SSR 23-1p: TITLES II AND XVI: Duration Requirement for Disability

Effective Date: November 7, 2023 Federal Register

Vol. 88, No. 214, page 76885

Policy Interpretation Ruling

This Social Security Ruling (SSR) rescinds and replaces SSR 82-52 :

Titles II and XVI: Duration of the Impairment.

Purpose: This SSR updates and consolidates our policy

regarding the duration requirement for establishing

disability under Titles II and XVI of the Social Security

Act (Act) and its implementing regulations. We published SSR 82-52 in 1982, and in the ensuing four decades we

revised several rules and issued policy guidance that leave

the original ruling misaligned with current regulatory

authority and policy guidance. For instance, we changed

the sequential evaluation process for widows and Title XVI

children; [1] established the process for evaluating medical improvement in continuing

disability review (CDR) cases; [2] instituted multiple work incentives for recipients of Title XVI

payments; [3] and extended the

reentitlement period for Title II claims. [4]

Citations (Authority) : Sections 216(i) , 223(d) , and 1614(a) of the Act,

42 U.S.C. 416(i), 423(d), and 1382c(a),

as amended; Regulations No. 4, subpart P, sections 404.988 , 404.1505 , 404.1509 , 404.1520 , 404.1523 , 404.1545 , 404.1574 , 404.1581 , 404.1592 , 404.1592a , 404.1592b , 404.1594 , and 404.1598 ;

Regulations No. 16 , Subpart I, sections 416.260 , 416.262 , 416.905 , 416.906 , 416.909 , 416.920 , 416.923 , 416.924 , 416.945 , 416.974 , 416.981 , 416.994 , 416.994a , 416.998 , and 416.1488 .

DATES: We will apply this SSR on November 7,

2023. [5]

Policy Interpretation:

9 , 404.1520 , 404.1523 , 404.1545 , 404.1574 , 404.1581 , 404.1592 , 404.1592a , 404.1592b , 404.1594 , and 404.1598 ;

Regulations No. 16 , Subpart I, sections 416.260 , 416.262 , 416.905 , 416.906 , 416.909 , 416.920 , 416.923 , 416.924 , 416.945 , 416.974 , 416.981 , 416.994 , 416.994a , 416.998 , and 416.1488 .

DATES: We will apply this SSR on November 7,

2023. [5]

Policy Interpretation:

To be disabled under Title II of the Act, or as an

adult [6] under

Title XVI of the Act, a claimant must be unable to engage

in any substantial gainful activity (SGA) by reason of one

or more medically determinable physical or mental

impairments (MDIs) which can be expected to result in death,

or which has lasted or can be expected to last for a

continuous period of at least 12 months. [7] We refer to the period of time during which a claimant is continuously

unable to engage in SGA because of one or more MDI(s) as

“duration.” [8]

The following information is in a question-and-answer

format that provides guidance on how we assess whether a

person meets the duration requirement for disability.

Questions 1 through 3 explain how we define and measure the

duration requirement. Questions 4 and 5 provide information

about how the duration requirement affects the sequential

disability evaluation process. Question 6 addresses how we

consider duration in continuing disability review (CDR)

cases when the beneficiary or recipient has a new, severe

MDI(s). Question 7 explains how we make a finding about the

expected duration of an impairment and what will happen if

we learn of a return to SGA within 12 months of a

claimant's onset of disability.

List of Questions—

- How does a claimant meet the duration requirement for disability?

- What is an MDI that “can be expected to result in death”?

- What do we mean by “12 continuous months” and how do we measure it in initial claims?

- How does the duration requirement affect the five-step sequential disability evaluation process?

o SGA within 12 months of a

claimant's onset of disability.

List of Questions—

- How does a claimant meet the duration requirement for disability?

- What is an MDI that “can be expected to result in death”?

- What do we mean by “12 continuous months” and how do we measure it in initial claims?

- How does the duration requirement affect the five-step sequential disability evaluation process?

- How does the duration requirement affect the three-step sequential disability evaluation process for Title XVI claimants who have not yet attained 18 years of age?

- How do we consider the duration requirement when the claimant has new, severe MDI(s) in continuing disability review (CDR) cases?

- What if we find that the claimant meets the duration requirement based on an expectation of continued severity, but the claimant returned to SGA within 12 months?

