CLARIFYING THE 12 MONTH DURATION RULE FOR SSDI AND SSI

You can only file a disability claim with Social Security for a condition lasting a minimum of 12 straight months.  This is because Social Security does not pay for short term disabilities.  Here is the requirement in the law.  Your condition must.....

1.  Have lasted or is expected to last for 12 straight months.  

2.  Or, if the condition will not last for at least 12 straight months, it must be expected to end in death (be a terminal condition).  For example, a claimant has advanced cancer which will not last for 12 months because death is expected sooner than 12 months.

NOTE:  YOU DO NOT HAVE TO BE OFF WORK 12 MONTHS TO FILE A CLAIM.  YOU MUST HAVE A MEDICAL CONDITION EXPECTED TO LAST FOR 12 STRAIGHT MONTHS. YOU MAY FILE A CLAIM AS SOON AS YOU FEEL YOU ARE DISABLED AND WILL BE OFF WORK FOR AT LEAST 12 MONTHS.

Some examples of situations that will NOT meet the 12 month duration requirement:

A.  You have gallbladder surgery and it puts you out of work for 2 months.  You recover, but get an unrelated bleeding ulcer that keeps you out of work for 3 months.  That's a total of 5 months.  Then, you need your shoulder operated on, which keeps you off work for 7 more months.  That's a total of 12 months.  Does this meet the duration requirement?  No.  You did not have one single impairment that lasted for a straight 12 months and you cannot combine different impairments to reach the 12 month requirement.

B.  You are in an accident that requires surgery.  Your doctor puts you in physical therapy for 4 months after the surgery, then releases you.  Can you file an SSDI or SSI claim?  No.  Here again, your condition did not last for 12 straight months, therefore, no benefit is payable under Social Security rules.

C.  You had brain surgery to remove a benign (non-cancerous) tumor.  This happened in January.  The doctor's records indicate that you had severe impairments for a few months after surgery.  However, you stopped seeing the doctor in August , so there are medical records for only 8 months.  Can you meet the 12 month duration requirement?  Maybe, maybe not.  To do so, you would have to get back to the doctor for examination to prove that your severe symptoms have continued after August and will be expected to last for a minimum of 12 months.  Social Security, however, will not pay a claim based on 8 months of medical records.  

D.  You had surgery on your back and were off work for 4 months.  You go back to work after 4 months and work for 8 months.  Then, you have to have a second surgery on your back.  The second surgery puts you out of work for 4 months.  Do you meet the 12 month duration requirement?  No.  Because you worked 8 months between surgeries, Social Security will count this as two separate impairments, neither of which lasted 12 straight months.
The duration requirement simply eliminates Social Security's obligation to pay any claim where a single impairment doesn't last at least 12 straight months.

Social Security rules are strange and non-senseical to most people.  Trying to win a disability claim without representation is like throwing darts blindfolded.  You might hit the Bull's Eye but the odds are very, very poor.  It really helps if you have an attorney/advocate who knows the rules.
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