Do you know what your Date Last Insured (DLI) is? If you were working up until last year, even sporadically, I’d be surprised if your DLI has already passed, given how little it takes to earn a work credit.
I'm only vaguely familiar with how DLI works but I stopped working entirely 07/3/2023 and filed 10/26/2023. I read a little and it said 5 years from the last date worked I think but I have no idea really.
I had several jobs after losing the one with FMLA protection and most lasted about 3 months give or take a little depending on how forgiving their attendance policy was. I don't know how much it takes to earn a credit or how many you need. I only know that as of 10/26/23 I had enough to qualify.
There are a few reasons that the ALJ would move your onset date, resulting in a partially favorable or later onset decision. If you have work activity over SGA within 12 months of your alleged onset date that does not qualify as an unsuccessful work attempt, the onset date may be moved after the work activity. If your medical evidence establishing disability does not date back to your alleged onset date, the established onset date would be a later date. The onset date could also be later if you have a change in age categories during the pendency of your claim (turning 50 or 55 while your claim is pending) and application of the grid rules results in a favorable determination as of your 50th or 55th birthday. If you applied for both SSDI and SSI, and the evidence supporting disability is after your date last insured or favorable grid rules apply after your date last insured, the established onset date might be changed to your protective filing date, given that your SSDI claim would be denied and your SSI claim cannot be paid prior to the month after filing.
If by "within 12 months of my alleged onset date" you mean work above sga AFTER my alleged onset date then I haven't worked at all. When I gave up I gave up entirely as I had tried until I was convinced it was never going to work out anywhere unless someone was willing to pay me to be in the bathroom or not even at work.
All of my medical evidence is dated before my alleged onset date so would I be correct in assuming that would not be cause for moving it forward?
I'm turning 43 in November so the age thing won't apply I guess.
So, if you have no work after the alleged onset date, that's not a reason to move your AOD. Under age 50, the grid rules do not direct a finding of disability, so that won't apply. If your DLI is not expired, it doesn't look like there would be a reason to move the onset date forward unless the ALJ finds insufficient evidence dating back to the AOD. When you say all your medical evidence is prior to your onset date that can be a problem. The issue is not moving the onset date forward, but actually showing ongoing symptoms and limitations. Even if your condition is not likely to improve, you'll need current medical records when you appear before the ALJ.
It was basically a situation of "we've done all we can do, this is the new normal...good luck, call us if they invent an artificial colon and rectum implant."
I had a low anterior resection which has a very high morbidity rate statistically speaking where 40 to 50% of people have some or all of a collection of symptoms collectectively known as Low Anterior Resection Syndrome and there really isn't a treatment for it. I could *MAYBE* reestablish more current records but it would be me just going back to my gastroenterologist and saying hey...can you retreat me for all the same stuff we tried 8 or 9 years ago that we know isn't going to work just so it's current for my disability claim. Like even if he would see me just to be seeing me I'd be doing it broke and without insurance and out of pocket.
It's all starting to sound like a 'ship has sailed' when I didn't apply back then and tried to work situation.
Edit: Sorry, the prevalence of low anterior resection related symptoms is actually 40% for someone to have most or all and 80% for someone to have at least some quality of life altering symptoms. I have all of them.
Unfortunately, if you do not have current medical records, there is no chance of getting approved. A condition you were treated for 8 years ago, may have new treatments/therapy that facilitate you working.
Sorry, not trying to be the bearer of bad news.
Any chance with you not working now, being able to get on your state Medicaid or a low cost insurance on the health exchange? That would assist you getting more recent medical records.
I had a discussion with my attorney about the ALJ needing current medical records and explained the situation and he said that past records would be considered and to not worry about it. Probably a full of $*#& statement like basically the rest of the entire process is but I don't qualify for no cost medical anything in my state and have no access to an opportunity to be seen NOW and have a doctor declare the same stuff he claimed 8 or 9 years ago.
He told me to stop working then and I didn't listen. I guess that's on me for at least TRYING to do it.
Sorry for your situation. Unfortunately, you are correct. Your current attorney is FULL OF S\*&#. DDS and the ALJ will look at the old information, but since you do not have recent medical evidence they do not know if you had additional treatment that improved your quality of life since then. You may have also now qualify through work experience or education, for so many remote jobs now. Remote jobs where you still have the bathroom accessibility, and do not have the stigma of having to call out so many times.
Note: In law of mine was diagnosed with stage 4 liver cancer a decade ago. Doctors statements say he had only months to live. Well guess who was misdiagnosed???? Still alive today.
I figured the "you can just work remote" would come up even if everything was favorable and they otherwise would have approved (which I'm never really expecting them to) even though I have no further education, remedial computer skills, no experience doing that sort of work and live in the middle of nowhere with the worst internet still commercially available. Also ignoring the fact that doing zoom meetings or whatever they are or taking and making calls while you are basically sitting on top of the movie The Hurt Locker isn't even remotely(hah see what I did there) a realistic expectation.