How does a claimant meet the duration requirement for disability?

What is an MDI that “can be expected to result in death”?

What do we mean by “12 continuous months” and how do we measure it in initial claims?

How does the duration requirement affect the five-step sequential disability evaluation process?

How does the duration requirement affect the three-step sequential disability evaluation process for Title XVI claimants who have not yet attained 18 years of age?

How do we consider the duration requirement when the claimant has new, severe MDI(s) in continuing disability review (CDR) cases?

What if we find that the claimant meets the duration requirement based on an expectation of continued severity, but the claimant returned to SGA within 12 months?

Answers—

isability evaluation process for Title XVI claimants who have not yet attained 18 years of age?

How do we consider the duration requirement when the claimant has new, severe MDI(s) in continuing disability review (CDR) cases?

What if we find that the claimant meets the duration requirement based on an expectation of continued severity, but the claimant returned to SGA within 12 months?

Answers—

- How does a claimant meet the duration requirement for disability? Duration is the period of time during which a

claimant is continuously unable to engage in SGA because of

one or more MDI(s). [9] To satisfy the duration

requirement for disability, the claimant's relevant MDI(s)

must have lasted or must be expected to last for a

continuous period of at least 12 months, unless we expect

the MDI(s) to result in death within 12 months of the onset

of disability. [10] An individual's inability to

perform SGA because of the relevant MDI(s) must also last

the required 12-month period, unless we expect an MDI(s) to

result in death within 12 months of the onset of

disability. A claimant must satisfy both elements to meet

the duration requirement. [11] A claimant who was previously entitled to a period of disability must again meet the

duration requirement for the current application before a subsequent period of disability

can be established. [12]

- What is an MDI that “can be expected to

result in death”? An MDI that “can be expected to result in

death” is one for which the generally accepted

prognosis within the medical field and the evidence in the

case file demonstrate that the claimant is expected to die

as a result of that impairment within 12 months of the date

that the claimant became unable to engage in SGA. We also

consider an MDI that actually results in death to be one

that was “expected to result in death.”

ult in

death” is one for which the generally accepted

prognosis within the medical field and the evidence in the

case file demonstrate that the claimant is expected to die

as a result of that impairment within 12 months of the date

that the claimant became unable to engage in SGA. We also

consider an MDI that actually results in death to be one

that was “expected to result in death.”

- What do we mean by “12 continuous

months” and how do we measure it in initial

claims? The phrase “12 continuous months” means

both that the MDI(s) must have lasted, or be expected to

last, for a continuous period of at least 12 months and

that the claimant's resulting inability to perform SGA by

reason of the MDI(s) must also have lasted, or be expected

to last, for not less than 12 months without interruption

or stopping. [13] We measure the 12-month period from any date [14] the claimant's MDI(s) first prevented the claimant from performing

SGA. [15] We do

not consider any period during which an MDI or combination

of MDIs did not prevent the claimant from performing SGA

when measuring duration. The duration period may begin

before, but cannot end before, the period during which we

can establish entitlement or eligibility. [16] For example, the duration period may begin before the date first insured

(DFI) in Title II disability insurance benefit (DIB)

claims, before the date of a spouse's death in Title II

disabled widow(er)'s benefit (DWB) claims, prior to the

potential onset date in Title II childhood disability

benefits (CDB) claims, or prior to the filing date in Title

XVI claims. Unless the MDI(s) is expected to result in death,

duration continues through the earliest of the following dates: When the MDI(s) no longer prevents the claimant

from engaging in SGA; or When the MDI(s) is no longer expected to prevent

the claimant from engaging in SGA. [17]

nset date in Title II childhood disability

benefits (CDB) claims, or prior to the filing date in Title

XVI claims. Unless the MDI(s) is expected to result in death,

duration continues through the earliest of the following dates: When the MDI(s) no longer prevents the claimant

from engaging in SGA; or When the MDI(s) is no longer expected to prevent

the claimant from engaging in SGA. [17]

- How does the duration requirement affect the

five-step sequential disability evaluation process? We consider the duration requirement at multiple

steps of the five-step sequential evaluation process we use

to evaluate disability in initial claims under Title

II, [18] age

18 redeterminations, [19] and adult claims under Title XVI. [20] At

step one, if the claimant is currently performing SGA we

will generally find that the claimant is not disabled.

