Is it Possible to Recover Past Due Benefits for a Disabiling Condition that Began 20 Years Ago
Posted Dec 30 2013 5:57pm
I recently received an email from a blog reader who tells me that she has recently been approved for SSDI based on a stroke. However, she was diagnosed with another disabling medication condition 20 years ago but never applied. Is there anything she can do about the older medical condition and recovering 20 years worth of past due benefits.
Here is my analysis: first, this is a difficult question to answer because I do not have all of the facts. For example there are circumstances where an informal communication with Social Security could be considered an application. There are also cases where even an unintentional misstatement by a Social Security employee could toll the statute of limitations.
These unusual circumstances of informal applications and misleading conversations might open the door slightly for a recovery of years of past due benefits but this type of situation is relatively rare and difficult to prove. There are slightly more common situations where a more recent application can be reopened relatively easily.
For purposes of my analysis, however, I am going to assume that my blog reader had no prior communication or formal application with SSA about her older medical condition and that her first disability communication occurred within the last year or two when she filed for disability based on the stroke and its complications.
Under SSDI rules, a claimant can only collect benefits going back 1 year prior to application. So, if my blog reader applied on September 1, 2012, the earliest she could be eligible for payment would be September, 2011. It does not matter if the judge found her disabled as of 2010, 2000, 1990 or 1980, she can only get payment as of September 2011.
Secondly, in order to go after benefits for any date prior to the current application onset date (i.e., the date of the stroke), she would have to appeal her favorable decision. This means giving up her favorable decision and putting her entire case back in to play – a risky move. If she does not appeal within the 60 day appeal period the current favorable decision becomes “permanent” and she cannot later go back and ask for benefits prior to that date.
Third, it is inherently difficult to go back more than 2 or 3 years. Often older medical records are not complete and it can be difficult finding a treating physician from the past to complete a functional capacity evaluation. In my experience, judges are also very reluctant to find that a claimant met the definition of disability more than 2 or 3 years ago.
Obviously there are unique circumstances in certain cases that might give rise to the payment of years of past due benefits and anyone who thinks that they may have good cause to reopen an old application should discuss the facts of his/her case with a lawyer. As a matter of general practice, however, it will be an uphill battle to collect years of past due benefits in most circumstances.