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Car accident and SSDI benefits?

In the United States, 2.35 million individuals are injured or disabled in a car accident each year with costs averaging $230.6 billion per year, or an average of $820 per person. While many individuals may have protection for an unexpected death, many drivers are not prepared for serious life-threatening injuries which may keep them from working for months or years. Recently on our disability forum a user wrote, “If I have been seriously injured in a car accident and will not be able to work for several months can I receive Social Security Disability Insurance (SSDI) benefits?”


Qualifying for SSDI after a car accident

Social Security Disability Insurance is not offered for short-term injuries from a car accident. In fact, if your condition is not expected to last for at least 12 continuous months the SSA will automatically deny your claim.

So what do you do if you cannot work for several months following a car accident? Unfortunately, there is not a good answer. The expectation is that workers will have some type of income or savings to help them during times of short-term employment. For example, many workers may have short-term benefits offered through their employer or they may have purchased additional short-term injury coverage.

Common Car Accident Injuries

As mentioned above, whether or not your injuries will be covered by SSDI will depend wholly on the severity of the injury and whether it will last 12 continuous months. Unfortunately, some of the most common car accident injuries including broken bones, whiplash, an injured back, muscle tears, and abrasions can be quite serious, maybe even life-threatening, but will not last 12 continuous months.

Making a disability determination for your car accident injury

If you have been involved in a car accident and you believe you will be unemployed for at least 12 continuous months you may qualify for SSDI benefits, but you will have to prove your condition is severe, does not allow you to work or make too much money, and you are insured for SSDI benefits.

So let’s look at a specific example. Let’s say you have a severe back injury and you will need surgery. It will not be sufficient simply to claim you cannot work or perform substantial gainful activity (SGA). You will need medical records to prove your case.

To make a disability determination the SSA will first review your medical records and determine if your condition is so severe it meets or equals a listing in the SSA Listing of Impairments. Back conditions are reviewed under Listing 1.0 Musculoskeletal System, Section 1.04 Disorders of the spine. Injuries reviewed under this listing will include herniated nucleus pulposus, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, and vertebral fracture.

The SSA will specifically be evaluating whether you have “evidence of nerve root compression characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss (atrophy with associated muscle weakness or muscle weakness) accompanied by sensory or reflex loss and, if there is involvement of the lower back, and positive straight-leg raising test.” Or the SSA will determine whether you have spinal arachnoiditis, or lumbar spinal stenosis resulting in pseudoclaudication.

Claimants who can prove their back condition after a car accident is as severe as the listing above may automatically qualify for SSDI benefits, assuming they meet the non-medical requirements for SSDI.
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