Tuesday, February 9, 2010

Retrospective Medical Opinion

Is an applicant entitled to receive Social Security Disability (“SSD“) benefits even if she has not worked in over 15 years? The answer might be yes.

To receive SSD benefits, you must establish that you became disabled before your “date last insured (“DLI”)” expires. I have consulted with many people who came to see me after they had been told that they were ineligible for SSD benefits because their DLI had passed. However, just because your DLI has expired does not preclude you from establishing you became disabled before then.

I represent a 48 year old woman who stopped working as a receptionist in 1992 because of depression. Her DLI was December 1997. She applied for SSD benefits November 2007, and had been unable to find an attorney willing to accept her case. Late last year, just before her hearing, she retained me.

The claimant had been treating for her depression steadily since 1994, including treating with her current psychologist since 1998. I amassed all of the claimant’s treatment records, and asked her psychologist to review them. Then I had the psychologist complete narrative and functionality reports to explain why the claimant had been unable to work since 1994. Based on the treatment records and the psychologist’s disability opinion, Administrative Law Judge Ronald Waldman approved the claimant’s SSD benefits.

Even though the claimant had not worked in more than 15 years, and even though her DLI had expired over a decade ago, the claimant’s 2007 SSD application was approved. The DLI is not akin to a statute of limitations that bars claims after a certain period of time. As long as the clinical and diagnostic evidence supports a treating doctor’s retrospective opinion that a claimant became disabled before the DLI, that claimant’s application should be approved.

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