If you have a medical condition that prevents you from working, you might file a claim for disability benefits from the Social Security Administration (SSA). Chances are, once you do so, you will receive what is known as a durational denial. Nearly 75% of all claims initially receive this denial—which means that the SSA expects you to be able to return to work within 12 months. If you receive a durational denial, you’ll have to file an appeal in hopes the SSA will reconsider.
What Is a Durational Denial?
Your physical or mental condition must meet the following criteria if you are to get SSA benefits:
- It will prevent you from working for 12 months.
- It is expected to prevent you from working for 12 months.
- It won’t improve in 12 months.
- It will result in death.
When you get a durational denial, the disability examiner believes you will be able to work because your condition is likely to improve during the 12-month window, and you will be able to continue to work on a long-term basis.
Your notice of denial from the SSA will contain the following information:
- A brief description of your medical condition
- The impairments of your condition that were considered
- The medical and nonmedical records that were considered
- The rationale behind the denial
The notice might say that there are other jobs you can still do, even if you can no longer do your current job. Some denial notices might include technical rationale, which is essentially the SSA’s reasoning for why you should still be able to work. If your notice doesn’t include that, you can request it from the SSA office.
What Should You Do If You Get a Durational Denial?
It’s natural to wonder how the SSA can predict whether or not you will be able to return to work. While the agency understands that you may be out of work for up to a year, it is up to you to provide the evidence to back up this claim.
Often, the SSA is wrong when telling those who have filed that they will be able to return to work. Durational denials are a controversial part of the claims process because so many people get them after filing a claim and they are subject to the individual biases of the disability examiner.
You’ll need to respond to the denial in a timely fashion with the correct documentation to support your claim, including medical evidence that your impairment meets the 12-month requirement. This 12-month timeframe is one of the most common reasons the SSA turns down a disability claim. It is possible that the disability examiner has no prior experience in dealing with your mental or physical condition or that the medical records they received were incomplete or outdated. You need to make sure that any recent lab tests, examination results, and doctor opinions are added to your medical file so that it is current.
Why Should You Hire a Lawyer to Assist With Your Claim?
When you are unable to work, Social Security disability benefits provide vital financial support. Since the majority of initial claims are denied, it’s a good idea to contact an attorney who understands the complexities surrounding Social Security disability law.
Hiring an attorney to help you with your initial claim is the best way to avoid getting a durational denial from the SSA. If you are denied, however, your attorney can help with your appeal.
There is only one lawyer who officially specializes in North Carolina Social Security disability in Dunn, NC. As a Social Security disability attorney, Vance Jennings at Brent Adams & Associates has completed a specialty certification with the North Carolina State Bar. Call (919) 781-7590 to schedule a consultation.