Determining Insured Status in Social Security Disability Claims

A “quarter of coverage” (QC) is the basic unit of coverage in determining a worker’s insured status for purposes of a Title II Social Security Disability claim. You need at least 6 QCs but not more than 40 QCs to be fully insured.

Insured status is a basic factor in determining whether you are entitled to disability insurance benefits.  Think of it as you do with other forms of insurance.  If the insurance on your automobile lapsed yesterday, and you were involved in a collision tomorrow, you would not be covered.  In the same way, you must be covered to receive Title II Social Security disability benefits.

SSA makes a distinction between being “currently insured” and “fully insured.”  But you must meet both requirements to be entitled to benefits.

You are “currently insured” if you have at least 6 quarters of coverage (QCs) during the 13-quarter period ending with the quarter in which you most recently became entitled to disability insurance benefits.

Most applicants for Social Security disability benefits are no longer working.  This means they stopped accruing quarters of coverage (QCs).  It also means they have what is known as a date last insured (DLI), either in the past or in the future, depending upon how long ago they stopped working.

The credits are based on the amount of your earnings.  In 2012, you receive one credit for each $1,130 of earnings, up to the maximum of four credits per year.  Each year the amount of earnings needed for credits goes up slightly as average earnings levels increase.  The credits you earn remain on your Social Security record even if you change jobs or have no earnings for a while.

The number of credits you need for Social Security disability benefits depends on how old you are when you become disabled.  If you became disabled prior to age 24, you need 6 credits (about 1 ½ years of work) in the 3 years before you became disabled.  If you are 24 through 30, you need credits for half of the time between age 21 and the time you became disabled.  At age 31 or older, you need at least 20 credits in the 10 years immediately before you became disabled.  It is a graded system, so that the older you are, the more credits you require.

Between the ages of 31 and 42, about 5 years of work, or 20 credits, is required. The number of credits needed increases by 2 each 2 years for people aged 44 through 62, and is equivalent to an additional 6 months of work, up to a maximum of 40 credits at age 62, which equals about 10 years of work, as follows:

under 24=1 ½ yrs (6 credits)

24-30 needs credits for half of the time between age 21 and the time you became disabled.

31- 42=5yrs (20 credits)

44=5 ½ yrs (22 credits)

46=6 yrs (24 credits)

48=6 ½ yrs (26 credits)

50=7 yrs (28 credits)

52=7 ½ yrs (30 credits)

54=8 yrs (32 credits)

56=8 ½ yrs (34 credits)

58=9 yrs (36 credits)

60=9 ½ yrs (38 credits)

62=10 yrs (40 credits)

 

To have Social Security disability insured status, you must meet one of following four rules and be fully insured:

Rule 1, which applies to most applicants, is known as the 20/40 requirement: You are insured in a quarter, if in that quarter you are fully insured, and have at least 20 QCs in the 40-quarter period ending with that quarter.

The other rules vary for claimants with previous disabilities, claimants under 31 (as noted above), and for the statutorily blind.

In conclusion, insured status is critical to your Social Security disability claim.  But it is also vital to other SSA benefit programs, including old age and survivors benefits.  SSA compiles this information into your earnings record based upon your W-2 tax records, so it is important to assure that this information is correct in your record.  Because SSA presumes that their compiled earnings record is correct, and difficult to rebut, you should always verify that your W-2 income, name, and social security information is accurate. The date last insured could mean the difference of being foreclosed from filing a disability claim, leaving only an SSI claim to fall back on.

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