However, if the claimant is not currently performing SGA,

or if the claimant is currently performing SGA but during

the period covered by the current application they did not

perform SGA for at least 12 continuous months, the duration

requirement could be met (as discussed in Question 1) and

the sequential evaluation process would proceed to step

two. At step two, if the claimant does not have a severe MDI,

or combination of MDIs that is medically severe, and has

lasted, or is expected to last, for a continuous period of

not less than 12 months or is expected to result in death,

the claimant cannot meet the duration requirement and we

will find the claimant is not disabled. [21] Further, we do not combine two or more successive,

unrelated impairments to meet the 12-month requirement in

initial claims. [22] For example, a claimant

involved in a bicycling accident on January 1, 2022,

suffered a pelvic fracture for which they underwent

immediate surgery. The fracture completely healed by August

1, 2022. The same claimant injured their rotator cuff in a

fall on July 1, 2022

do not combine two or more successive,

unrelated impairments to meet the 12-month requirement in

initial claims. [22] For example, a claimant

involved in a bicycling accident on January 1, 2022,

suffered a pelvic fracture for which they underwent

immediate surgery. The fracture completely healed by August

1, 2022. The same claimant injured their rotator cuff in a

fall on July 1, 2022. With treatment, the rotator cuff

injury resolved completely by February 2, 2023. The MDIs

were unrelated and neither MDI lasted 12 months. We will

find the claimant not disabled at step two because there is

no severe MDI that could meet the duration

requirement. [23] Because of the duration requirement, we will not

consider an MDI that completely resolves in less than 12

months after step two of the sequential evaluation process.

Consider, instead, a case where the individual sustained a

pelvic fracture that resolved completely within nine months

but had a subsequent rotator cuff injury that remained

severe for 12 continuous months. Sequential evaluation for

the rotator cuff impairment would continue but we would not

consider the pelvic fracture beyond step two. If the analysis proceeds to step three, we will

consider: (1) whether an MDI(s) meets or medically equals a

listing in the Listing of Impairments (listings), according

to the set of medical criteria in the listing; and, if so

vere for 12 continuous months. Sequential evaluation for

the rotator cuff impairment would continue but we would not

consider the pelvic fracture beyond step two. If the analysis proceeds to step three, we will

consider: (1) whether an MDI(s) meets or medically equals a

listing in the Listing of Impairments (listings), according

to the set of medical criteria in the listing; and, if so

(2) whether the MDI(s) meets the duration

requirement. [24] Once the claimant establishes that their

MDI(s) is severe enough to meet or equal a listed

impairment, the claimant must also show that this level of

severity lasted, or is expected to last, for a continuous

period of at least 12 months, or that the impairment is

expected to result in death. [25] Some listings specify a period of time we will consider

the claimant under a disability if their MDI(s) meets all

the criteria of the listing. This listing specification

does not change, supersede, or establish that the MDI(s)

meets the duration requirement. We use this listing

specification in certain instances to establish the

appropriate timeline for our continuing disability review

process as it relates to that impairment. The evidence of

record must show that the MDI(s) also meets the duration

requirement. For example, listing 6.04 (chronic kidney

disease, with kidney transplant) states that we will

consider an individual who has a kidney transplant due to

chronic kidney disease to be under a disability for one

year from the date of the transplant due to the potential

for complications, such as rejection episodes and post-

transplant functioning. Thereafter, we will evaluate any

residual limiting effects of the impairment. If the

claimant engages in SGA within 12 months from the date the

MDI(s) first prevented them from performing SGA we

generally will find them not disabled under the Act (as

discussed in Question 7)

transplant due to the potential

for complications, such as rejection episodes and post-

transplant functioning. Thereafter, we will evaluate any

residual limiting effects of the impairment. If the

claimant engages in SGA within 12 months from the date the

MDI(s) first prevented them from performing SGA we

generally will find them not disabled under the Act (as

discussed in Question 7). [26] Other listings contain criteria with temporal

requirements during which certain findings must be present.

