Which Social Security Disability cases often receive a durational denial?

You may receive a durational denial after submitting a claim for Social Security (SS) Disability benefits. This type of denial means your medical condition, illness, or injury didn’t meet the time period requirements set by the Social Security Administration (SSA) that define a true disability.

Reasons Claimants Receive Durational Denials

When a disability examiner reviews your application, he looks specifically at your medical condition and whether it meets the following durational requirements:

  • It’s impossible for you to work for 12 months at a substantial gainful level due to a physical or mental condition.
  • Your physical or mental condition will likely prevent you from working for 12 months.
  • It’s not expected that your mental or physical condition will improve in 12 months.
  • It’s likely your mental or physical condition will result in death.

If your claim is denied due to durational limitations, it means the claims examiner didn't find sufficient evidence to prove your condition will be persistent and continue to interfere with your ability to work after a 12-month period. 

Cases That Often Receive Durational Denials

reasons for SS durational denialsProviding medical evidence that proves your condition will last beyond 12 months is critical in receiving an approved claim from the SSA. However, it’s often tough to do this.

Not only does the examiner who reviews your case have little–to–no medical experience, the medical consultant who helps make the determination doesn’t know or understand your condition.

Both are making decisions about your case using their own individual perspectives and opinions to forecast the likelihood of your recovery.

Certain cases in particular tend to receive durational denials, including:

  • Car accidents that result in broken bones
  • Accidents that cause traumatic injuries
  • Recoveries after major surgeries

In cases involving broken bones, the SSA evaluates how the break impacts your ability to do your job on a daily basis. A claims examiner wants to understand how your fracture interferes with your ability to perform at work. For example, the SSA's Blue Book of Impairments requires that for a broken leg bone, the bone must fail to have a “solid union,” and this must be shown through X-rays, MRIs, CT scans, and other medical imaging. Additionally, your inability to move around must be expected to last at least a year.

Contact Cuddigan Law

Over 60 percent of initial SS claims are denied, which is why the best way to avoid receiving a durational denial is to contact a skilled SS disability attorney. The legal team at Cuddigan Law understand the complex rules governing Social Security Disability benefits law, and our experts know how to assist you with an appeal should your claim be denied.

Call Cuddigan Law at (402) 933-5405, to get help with your SS disability application 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