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Did you apply for Social Security Disability Insurance (SSDI) and receive a durational denial from the Social Security Administration (SSA)? This means that the examiner and consultant who evaluated your claim didn't think your condition would last long enough for you to qualify for benefits. Fortunately, they don't have the final say on the matter. Here's what you need to know about the disability duration requirement for SSDI and how Keefe Disability Law's skilled legal team handles appeals and helps clients fight for the benefits they deserve.
Understanding SSDI Duration-of-Disability Requirements
To qualify for SSDI, you have to prove that your condition is severe enough to prevent substantial gainful activity (SGA) and is sufficiently long-lasting. This requires an understanding of both SGA and the duration requirement. Essentially, SGA is the maximum amount you can earn each month while still qualifying for benefits. (The limit is updated each year; in 2022, it was $1,350 for most people and $2,260 for legally blind applicants.)
You May Meet the SSDI Durational Requirement if
- Your disability has kept you out of work or prevented substantial gainful employment for a minimum of 12 consecutive months
- The condition is expected to prevent SGA for at least 12 months
- Your disability won't improve in the next 12 months
- Your condition is terminal and will result in death
Wondering why your application was denied when you have a medically determinable impairment that meets one of the above requirements? It's possible that your doctor couldn't provide an estimate for when – or whether – your condition would improve, or perhaps your application lacked strong supporting evidence from acceptable medical sources. Either way, you have the option to appeal.
Ways to Appeal a Durational Denial
You generally have 60 days to initiate an appeal of a Social Security decision – and the countdown starts the day you receive the letter (or other communication) notifying you of the durational denial. There are four levels, or stages, in the appeals process: reconsideration, hearing before an administrative law judge (ALJ), review by the Appeals Council, and Federal Court review.
What to Know About the Stages of the SSDI Appeals Process
- Reconsideration. This is a complete review of your claim, conducted by an SSA examiner and medical consultant who weren't involved in the initial decision. The SSA will consider all the information included in (or with) your original application, as well as any additional evidence you provide. You can request an appeal by reconsideration online or by filling out the appropriate paperwork at your local Social Security office.
- Hearing by an ALJ. Disagree with the decision made at the reconsideration stage? You can go to the SSA website or your local Social Security office to request a hearing by an ALJ. This is a review of your claim by an administrative law judge who wasn't involved in the decisions made at the initial or reconsideration levels. It includes an evaluation of your initial application and new evidence.
- Review by the Appeals Council. If you disagree with the hearing decision, you can visit the SSA website to request a review by the Social Security Appeals Council. The council could: grant your request for a review, deny or dismiss the request, issue a new decision, or send your case back to the ALJ for further action.
- Federal Court Review. Disagree with the council's decision? Filing a civil lawsuit in Federal district court is the final stage of the appeals process. A knowledgeable disability lawyer can help you understand your legal rights and options.
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.
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