When a person files a claim for disability benefits with the Social Security Administration, they will be asked, “What is the Alleged Onset Date of your disability?” I like to explain to my clients that it is more of a legal term than a medical one. What Social Security is really asking is, “When did you need to stop working full-time due to your disabling medical condition(s)?”
What Is the Alleged Onset Date In My Disability Claim?
In Title II SSDI disability claims and Title XVI SSI adult disability claims, the alleged onset date (AOD) is always the date the claimant alleges they became unable to work because of their medical condition, whether or not that date appears to be appropriate or in line with the evidence. For the Social Security Administration’s more formal definition of “AOD,” click here: Alleged Onset Date.
For example, let’s say that John started having back pain on January 1, 2019. He worked full-time through the pain for several years until January 1, 2021, when he had to stop work entirely due to debilitating back pain. When asked, “What is the Alleged Onset Date of your disability?” John will logically think and say, “January 1, 2019.” After all, that is when his back pain started. However, for purposes of his Social Security disability claim, his Alleged Onset Date is more appropriate as January 1, 2021, because this is the date he stopped work due to his condition.
With Social Security Disability Insurance (SSDI), you can receive retroactive pay as far back as 12 months before the date you apply for benefits. Of course, to receive retroactive benefits before the application date, you must be found disabled before the application date. To obtain a full 12 months in backpay benefits, you must establish that you became disabled at least 17 months before the date you applied. That’s because there is a five-month waiting period after the onset of disability, during which benefits are not paid or owed.
[Note: There is no retroactive pay for Supplemental Security Income benefits (SSI). If approved for SSI, you receive benefits as of the first month after your application.]Why Is My Alleged Onset Date Important?
Your disability onset date determines how much you will receive in past-due benefits, called “back pay” or “past-due” benefits. For example, let’s say that you applied for SSDI on December 1, 2022, and you alleged in your application that your disability began on September 1, 2022. The Social Security Administration (SSA) reviews your claim and issues a decision on December 1, 2023, approving you for benefits. If the Social Security Administration agreed with your onset date of September 1, 2022, you would qualify for backpay benefits from February 1, 2023, to the present (five months after your AOD of September 1, 2022).
On the other hand, let’s assume that the Social Security Administration disagreed with your onset date and set February 1, 2023, as your “established onset date” of disability. You would qualify for less back pay and receive benefits only from July 1, 2023 (five months after your established onset date of February 1, 2023). This move by the SSA cut out several thousand dollars of your past-due benefits.
The onset date can also determine whether your claim is approved since you must be disabled for 12 months (or be expected to be disabled for 12 months) to qualify for disability benefits. The onset date is when the clock starts ticking for this 12-month durational requirement.
When Can Social Security Change Your Onset Date?
The date you enter on your application for benefits is your “alleged onset date,” or AOD for short. After evaluating the evidence in your claim, Social Security may accept this date as the date your disability began. If Social Security disagrees with the date you say you became disabled, it can establish an onset date later than you think is appropriate. To determine your established onset date (EOD), the SSA will look at your alleged onset date (AOD), when you last worked, and what the medical evidence shows. If the SSA changes the onset date from your AOD, it sets your established onset date. However, the SSA must explain why your alleged date is inappropriate and why its EOD is correct.
What Can You Do If the SSA Changes Your Onset Date?
If the SSA changes your AOD to a later EOD, you will lose some backpay, and your eligibility for Medicare or Medicaid will be delayed. However, you can appeal the established onset date by asking Disability Determination Services (DDS) to reconsider the EOD. Or, if your EOD was set at the reconsideration level, you can ask an administrative law judge to review the EOD at a hearing. If an ALJ sets the EOD at a hearing, you can appeal to the Appeals Council.
Should I Appeal the Amendment of My Onset Date?
When you appeal the onset date, the scope of review is not limited to the dates. Your entire claim is up for review. The DDS or SSA can review the disability determination itself on appeal, and – in a “worst-case scenario”- an adjudicator could reverse your approval and say you are not disabled at all. If you’ve been approved for benefits, you should speak to an experienced disability lawyer for a case evaluation to determine whether you should appeal an EOD.
Sometimes, when the SSA changes your AOD to a later EOD, the EOD is still more than 17 months before the date you applied for disability benefits. In such a scenario, the change in the onset date will not matter because you cannot receive retroactive back pay benefits for more than 12 months before your application date (plus the five-month waiting period) anyway.
When Are the AOD and EOD the Same?
Suppose you are approved for disability benefits. Social Security determines that your disability began on the same date you alleged in your application. In that case, the AOD is effectively the same as the EOD.
Your Alleged Onset Date Is Just the Starting Point
The claimant’s AOD is the starting point in deciding the established onset date. The EOD is when Social Security establishes the claimant first meets the medical, vocational, and other entitlement or eligibility requirements for disability benefits. If the medical and other evidence in the claim file is consistent with the AOD, the AOD will become the EOD. If other non-medical factors in evidence prohibit the disability examiner (DE) from establishing an EOD as of the AOD, the field office (FO) proposes a potential onset date (POD). One example would be evidence of work activity or too many assets for a couple of months to qualify for SSI after the AOD.
The AOD May Be The Last Day of Substantial Gainful Activity (SGA)
Social Security considers the date the claimant stopped performing “substantial gainful activity” (SGA) when establishing the EOD. The Social Security Administration will not establish the onset date before the last day SGA was performed.
When Do Your Disability Payments Begin?
If approved for SSI disability benefits, your monthly benefits will start the first month following your established onset date. If you are approved for Social Security disability, you have a five-month waiting period from your EOD before benefits begin. Either way, your disability claim will probably be approved long after the onset date of your disability. Therefore, you will likely be owed some monthly back payments for the period while you are waiting for a decision.