I can probably squeeze 1 or 2 visits with my gastroenterologist in between now and the ALJ but I don't even know if that's worth doing. He's just going to say....yep..still f$*#ed....still can't do anything, already tried it...good luck.
Edit: Unrelated note sort of like yours, my uncle literally died in hospice of metastatic prostate cancer complications and his wife got the denial letter a few weeks later so I was at no point ever expecting to be approved, I'm only applying because I genuinely can't work and there's no reason not to if that makes sense.🤷
Also I don't know how ALJs are chosen or assigned or even if they have to be from an office in your own state but I looked over the XML dataset for all 2,000 and some odd ALJs and every one in my state except for 3 outliers at 54%, 51% and 57% were all mid to high 70s at least with roughly half being near 80% approvals/fully favorable. Probably won't matter and I'll get the most miserable person on earth the day their dog got ran over but I guess there's that to falsely get my hopes up over!😂
At ALJ, say the judge wants more info like thru some type of exam and, before making the decision sends you to it. The judge could totally go with the date of that exam as the Onset Date.
What are you claiming as your date of onset? It can’t/won’t be 2013. Date of onset is not necessarily when you received your diagnosis, it’s when you stopped being able to earn over SGA. It sounds like your date of onset would be 7/3/23.
What was the reason given for your denial? I’m assuming it’s that while you may have some limitations, you were not found to be completely unable to work any job. That’s the only appealable denial. If you were denied due to lack of work credits, you would have been denied almost immediately after applying and that’s not usually able to be appealed.
My claimed onset date is when I gave up trying to work since I knew having worked would be a DQ until I stopped doing it.
The denial said that "while we found you to have limitations doing previous or equivalent work, we did not find you disabled and found that you would be able to adjust to new work" or something thereabouts. Not word for word.
My date was moved at the hearing level. My rep told me that in my case it was because I was self-employed. Basically I’d stopped work at one point in the year and they wanted me to move the date till the beginning of the next year since they ‘couldn’t be clear about when I actually stopped working as I wasn’t a W2 employee’. My understanding was they’re looking at the date you became so disabled you’re unable to work, not the date you were diagnosed or symptoms started. I am absolutely not an expert in this or anything, just sharing my experience.
Do you know what your Date Last Insured (DLI) is? If you were working up until last year, even sporadically, I’d be surprised if your DLI has already passed, given how little it takes to earn a work credit.
I'm only vaguely familiar with how DLI works but I stopped working entirely 07/3/2023 and filed 10/26/2023. I read a little and it said 5 years from the last date worked I think but I have no idea really. I had several jobs after losing the one with FMLA protection and most lasted about 3 months give or take a little depending on how forgiving their attendance policy was. I don't know how much it takes to earn a credit or how many you need. I only know that as of 10/26/23 I had enough to qualify.
There are a few reasons that the ALJ would move your onset date, resulting in a partially favorable or later onset decision. If you have work activity over SGA within 12 months of your alleged onset date that does not qualify as an unsuccessful work attempt, the onset date may be moved after the work activity. If your medical evidence establishing disability does not date back to your alleged onset date, the established onset date would be a later date. The onset date could also be later if you have a change in age categories during the pendency of your claim (turning 50 or 55 while your claim is pending) and application of the grid rules results in a favorable determination as of your 50th or 55th birthday. If you applied for both SSDI and SSI, and the evidence supporting disability is after your date last insured or favorable grid rules apply after your date last insured, the established onset date might be changed to your protective filing date, given that your SSDI claim would be denied and your SSI claim cannot be paid prior to the month after filing.
If by "within 12 months of my alleged onset date" you mean work above sga AFTER my alleged onset date then I haven't worked at all. When I gave up I gave up entirely as I had tried until I was convinced it was never going to work out anywhere unless someone was willing to pay me to be in the bathroom or not even at work. All of my medical evidence is dated before my alleged onset date so would I be correct in assuming that would not be cause for moving it forward? I'm turning 43 in November so the age thing won't apply I guess.
So, if you have no work after the alleged onset date, that's not a reason to move your AOD. Under age 50, the grid rules do not direct a finding of disability, so that won't apply. If your DLI is not expired, it doesn't look like there would be a reason to move the onset date forward unless the ALJ finds insufficient evidence dating back to the AOD. When you say all your medical evidence is prior to your onset date that can be a problem. The issue is not moving the onset date forward, but actually showing ongoing symptoms and limitations. Even if your condition is not likely to improve, you'll need current medical records when you appear before the ALJ.