These temporal requirements do not establish that the

MDI(s) met the duration requirement but instead serve as a

specific indicator of listing-level severity. For example,

listing 11.02 (Epilepsy, generalized tonic-clonic seizures

or dyscognitive seizures) states that the seizures must

occur at least once a month for at least three consecutive

months, despite adherence to prescribed treatment. The

frequency of seizures outlined in the listing criteria

establishes that the impairment is of listing-level

severity but is distinct from the duration requirement. To

meet the duration requirement, the evidence must show the

MDI(s) lasted at listing level or is expected to last at

listing level for 12 continuous months and that the

claimant's resulting inability to perform SGA by reason of

the MDI(s) has lasted, or is expected to last, for not less

than 12 months without interruption or stopping. If we cannot find the claimant disabled at step three,

the sequential evaluation process continues. [27] We assess the claimant's residual functional capacity (RFC), which is the

most an individual can do despite their impairment-related

limitations. [28] Because of the duration

requirement, we will not include limitations in the RFC

assessment that completely resolve, or that we expect to

completely resolve, within 12 months

t step three,

the sequential evaluation process continues. [27] We assess the claimant's residual functional capacity (RFC), which is the

most an individual can do despite their impairment-related

limitations. [28] Because of the duration

requirement, we will not include limitations in the RFC

assessment that completely resolve, or that we expect to

completely resolve, within 12 months. If the analysis proceeds to steps four or five of the

sequential evaluation process, we consider the claimant's

RFC when determining whether an individual can perform past

relevant work, or other work that exists in significant

numbers in the national economy.

- How does the duration requirement affect the

three-step sequential evaluation process for Title XVI

claimants who have not yet attained 18 years of age? For Title XVI disability claimants under age 18, we

will consider the child disabled if the child does not

perform SGA and has a medically determinable physical or

mental impairment, or combination of impairments, that

causes marked and severe functional limitations and has

lasted or can be expected to last for a continuous period

of not less than 12 months, or is expected to result in

death. [29] In

these cases, we use a three-step sequential evaluation

process, and the duration requirement for disability

applies throughout the sequential evaluation process for

children. [30] At steps one and two of the sequential evaluation

process for Title XVI children, we will apply the same

rules discussed for steps one and two of the adult

sequential evaluation process (as discussed above in

response to Question 4). If the child satisfies the

requirements for both steps one and two, we will proceed to

step three where we consider whether the child's MDI(s)

meets, medically equals, or functionally equals a

listing

process for Title XVI children, we will apply the same

rules discussed for steps one and two of the adult

sequential evaluation process (as discussed above in

response to Question 4). If the child satisfies the

requirements for both steps one and two, we will proceed to

step three where we consider whether the child's MDI(s)

meets, medically equals, or functionally equals a

listing. [31] At step three, to establish that the child has an MDI(s)

that meets, medically equals or functionally equals the

listings, the evidence must show that the MDI(s) has

lasted, or is expected to last, for a continuous period of

at least 12 months at listing level severity or is expected

to result in death. [32] If a child's MDI(s) is severe

but does not meet or medically equal any listing, we will

determine if the MDI(s) functionally equals the

listings. [33] We will decide that the

MDI(s) functionally equals the listings if it results in

marked limitations in two domains of functioning, or an

extreme limitation in one domain of functioning for a

continuous 12-month period. [34] If the child's MDI(s) does not meet, medically equal, or functionally equal the

listings, or does not meet the duration requirement, we

will find the child is not disabled.

- How do we consider the duration requirement when

the claimant has a new, severe MDI(s) in CDRs

cases? In CDR cases, the beneficiary or recipient has already

satisfied the duration requirement and established

disability. As a result, we only consider the duration

requirement when the impairment for which the claimant was

originally found disabled has improved, and disability

ended. How we consider duration when evaluating a new severe

MDI(s) depends on whether the new MDI(s) is disabling and,

if so, when it became disabling. To be disabling, the new

impairment(s) must be so severe as to prevent SGA

ty. As a result, we only consider the duration

requirement when the impairment for which the claimant was

originally found disabled has improved, and disability

ended. How we consider duration when evaluating a new severe

MDI(s) depends on whether the new MDI(s) is disabling and,

if so, when it became disabling. To be disabling, the new

impairment(s) must be so severe as to prevent SGA. [35] If the previously established MDI(s) is no longer disabling but

the new, severe MDI(s) is disabling, and if the new

disabling MDI(s) begins in, or before, the month in which

the previously established MDI(s) is no longer

disabling, [36] we

do not consider duration and will find that disability

continues. [37] If,

however, the claimant has a new disabling MDI(s) that

begins after the month in which the last impairment(s) was

no longer disabling, we consider the duration requirement

and determine whether to establish a new period of

disability using the rules for initial claims.

