If I file a new claim after a hearing denial, how do they calculate back pay? The date of last insured is Dec. 31 2013. Would they go back to my first alledged AOD? Or I guess its what ever I put on my new app...does any one know???
If I file a new claim after a hearing denial, how do they calculate back pay? The date of last insured is Dec. 31 2013. Would they go back to my first alledged AOD? Or I guess its what ever I put on my new app...does any one know???
Social security will not go back more than 1 year from the initial application date for backpay purposes.
AOD = alledged onset of disability = when you say when you became disabled.
EOD = Established Onset of Disability set by SS = when they say you were disabled.
Example:
1. You file 2nd new application today = 9/28/2011
2. Your AOD (1st application) was 1/1/2008
3. SS denied your 1st application at level 3 so you decide to file a 2nd
application.
4. When you file the second application on 9/28/2011, you still alledge your
disabilty started on 1/1/2008.
5. You are approved and it was detemined this 2nd time that you were
indeeed disabled on 1/1/2008.
6. But, the initial application date on your 2nd claim is 9/28/2011.
7. Even tho SS found you disabled on 1/1/2008, they only will go back 1
year prior to the initial application date for backpay/medicare purposes.
8. One year prior to 9/28/2011(2nd initial application date) = 9/28/2010
9. Backpay is from 9/28/2010 to present even tho they found you disabled
on 1/1/2008.
10. Since they agreed you were disabled on 1/1/2008, you have satisfied
the 5 month waiting period for the 9/28/2010 onset.
11. You are eligible for medicare on 10/2012.
HTH
Last edited by BlueSkies14; 09-28-2011 at 06:08 PM.
The Following User Says Thank You to BlueSkies14 For This Useful Post: ferd144 (11-01-2011)
The preceding post I made was in error. It seems if you file a new claim after a level 3 (ALJ) denial, your new AOD on the 2nd application must be a date after the date the ALJ denied your initial claim.
I also post infrequently in another SSDI forum. They have both a SSDI attorney and the owner of the forum who worked for the SSA over 30 years before retiring who post there occasionally and they both offer some excellent tips. I posted in that forum "was it better to perhaps start a new claim after being denied at the ALJ level". Here is what the attorney wrote back to me. HTH someone.
Quote:
Expect to refile a new claim after a full ALJ hearing denial with your
alleged onset of disability (AOD) at least 1 day *after* the hearing denial
date. Judges rarely "invade" prior hearing denials unless there is a
dramatic issue with missing evidence. ALJ hearing dismissals, on the other
hand, can allow you to use your reconsideration denial date as your AOD.
Hearing dismissals occur when no hearing happens, such as when you miss
your hearing without a good reason (good cause) or withdraw from one before
it happens.
Consider that recently, SS has forced claimants to choose between appealing
hearing decisions to the Appeals Council and refiling (a now infamous
Social Security Ruling 11-1p). You used to be able to have both going on.
I am saying this because it is not always bad to refile. Appealing your
hearing decision is essentially the only way to argue for your past
benefits after full hearing denials. But consider this: Historically, the
Appeals Council can take 6 months to a year or more to decide. Remands go
back to the same ALJ the first time. I sometimes tell clients now (since
the ruling) that if their medical problems have gotten worse, locking in
ongoing benefits may be more important than arguing for back-pay. Kind of
blunt, but if previous medical records are not clear enough to prove
disability, ongoing survival needs to trump principal.
Andrew
The preceding post I made was in error. It seems if you file a new claim after a level 3 (ALJ) denial, your new AOD on the 2nd application must be a date after the date the ALJ denied your initial claim.
I orginally filed for disablity a year before , and was denied, I did not go any further. When I decided to file again a year later , i was not able to use the orginal onset date, I lost backpay because of this . the first claim did not go all the way to the ALJ, so it applies to anyone , if they start over a claim.
Did you stop pursuing the initial claim after level 1 or 2 denial, Mscat? Why did you not appeal to level 3? Did you have a lawyer then or were you going it alone?
Did you stop pursuing the initial claim after level 1 or 2 denial, Mscat? Why did you not appeal to level 3? Did you have a lawyer then or were you going it alone?
I stopped after I was at level 1 , I listed my condition as clinical depression only , and thought it was not good enough to win. Unfortunately my condition only got worse and worse, so did the diagnoses , and it was before i got burned > I did not really know what I was doing and had no help . After the year had passed my mental health was a mess , and going through the severe burns/that was the physical part , I only had to appeal at the reconsideration stage and won.
Thanks Mscat. Let me ask you something. Did you have a lawyer the 2nd time you applied? I don't remember.
No I did not have a Lawyer. However, I was fully prepared to get one if I lost at the reconsideration level. I was not hopeful I would win. I will tell you something though, I took pictures of my burns.... It was actually pretty disturbing, but I wanted social security to know how serious the burns were, I think to this day that is how i won. It was the "gross" factor. Evenso I have a lot of mental health issues too. I still think that if I had not added those pictures i mayhave not been approved. I thought that social security probably had all the medical records , but sometimes a picture speaks volumes.
Yeah, I agree Mscat. A picture can often convey what you can not with words alone. You had a good strategy btw. Get a lawyer if denied at level 2.
thank you BlueSkies I do not know what I thinking at the time to take those pictures, it may have been I had a new camera .My therapist even told me that was a good thing to do . As painful and embarassing as it was , i took a shot in the dark. I have since become more stable , and feel a lot better now , time really can heal. I do see the therapist regulary and Psych. Dr. every couple of months. I am not sure if I could work a SGA right now , and even brough it up to the therapist, he did not think so either, that was disheartning. I thinkl I am better off right where I am at. I am now 43, so i may sound young to a lot of people ,but feel so old all the time.
I thought that social security probably had all the medical records , but sometimes a picture speaks volumes.
