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SSDI - Not sure how long condition will last

Can I get SSDI if my condition does not last 12 months?

Injured or sick workers who are not able to work for at least 12 continuous months due to a severe mental or physical health condition may be able to receive Social Security Disability Insurance (SSDI) from the Social Security Administration (SSA), but workers who cannot prove their condition will last at least 12 continuous months will have their SSDI case immediately denied. Recently on our disability forum we had a disability applicant ask, “What if I don’t know how long my condition will last. Can I still get SSDI benefits?

Determining how long your condition will last for SSDI

The simplest answer to this question is that it will be impossible to win benefits for a condition which is not expected to last for 12 continuous months, regardless of the severity of your current condition. What if your not sure how long your condition will last? That question will be more difficult to answer and will depend on your condition, and some conditions are easier than others to evaluate. For instance, the SSA may evaluate how long other claimants, with a similar condition, were unable to work. A good example is a heart transplant recipient. Given that this is a very serious surgery the SSA agrees that it is automatically disabling up to one year, at which time they will re-evaluate the claimant to determine their residual capacity to work.

Does this mean that you will automatically be out of work for a full year if you have a heart transplant? And if so, how would you really know? You wouldn’t. I have a step brother who had a heart transplant and returned to full-time employment within a few months, but he is probably the exception, not the rule. In this particular instance the SSA looks at the totality of heart transplant recipients and makes a determination based on what generally happens.

This is just one example. Other cases are less clear cut. For instance, what if you broke your leg or you were injured in a car accident? You might be near death at this specific point in time but you really have no way of knowing for sure if you will be back to work in 12 months. If you have a broken leg it will be very difficult to prove that you couldn’t be back at work within a few weeks (if you had a sedentary job) and maybe a few months (if you performed light, medium or heavy work). Other claimants, however, may have severe complications for the same injuries which do not allow them to return to work within 12 months.

Of course another factor the SSA may consider is your age. The SSA may assume that a younger worker who is working a sedentary job would have an easier time returning to work than an older worker who has been working heavy labor their entire life. Additionally, the older workers will also have less ability to retrain for new work. All of these factors will be considered by the SSA.

Keys to proving your condition will last 12 months

The main step to determine the length of your condition is to talk to your doctor. They should be able to give you information about your condition and what you can expect or at the very least what they have seen with other patients with a similar condition. If this fails, talk to a disability lawyer.
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