DI 25501: Onset
TN 11 (11-12)
This section explains our policy regarding determining the onset date and established onset date in traumatic injury claims.
REMINDER:
The onset date is the first day the claimant meets the definition of disability or statutory blindness as defined in the Act and regulations.
The established onset date (EOD) is the date that a claimant meets the definition of disability and all the relevant entitlement or eligibility factors.
A. Determining onset with traumatic impairments
If a traumatic injury caused the claimant’s disability, the onset of disability is the day of the traumatic event. The fact the claimant worked on the day of the trauma is not relevant. If medical evidence from the date of the traumatic event is not available, but medical or other records refer to the original trauma, and there is no contradictory evidence, we establish the EOD as of the date of the traumatic event, provided the claimant meets the technical factors for disability on the date of the injury.
When a traumatic injury occurs after the alleged onset date (AOD), we must address medical severity for the period between the AOD and the date of the traumatic injury.
EXAMPLE: A claimant has an AOD of 02/16/2011. The claimant is involved in an automobile accident on 08/02/2011. Injuries sustained as a result of the accident are sufficient to allow Disability Insurance Benefit (DIB) onset as of 08/22/11. However, the DDS must obtain medical evidence for the period between the AOD and the injury to determine if we can establish an earlier EOD.
B. Component roles regarding establishing the EOD with traumatic impairments
1. Field office (FO)
The FO will identify the date the claimant alleges a traumatic injury, and all relevant technical entitlement requirements.
2. Disability Determination Services (DDS)
The DDS will determine an onset date on the date of the traumatic injury as supported by the medical evidence for the disability.
C. Component instructions regarding establishing the EOD with traumatic impairments
1. Field office (FO)
Review the Disability Report–Adult (Form SSA-3368) and identify the date of the traumatic injury. Annotate the traumatic injury date in the Electronic Disability Collect System (EDCS) for electronic claims or in item 5 of the Disability Report—Field Office (Form SSA-3367) for paper claims.
2. Disability Determination Services (DDS)
Establish the EOD as of the date of the traumatic injury, if trauma caused the disabling impairment and the medical evidence supports it. The claimant must meet the technical requirements for disability on that date.
REMINDER: If medical evidence from the date of the traumatic event is not available, but medical or other records refer to the original trauma and there is no contradictory evidence, you may establish the EOD as of the date of the trauma.