The Durational Requirement and Disability

To qualify for Disability or SSI, a Claimant must meet the SSA’s Durational Requirement.  This means a Claimant must be dealing with a severe impairment that is expected to last a year or more or result in death.  While this does not mean that one must wait a year to claim benefits, it does mean that the nature of the illness should not be transient or quickly recovered from.  The SSA does not offer partial disability benefits or short-term disability benefits like many policies do.  It is important therefore to ensure that their durational requirements are met.  The SSA requires that a severe impairment last a year (or be expected to do so or result in death).  As such, this durational requirement can be used by the SSA to deny your claim for Disability or SSI Benefits.

Not every impairment or illness can be clearly determined to be expected to last for more than a year.  As such, a denial based on this fact is often guesswork at best, and should be appealed.  During the appeals process, it is of the utmost importance to continue seeking treatment for one’s illness, and ensuring that orders from physicians are followed to the greatest practical extent.  Many Claimants who receive such a denial at the initial or reconsideration levels of application succeed at the Administrative Law Judge (ALJ) Level.  Often by this time, they have waited two or more years for their case to be heard, and have sought treatment for this entire time period.

Because of the length of time associated with the appeals process, and because of the SSAs rules about claiming back pay, it is advisable to apply for benefits as soon as possible after becoming unable to work.  Not only does this create a common-sense onset date, but it also is a time period during which many Claimants have good medical coverage (or COBRA) that creates solid evidence of disabling conditions.  This evidence is often pivotal later, especially if a Claimant becomes uninsured, or has to seek care through a state health department or other institutional source that may not be as comprehensive.  SSI Claimants are only able to claim benefits back to their file date, and Disability Applicants may claim up to a year of benefits prior to their file date (which actually requires 17 months of provable disability).  Moving quickly with a filing should allow Claimants to maximize their benefits.

Does this sound like a lot of information to account for and process?  Visit our glossary to better understand commonly used SSA definitions, or contact a Georgia Disability Attorney at O’Brien & Feiler to discuss your case, and perhaps help you secure benefits.

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