Initiating a Social Security Disability Claim in Maine, MA & NH: the Duration Requirement

One of the most typical misunderstood requirements for purposes of establishing a Social Security Disability claim is the duration requirement.  The Social Security Act and its corresponding regulations require that one prove they are suffering from a severe medical impairment that has lasted or or expected to last 12 months or longer, or result in death.   This provision has been interpreted quite strictly, and for anybody who is considering an application for Social Security disability benefits, it’s important to pay heed to this rule or a denial is very likely to follow.

The Social Security Act defines a “disability” as the “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”   42 U.S.C. §(d)(1)(A).    It is important to recognize that the language of the statute is meant to exclude from entitlement conditions those conditions which are of shorter term duration, and which will allow one to return to work within a matter of months.  For example, while having back surgery (even a multilevel fusion) may constitute a severe impairment which will cause one to be out of work for a stretch of time, most such surgeries would not anticipate a recovery time of a year or longer.

The more difficult type of situation comes about with conditions that may have periods of remission (with, for example, periods of exacerbation) which require you to remain out of work for stretches of time but might allow for returns to work for stretches of time.   In such a circumstance, one may still be able to reach the duration requirement of a year or longer by establishing that the attempts to return to work are what are deemed to be unsuccessful work attempts: this is something an experienced Social Security disability lawyer will be able to evaluate for you.

Unfortunately, the Social Security regulations are less kind in its interpretation of the statute and how it deals with multiple illnesses.  As a practicing Social Security Lawyer in Maine, MA and NH for 28 years, we come across individuals all of the time who are dealing with a variety of illnesses that have been plaguing them for years.  Parsing out which ones have become severe, and when, is many times, difficult. And yet, let’s take, for example, an individual who has been suffering from back problems for many years, and then then has to go out of work for surgery.  While they are out of work from the back surgery for a number of months while recovering, they then have a heart attack (a condition unrelated to the heart attack), which then additionally disables them for a number of months.  Unfortunately, they don’t understand why they have been denied on their initial application by the Social Security Administration.

Assuming the individual recovers within a year from the back surgery (and, thus, the back problem does not remain severe and disabling for a year or longer), and the individual then recovers from the heart attack within a year, the Social Security regulations would dictate that the individual would not meet the duration requirement of a year or longer even if the combination of the two conditions has caused them to remain disabled for a year or longer.   This result comes directly from the Social Security regulations that provide as follows: “[w}e cannot combine two or more unrelated severe impairments to meet the 12-month duration test. If you have a severe impairment(s) and then develop another unrelated severe impairment(s) but neither one is expected to last for 12 months, we cannot find you disabled, even though the two impairments in combination last for 12 months.”

As a practicing Maine, MA and NH Social Security lawyer understanding how to evaluate what has been transpiring for our clients from a medical standpoint and whether it will meet the various Social Security regulations and rules is essential to a successful outcome in the case. If you or someone you love has been struggling with a number of illnesses and don’t know whether Social Security disability benefits is the correct route for you to take, contact the Law Offices of Russell J. Goldsmith for a no-cost, no obligation evaluation of your claim.  We’ll make sure you understand your rights and whether Social Security disability benefits are appropriate for you.