The Controversial Nature of Durational Denials

When your medical condition makes it impossible for you to perform substantial gainful activity (SGA) for 12 months or more, you may choose to file a disability claim with the Social Security Administration (SSA). 

However, you may receive a "durational denial" letter explaining that your condition doesn’t meet the criteria used by the SSA to determine if yours is a true disability. Your claim can only be granted approval if your condition meets the following requirements:

  • Your physical or mental condition prevents you from performing SGA for 12 months.
  • Your physical or mental condition is expected to prevent you from performing SGA for 12 months.
  • Your physical or mental condition won't improve in 12 months.
  • Your physical or mental condition will result in death.

Why Durational Denials Are Controversial

SS disability durational claim denialWhen a claims examiner evaluates your application, he looks primarily at your medical condition and how it’s impacted your ability to work and for how long. If your physician isn’t able to forecast a future date for your improvement or can’t provide the needed medical reports and data to show that your impairment will continue for 12 months or more, the SSA’s disability examiner and the medical consultant will, together, make their own forecast of recovery.

This is why durational denials are so controversial. Your forecast of recovery is often: 

  • Made by someone who has little–to–no experience in the medical field.
  • Determined by a medical consultant who doesn’t know your condition.
  • Made by people who rely on their own personal knowledge and are subject to individual biases to make a decision.
  • Subjective and based primarily on opinion.

Thus, it’s possible an interpretation of your medical condition will be left to people who are, in effect, guessing about the likelihood that your condition will improve before 12 months

Contact Cuddigan Law

Social Security Disability benefits are critical when you’re unable to work and need financial assistance to get you through a rough time. 

If you receive a durational denial letter or want help with your application to avoid being denied by the SSA, contact Cuddigan Law for help. Our attorneys understand the complex rules governing Social Security disability law, and we know how to assist you with an appeal should your claim be denied. 

Call Cuddigan Law (402) 933 5405 to get help with your Social Security disability application or appeal today. Let our experienced lawyers go to work for you. Contact us to speak with an intake specialist for free. 

 

Sean D. Cuddigan
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SSA and VA Disability Attorney in Omaha, Nebraska
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