Social Security Disability Notice of Award Question

"I used your RFC form to help my sister win her disability appeal at the reconsideration level. Thank you for posting this invaluable document on your website.

Her Notice of Award has a mistake in her date of eligibility. She was found disabled under SSA rules on April 2, 2014, but her eligibility date is listed as August 2015. Given the required five full-month waiting period, her eligibility date should be October 2014 (something the SSA folks agree with over the phone).

She has received back pay from August 2015, but I'm trying to get retroactive pay from October 2014 for her, too. Her local field office says the case was sent to the "payment center" almost two months ago, but I can't get more of an update than that. My question is: Does she need to file some kind of appeal paperwork for the error? I don't want to appeal the decision since it was favorable, but her 60-day window is approaching for filing an appeal if something like that is necessary.

Fixing the eligibility date is important because of the retroactive pay, but also because she would be eligible for Medicare sooner as well.

Any thoughts on how I should proceed?"

Without knowing the exact facts of your sister's disability claim and the decision it is hard to make a comment as to why her eligibility date is 08/2008, if she was actually found to be disabled under SSA rules as of 04/02/2007.

Most likely when you called the local Social Security office your call was answered by a service representative not a claims representative. Service representatives do not process disability claims, consequently it is likely that the service representative agreed if your sister was found disabled as of 04/02/2007 that she would actually be entitled 10/2007. The service representative may not have even looked at your sister's award letter or even her master beneficiary record when you called. Most likely they checked to see if the payment center was working on your sister's disability claim and that was it.

That being said, there is always a chance that any appeal of a disability onset date could result in a reopening of your sister's disability claim, and there is no guarantee that Social Security would find her disabled again. Social Security considers an onset appeal as another look at the total disability claim not just the period of 04/2007 - 08/2008 , therefore the decision to file an appeal of onset should be weighed out very carefully.

There is a chance that your sister's date of eligibility was not a mistake and that Social Security decided to approve her disability claim but decided to change her date of onset (the date she was found to be medically disabled to work).

Social Security can change an individual's allegation of disability onset, if they find there is not enough medical evidence to support their alleged date of onset. It does not appear your sister's date of filing had any affect on her back benefits by the information you have provided in this message, and that would be the only other thing that I can think of that might affect her month of eligibility. Social Security is only allowed to pay twelve months of retroactive disability benefit provided that an individual has actually been unable to perform substantial work activity for seventeen months (five full calendar months for the waiting period and twelve months back from the date of filing).

Without knowing the full details of your sister's claim, I would say that your sister had a change of onset to sometime in February/2008 thus giving her an entitlement date of 08/2008.

If your sister's eligibility date is truly an error, which I am not saying could not have happened, you should not need an appeal.

You should probably have your sister call her local Social Security office and ask to speak to the claims representative who handled her disability claim. The claims representative should be able to have the error corrected with a quick call to the payment center.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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