Qualifying for Social Security Disability Insurance (SSDI) requires meeting specific criteria. Not only must you have worked in jobs covered by Social Security long enough to amass sufficient credits to qualify for SSDI, but you must have a disability or medically determinable impairment that's expected to prevent substantial gainful employment for at least 12 months or result in death.
If you applied for SSDI and received a durational denial from the Social Security Administration (SSA), the disability examiner and medical consultant who reviewed your claim didn't think your condition would last long enough to qualify you for benefits. Here's what you need to know about SSDI's duration-of-disability requirement and how an experienced disability lawyer can help you get your case back on track after a durational denial.
Disability Duration and SSDI Eligibility
The SSA has a very specific definition of disability – and, sadly, getting a disabling diagnosis from your doctor doesn't necessarily mean you'll be eligible for SSDI benefits. To qualify for SSDI, your condition must prevent substantial gainful activity, meaning that you make less than a specified amount each month. (Though updated annually, in 2022, this amount was $1,350 for most people and $2,260 for statutorily blind applicants.) Additionally, you must make less than the specified amount for at least 12 months in a row.
Ways to Meet the SSDI Duration-of-Disability Requirement
- You have a condition that has prevented substantial gainful employment for a minimum of 12 months.
- Your disability is expected to prevent substantial gainful activity for 12 months or longer.
- Your condition won't improve within the next 12 months.
- Your disability is terminal and will result in death.
Providing clear medical evidence of your condition is vital when applying for SSDI. If you received a durational denial, despite having a disability that meets one of the duration requirements, it could mean that:
- Your doctor wasn't able to state with confidence (or prove with data) that your injury or illness would prevent you from working for 12 months or more; or
- Your application didn't include sufficient medical evidence proving the lasting nature of your disability to the SSA claims examiner and medical consultant assigned to your case.
The Problem With Durational Denials
Durational denials are somewhat controversial. Not only are they subjective and primarily based on opinion, but these crucial decisions are made by examiners who often have little-to-no medical experience and are signed off on by medical consultants who don't know you or your condition. Even worse, these individuals may rely on personal knowledge or biases when making their decisions, perhaps without even realizing it.
What to Do If You Received a Durational Denial
Receiving a durational denial can be a significant setback, but, fortunately, these decisions aren't etched in stone. Durational denials made by SSA claims examiners are often successfully disputed and reversed on appeal.
After receiving the denial, you have 60 days to initiate an appeal and request a reconsideration of the decision. However, at this stage, there's far too much at stake to go it alone. Consult a knowledgeable disability lawyer as soon as possible to ensure you understand your rights, options, and obligations throughout the SSDI appeals process.
Need Help Dealing With an SSDI Durational Denial? You've Come to the Right Place
Since 1994, Keefe Disability Law's Boston-based legal team has helped disabled clients throughout Massachusetts, New Hampshire, and Rhode Island fight for the SSDI benefits they need and deserve. We assist clients at all stages of the disability process – from initial application to appeal. Ready to find out what our seasoned attorneys can do for you and your SSDI claim?
Request a Free Consultation
Complete our online contact form or call us at 508-283-5500 (toll-free 888-904-6847) to schedule an appointment for a free consultation regarding your SSDI durational denial and potential appeal. For additional information, request our complimentary guide, 7 Costly Mistakes That Can Ruin Your Social Security Disability Claim.
Are You Looking for a Social Security Disability Attorney in Boston, MA?
If you are looking to apply for social security disability, you need to speak with an experienced social security disability lawyer as soon as possible. Please contact us online or call our Natick Office directly at 888.904.6847 to schedule your free consultation.