In many instances, we do not need to establish an exact EOD for DIB claims. After
the first day of the month, all other days of that month have an equal effect on the
claimant’s monthly benefit and waiting period. Onset on the first day of the month
affects the date that the five-month waiting period starts. If we establish the EOD
after the first day of the month, the five-month waiting period begins on the first
day of the following month. Onset on the first day of the month can also affect the
amount of the claimant’s monthly benefit (the primary insurance amount or PIA), the
timeframe used to calculate the disability waiting period, or the Medicare eligibility
period. Therefore, if we can determine the claimant did not become disabled on the
first day of the month, any date within that month is a fully favorable onset date
as long as:
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•
the claimant did not allege an onset date on the first day of the month, or
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•
the claimant did not first meet the medical or medical-vocational criteria on the
first day of the month.
Sometimes we cannot pinpoint the exact day in a given month a claimant became disabled.
If we can determine the claimant did not become disabled on the first day of the month,
any date within the given month is a fully favorable onset date.
EXCEPTION: For Title II DIB claims with partially favorable onsets established at the beginning
of a quarter (i.e., first day of the month). and the onset is not limited by attainment
of age, the last day of SGA, or a traumatic onset, change the onset to the last day
of the previous quarter (e.g., 03/31, 06/30, 09/30, or 12/31) to provide the most
favorable onset, as this affects the freeze period.