Who Is Considered Disabled: Durational Threshold Requirement for Social Security

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Question

What does it mean to get a "durational denial" for Social Security disability? How come I was denied if I couldn't work due to recovering from back surgery for six months, followed by three months of being unable to work because I broke my ankle?

Answer

There are several threshold criteria you must meet before even being considered disabled by Social Security: you must have a severe medical condition that results in an inability to work at the substantial gainful activity (SGA) level (basically, earning $1,070 per month), and your condition, or impairment, must last, or be expected to last, at least 12 calendar months. The requirement that your inability to work must last 12 months is the durational requirement.

Not surprisingly, most claims for Social Security benefits based on disability are given what is called a "durational denial." That is, even though Social Security may acknowledge a claimant's condition is severe and prevents that person from working (for instance, two broken legs from a car accident), if the SSA does't believe the condition will last a full twelve months, the agency will issue a durational denial.

If you have one severe impairment that is expected to last less than a year, and another, unrelated impairment that overlaps but is also expected to last less than 12 months, you can't combine them to meet the 12-month requirement. For example, if one disabling impairment started eight months ago and then stopped and another disabling impairment started three months ago but is expected to last only eight months, the duration requirement will not be met, even though you will be unable to work for a total of 13 months.

Learn more about the medical eligibility requirements for disability.

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LA-NOLO5:DRU.1.6.5.20141022.29090