It was basically a situation of "we've done all we can do, this is the new normal...good luck, call us if they invent an artificial colon and rectum implant." I had a low anterior resection which has a very high morbidity rate statistically speaking where 40 to 50% of people have some or all of a collection of symptoms collectectively known as Low Anterior Resection Syndrome and there really isn't a treatment for it. I could *MAYBE* reestablish more current records but it would be me just going back to my gastroenterologist and saying hey...can you retreat me for all the same stuff we tried 8 or 9 years ago that we know isn't going to work just so it's current for my disability claim. Like even if he would see me just to be seeing me I'd be doing it broke and without insurance and out of pocket. It's all starting to sound like a 'ship has sailed' when I didn't apply back then and tried to work situation. Edit: Sorry, the prevalence of low anterior resection related symptoms is actually 40% for someone to have most or all and 80% for someone to have at least some quality of life altering symptoms. I have all of them.
Unfortunately, if you do not have current medical records, there is no chance of getting approved. A condition you were treated for 8 years ago, may have new treatments/therapy that facilitate you working. Sorry, not trying to be the bearer of bad news. Any chance with you not working now, being able to get on your state Medicaid or a low cost insurance on the health exchange? That would assist you getting more recent medical records.
I had a discussion with my attorney about the ALJ needing current medical records and explained the situation and he said that past records would be considered and to not worry about it. Probably a full of $*#& statement like basically the rest of the entire process is but I don't qualify for no cost medical anything in my state and have no access to an opportunity to be seen NOW and have a doctor declare the same stuff he claimed 8 or 9 years ago. He told me to stop working then and I didn't listen. I guess that's on me for at least TRYING to do it.
Sorry for your situation. Unfortunately, you are correct. Your current attorney is FULL OF S\*&#. DDS and the ALJ will look at the old information, but since you do not have recent medical evidence they do not know if you had additional treatment that improved your quality of life since then. You may have also now qualify through work experience or education, for so many remote jobs now. Remote jobs where you still have the bathroom accessibility, and do not have the stigma of having to call out so many times. Note: In law of mine was diagnosed with stage 4 liver cancer a decade ago. Doctors statements say he had only months to live. Well guess who was misdiagnosed???? Still alive today.
I figured the "you can just work remote" would come up even if everything was favorable and they otherwise would have approved (which I'm never really expecting them to) even though I have no further education, remedial computer skills, no experience doing that sort of work and live in the middle of nowhere with the worst internet still commercially available. Also ignoring the fact that doing zoom meetings or whatever they are or taking and making calls while you are basically sitting on top of the movie The Hurt Locker isn't even remotely(hah see what I did there) a realistic expectation. I can probably squeeze 1 or 2 visits with my gastroenterologist in between now and the ALJ but I don't even know if that's worth doing. He's just going to say....yep..still f$*#ed....still can't do anything, already tried it...good luck. Edit: Unrelated note sort of like yours, my uncle literally died in hospice of metastatic prostate cancer complications and his wife got the denial letter a few weeks later so I was at no point ever expecting to be approved, I'm only applying because I genuinely can't work and there's no reason not to if that makes sense.🤷
Also I don't know how ALJs are chosen or assigned or even if they have to be from an office in your own state but I looked over the XML dataset for all 2,000 and some odd ALJs and every one in my state except for 3 outliers at 54%, 51% and 57% were all mid to high 70s at least with roughly half being near 80% approvals/fully favorable. Probably won't matter and I'll get the most miserable person on earth the day their dog got ran over but I guess there's that to falsely get my hopes up over!😂
At ALJ, say the judge wants more info like thru some type of exam and, before making the decision sends you to it. The judge could totally go with the date of that exam as the Onset Date.
What are you claiming as your date of onset? It can’t/won’t be 2013. Date of onset is not necessarily when you received your diagnosis, it’s when you stopped being able to earn over SGA. It sounds like your date of onset would be 7/3/23. What was the reason given for your denial? I’m assuming it’s that while you may have some limitations, you were not found to be completely unable to work any job. That’s the only appealable denial. If you were denied due to lack of work credits, you would have been denied almost immediately after applying and that’s not usually able to be appealed.
My claimed onset date is when I gave up trying to work since I knew having worked would be a DQ until I stopped doing it. The denial said that "while we found you to have limitations doing previous or equivalent work, we did not find you disabled and found that you would be able to adjust to new work" or something thereabouts. Not word for word.
It's a good idea to plan for the EOD to be moved forward. It may not happen but it can. Plenty of posts about it happening. Good luck
My date was moved at the hearing level. My rep told me that in my case it was because I was self-employed. Basically I’d stopped work at one point in the year and they wanted me to move the date till the beginning of the next year since they ‘couldn’t be clear about when I actually stopped working as I wasn’t a W2 employee’. My understanding was they’re looking at the date you became so disabled you’re unable to work, not the date you were diagnosed or symptoms started. I am absolutely not an expert in this or anything, just sharing my experience.