TN 11 (11-12)

Citations:

20 CFR 404.131

A. Policy for date last insured and EOD

1. What is the date last insured?

The date last insured (DLI) is the last day of the quarter a claimant’s meets insured status for disability or blindness. For title II Disability Insurance Benefit (DIB) claims, adjudicators cannot establish onset after the DLI.

NOTE: We compute the DLI for claimants who apply for DIB due to statutory blindness based on fully insured status alone. For more details on fully insured status, see RS 00301.150. If a claimant is fully insured at the time of the EOD, he or she meets insured status for the purpose of establishing an EOD based on blindness. For instructions on onset and blindness, see DI 25501.380.

2. There can be more than one DLI

There are situations where there may be more than one DLI.

• At the EOD, a claimant who meets our statutory definition of blindness has to be fully insured at the time he or she meets our statutory definition of blindness; while a claimant who is disabled must be both currently and fully insured at the time he or she meets our medical and technical requirements for disability. Thus, there can be one DLI for blindness and another DLI for disability.

• A claimant may have more than one DLI if he or she has quarters of coverage for both Medicare Qualified Government Employee (MQGE) benefits and quarters of coverage for DIB.

• A claimant who does not have a steady work history may have more than one DLI based on multiple periods of insured status.

3. Disability Insured Status Calculator (DISCO) and the Disability Wizard (DIBwiz)

The DISCO program retrieves online earnings, NUMIDENT, and supplemental security record data to produce DIB insured status calculations. DISCO calculates and displays periods when a claimant is insured for title II benefits. The Disability Wizard Quality Management Tool (DIBwiz QMT) helps to establish proper EODs and to identify prior entitlement and T2 insured status. The field office (FO) may use either of these tools to assess key technical entitlement issues, such as insured status, earnings, and prior filings.

Additional information on DISCO, DIBwiz and other tools are available on the toolbar support website at http://toolbar.ssahost.ba.ssa.gov/.

B. Component roles regarding the relationship between the date last insured and EOD

1. Field office (FO)

The FO provides the Disability Determination Services DDS with the DLI. If the claimant alleges a visual impairment, the FO also provides the DDS with a DLI for blindness in certain situations. For more detailed information, see DI 11005.045C.1. and DI 25501.380C.1.

The field office must consider lag earnings when computing DLI. See RS 01404.005B for information on when lag earnings must be developed.

2. Disability determination services (DDS)

The DDS establishes EOD or blindness at the earliest possible date based on medical, vocational, and technical factors provided by the FO. The DDS must not establish the EOD after the DLI.

C. Component instructions regarding the relationship between the date last insured and EOD

1. Field office (FO)

Determine the claimant’s DLI.

• For more information on computing the DLI, see RS 00301.101 through RS 00301.800.

• The FO may use electronic tools such as DISCO and DIBwiz.

• Record the DLI in item 6 of the SSA-3367 (Disability Report – Field Office).

• Provide the DLI for blindness if the claimant alleges a visual impairment.

NOTE: After the FO creates a case in the Electronic Disability Collect System (EDCS), the DLI will propagate to EDCS from the mainframe. However, the DLI will only propagate to EDCS if you run the MCS EC Computation (#2 and #21 on the MCS Main Menu) before entering EDCS. For more information concerning data propagation and for directions on how to change propagated data, see DI 81010.035.

2. DDS

Establish the EOD at the earliest possible date based on medical, vocational, and technical factors provided by the FO.

Deny the claim if you cannot establish the EOD on or prior to the DLI.

REMINDER: You must always establish that severity of the impairment(s) is expected to last for 12 months from the onset date (the duration requirement), even if the DLI is in the past.  That is, you may need to request medical evidence of record after the DLI is expired. For the definition of the onset date see DI 25501.200. For the definition of the duration requirement see DI 25505.025.