Note: There are two categories of disability, Title II, Disabled Insurance Benefit (SSDI) and Title XVI, Supplemental Security (SSIDI) claims. This article applies to coverage under SSDI, but is not applicable to SSIDI.
To obtain SSDI, the claimant generally need to meet two tests: the recent work test and the duration of work test.
Certain blind workers have to meet only the duration of work test.
Test1: Recent Work Test. Must have worked approximately five out of the 10 years before your disability totally removed you from the workforce. This rule recognizes that workers who became disabled while still young obviously did not have the opportunity to acquire lengthy work records.
How is the recent work test performed? SSA computes the “date last insured” (DLI) is the last date that an individual is eligible to receive Social Security Disability Insurance (SSDI). Your DLI depends on when you last worked. In order to receive SSDI, you must pass the “recent work test“, which means you must have worked five of the past ten years (technically, 20 of the last 40 quarters). The rules are different if you are under 30. See section following for further discussions.
Recent Work Test
- age 24 <= 21 worked 1.5y out of 3y before disability
- age 24-31 >24 to <31 worked 50+% since turning 21 e.g. age 29, then 29-21 = 8 or worked at least 4y out of 8y
- age 31 => 31 worked 5 or 10yrs before disabled
Test2: The duration test is based on your age at the time you become disabled. The test basically requires you worked and paid into the Social Security fund through the payment of Social Security taxes for a long enough time to be covered by SSDI.
The following table integrates these two test.
Case 1: The claimant, age 27 (DOB 12/31/20×1), had worked for three years (age 22, 23, 27) and became disabled in quarter 4, age 27 (onset date). The claimant have met the recent work test (3 years out of 6 years before onset date). The claimant, before age 28 has 6 quarters (or 1.5 years) of work, consequently the claimant have met the duration test.
Case 2: The claimant, age 50 (DOB 12/31/19×1), had worked for five years (age 40 to 45) and became disabled in quarter 4, age 50 (onset date). The claimant have met the recent work test (5 years out of 10 years before onset date (20/40 insured test)). The claimant, before age 50 has 30 quarters (or 7.5 years) of work, consequently the claimant have met the duration test.
DLI, Date Last Insured
An individual’s “date last insured” establishes the period of coverage during which an individual must prove that they became disabled. The taxes paid to Social Security act like a “premium” paid for any other insurance. Once paid in and credited, each quarter of coverage establishes a certain amount of time during which an individual can establish that they became disabled. Just as with an expired policy for car insurance or medical insurance, if a person becomes unable to work after a date last insured, there is no recourse for Title II Worker’s benefits under Social Security law.
As mentioned above, an individual earns “coverage” for Social Security Title II Disability benefits by working at a sufficient earnings level and paying FICA taxes, which stands for the “Federal Insurance Contributions Act.” FICA taxes are comprised of two separate taxes, Social Security and Medicare taxes. If a worker earns enough in wages in a given quarter, those wages go towards the worker’s eligibility for Title II benefits. In 2015, to qualify for a “quarter of coverage,” an individual must have earned $1,220 in the respective quarter.
Based on how many quarters of coverage you earn over your working life, and when you stopped working, the Administration will then calculate an individual’s date last insured. The most common method for calculating this date is called the “20/40 Insured Test”. Social Security will look at your earnings record, and generally count back 20 covered quarters, and will then count forward by 40 quarters (both covered and uncovered, see glossary). Typically, this means that if an individual has worked full time for five years in the last ten years, they are still “insured” for Title II benefits.
Date last insured (DLI) refers to the last date you are eligible to receive Social Security disability insurance (SSDI). In order to receive SSDI you must pass the “recent work test.” This means that you need to have worked the past 5 out of 10 years. More specifically, you must have worked 20 of the last 40 quarters.
Case: “ . . . your disability benefits will not start August, 20×7. The reason is that your earnings record did not pass our 20/40 Insured Test.”