Why Wouldn't I Be Insured For SSDI If I Have My Full 40 Credits?

May 18 2019 - 9:51am

Hello Lary and Staff,

I'm a little perplexed on how the Social Security Administration works with work credits and SSDI Disability. I have worked all my life and had injuries at work that makes it hard to function at all. Now that I have gone to an ALJ hearing and been denied, Social Security is saying I don't have enough credits because of being out of work 3 1/2 years from my injuries. This seems shady as in 2009 was my last statement from Social Security and I had my full 40 credits. Now I do not have enough for Disability, please advise and help. Much Appreciated!

Hi,

In order to meet the insured status requirement for Social Security disability (SSDI) benefits you must be both a) fully insured, and b) have earned a sufficient number of quarters of coverage (QC) during the years directly leading up to the onset of your disability. To be fully insured you must have at least 40 QCs, or if you become disabled prior to the year in which you reach age 62 and after the year in which you reach age 28 you must have the equivalent of at least 1 QC for the number of years starting with the year you turned age 22 and ending with the year you became disabled. For example, a person who becomes disabled in the year they turn age 52 would need at least 30 QCs to be fully insured for SSDI (i.e. 52-22). The minimum number of QCs needed for fully insured status for a person who becomes disabled in or before the year in which they turn age 28 is 6 QCs.

By the way, the method described above is also used to determine fully insured status for Social Security survivor benefits.

To meet the additional insured status requirement for SSDI, a person becoming disabled at age 31 or older must have earned at least 20 QCs within the 40 quarter period leading up to the onset of their disability. Basically, that means that a person must have earned at least the equivalent of 5 full years worth of QC's during the 10 year period ending with the onset of their disability. So, for example, a person age 31 or older who became disabled during the last 3 months of 2018 would need to have earned at least 20 QCs during the years 2009 through 2018 to be insured for SSDI benefits (https://secure.ssa.gov/apps10/poms.nsf/lnx/0300301120#a). Fewer than 20 QCs are required for people who become disabled prior to age 31, with the exact number depending on their age at the time that their disabling impairment began (https://secure.ssa.gov/apps10/poms.nsf/lnx/0300301140).

I don't have enough information about your case to be able to give you advice, but if you've received an unfavorable determination at the hearing level of appeal the next step in the appeals process would be an appeals council review (https://www.ssa.gov/pubs/EN-05-10041.pdf). If you want to request an appeals council review you must normally submit your request within 60 days of the date of the notice informing you of your hearing level decision. Or, you could drop your prior claim and file a new claim for SSDI, but if you last met the insured status requirement at some point prior to the date that your hearing request was disallowed, your new claim would be denied for not meeting the insured status requirement. You could not be awarded SSDI based on a new claim with a disability onset date prior to the date of your hearing decision, since that would require overturning the Administrative Law Judge's (ALJ) determination. An ALJ determination made at the hearing level can only be overturned at a higher level of appeal.

Best, Jerry