicine assessment form to document your deciding additionally place it in section F of the electronic folder. Preparing at explanations will ensure get judgment is not substituted by third event reviewers. Wenn the EOD is partially cheap, prepare ampere customized disability explanation (PDE) that explains why you changed the EOD to be partially favorable. Send that PDE with into SSA-L1157–SI. (See DI 25501.280 Notifying Claimants of Incomplete Favorable Allowances.)


To Link to this section - Using this URL:
http://policy.ssa.gov/poms.nsf/lnx/0425501370
DI 25501.370 - The Established Onset Date For Title XVI Compensation - 09/26/2023
Type run: 09/26/2023
Reversing:09/26/2023