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Stephanie O Joy, Esq
Stephanie O Joy, Esq, Soc. Sec. Attorney
Category: Social Security
Satisfied Customers: 13564
Experience:  22+ years legal exp. - 12+ years owning/operating her own SSD Law practice.
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My brother was recently diagnosed with alcohol induced

Customer Question

My brother was recently diagnosed with alcohol induced dementia. He stopped paying into SSI in 2005 and has been told he is not eligible for SSDI. I believe his onset was years ago. Do I have a shot of proving this and getting him SSDI? the SSI he gets is meager and cannot afford him more than a very poor quality boarding home.
Submitted: 2 years ago.
Category: Social Security
Expert:  Stephanie O Joy, Esq replied 2 years ago.

Hi, with regard to your post.

OK, so he is getting SSI, so he proved that he is disabled legally, either due to dementia or some other basis. Generally, when one applies for SSI, it is an automatic application for SSDIB. So that application will tell you when he claimed to be disabled as of. Is that date AFTER he became uninsured for SSDIB? If so, there is no SSDIB to be had, because he hadn't purchased it for this later time. Because an SSI application IS an SSDIB application, the SSA presumably adjudicated the SSDIB application and if he didn't get SSDIB, it would be because it found that his disability didn't begin until AFTER he no longer had SSDIB insurance. But, if he alleged a disability onset date of far later than it really was (why he'd do that, I don't know), then perhaps they didn't adjudicate a medical decision for that earlier time, since he never alleged it. Possibly, then, you could refile and attempt to prove that earlier time now.

So I'd look at that OLD application and determine when he alleged in that application that he became unable to work due to disability. You find out what date his "insured status" for SSDIB ended (maximum of 5 years after he stopped working, but can be less) (also known as his DLI, "date last insured"), and you determine if he factually was unable to work due to disability before his insured status ran out. You then look at his file to determine if the dates you are interested in were considered, or never considered. If never considered, you may have a shot now. If they were adjudicated, that if it was over 60 days ago, there would generally be a "res judicata" - a final decision that he never appealed. If the reason he didn't appeal on time was justified, you may be able to get that missed deadline waived and new appeal accepted as timely even though it is not.

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