How to Appeal a Durational Denial

When you receive a “durational denial” from the Social Security Administration (SSA), this means your claim for disability benefits was denied because the SSA doesn't believe you meet the “durational requirements” or the agency’s time requirements for your medical condition. While you can often successfully appeal a durational denial, it’s in your best interests to do so with the help of a skilled Social Security (SS) disability attorney.

Understanding the Durational Requirements

There are many reasons the SSA turns down a disability claim, but one used most often is your claim doesn’t meet the durational requirements set by the agency. The SSA requires that your impairment must have lasted at least 12 months or is expected to last that long, and the agency makes its determination based on your current medical records.

This 12-month timeframe is a critical factor used by the SSA when defining “disability.” And the disability “projection” used to decide if your claim should be approved or denied is often subjective and based on opinion rather than in-depth knowledge of your ongoing, disabling condition.

It's possible the claims examiner and the medical consultant have no background in your illness—and they could make a determination based on incomplete medical records. If your file isn't up to date, the SSA may draw a conclusion based on outdated medical information, so you need to ensure that recent lab tests, results, and doctor opinions are added to your file.

Additionally, your disability must prevent you from performing “Substantial Gainful Activity” (SGA) for at least 12 consecutive months. Thus, if you’re employed while at the same time trying to work through your pain or the symptoms of your illness, your wages cannot exceed SGA—the monetary cap set by the SSA.

Ways to Appeal

Durational denials are a common, easy way for the SSA to deny your claim, and they're a controversial piece of the claims process—primarily because so many people receive them. If you receive a denial stating that your condition is expected to improve or will not remain severe for twelve months this is what is known as a durational denial.  If you believe that you will not be able to return to work and you should appeal. Most of the time when Social Security says that your condition will not remain severe enough for you to return to work because of the durational requirement they are wrong. Usually, you’ll contest the durational projection, and it’s important that you present as much medical information, documentation, and supporting evidence as possible to show your impairment meets the 12-months requirement.

No matter how you choose to appeal, it’s important to take an unfavorable decision by the SSA to the next level and contest the findings. Responding to the denial in a timely fashion is necessary.

Contact Cuddigan Law

Receiving a denial from the SSA can be frustrating and overwhelming, especially when you need financial support to get you through a tough time. Because over 60 percent of initial SS claims are denied, the best way to avoid receiving a durability denial is to 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 speak with an intake specialist for free.