- What if we find that the claimant's MDI(s) meets

the duration requirement based on an expectation of

continued severity, but the claimant returned to SGA within

12 months? A claimant who recovers their ability to engage in SGA

within 12 months is not disabled under the Act. [38] How we evaluate

an actual return to work that is SGA depends, in part, on

whether we have already approved an award of benefits. If we have not issued a final determination or decision

that the individual was disabled and entitled to benefits,

and we determine the individual returned to work within 12

months of the first date the individual's MDI(s) otherwise

met the definition of disability, we deny the claim. If we

issued a final determination or decision that the

individual was disabled, and we later find that the

individual has returned to SGA after an award of benefits,

but within the 12-month period after onset, we do not

reopen and reverse the determination or decision

n 12

months of the first date the individual's MDI(s) otherwise

met the definition of disability, we deny the claim. If we

issued a final determination or decision that the

individual was disabled, and we later find that the

individual has returned to SGA after an award of benefits,

but within the 12-month period after onset, we do not

reopen and reverse the determination or decision. This is

because once disability payments begin, individuals might

be entitled to a trial work period (Title II), or to

continued Supplemental Security Income payments under

section 1619(a) of the Act. [39] If we issued a final determination or decision that the

individual was entitled to disability insurance benefits

and we later determine the individual returned to SGA

during the 5-month waiting period for Title II, we may

reopen and revise the determination or decision to issue a

denial. These individuals are not entitled to any

disability benefit payments. If we later determine the

return to work was an unsuccessful work

attempt, [40] we may reopen

and revise the denial to issue an allowance. However, we

can only reopen the determination or decision within the

time limitations under the rules of administrative

finality. [41]

How does a claimant meet the duration requirement for disability?

Duration is the period of time during which a

claimant is continuously unable to engage in SGA because of

one or more MDI(s). [9] To satisfy the duration

requirement for disability, the claimant's relevant MDI(s)

must have lasted or must be expected to last for a

continuous period of at least 12 months, unless we expect

the MDI(s) to result in death within 12 months of the onset

of disability. [10] An individual's inability to

perform SGA because of the relevant MDI(s) must also last

the required 12-month period, unless we expect an MDI(s) to

result in death within 12 months of the onset of

disability. A claimant must satisfy both elements to meet

the duration requirement

12 months, unless we expect

the MDI(s) to result in death within 12 months of the onset

of disability. [10] An individual's inability to

perform SGA because of the relevant MDI(s) must also last

the required 12-month period, unless we expect an MDI(s) to

result in death within 12 months of the onset of

disability. A claimant must satisfy both elements to meet

the duration requirement. [11] A claimant who was previously entitled to a period of disability must again meet the

duration requirement for the current application before a subsequent period of disability

can be established. [12]

What is an MDI that “can be expected to

result in death”?

An MDI that “can be expected to result in

death” is one for which the generally accepted

prognosis within the medical field and the evidence in the

case file demonstrate that the claimant is expected to die

as a result of that impairment within 12 months of the date

that the claimant became unable to engage in SGA. We also

consider an MDI that actually results in death to be one

that was “expected to result in death.”

What do we mean by “12 continuous

months” and how do we measure it in initial

claims?

The phrase “12 continuous months” means

both that the MDI(s) must have lasted, or be expected to

last, for a continuous period of at least 12 months and

that the claimant's resulting inability to perform SGA by

reason of the MDI(s) must also have lasted, or be expected

to last, for not less than 12 months without interruption

or stopping. [13]

how do we measure it in initial

claims?

The phrase “12 continuous months” means

both that the MDI(s) must have lasted, or be expected to

last, for a continuous period of at least 12 months and

that the claimant's resulting inability to perform SGA by

reason of the MDI(s) must also have lasted, or be expected

to last, for not less than 12 months without interruption

or stopping. [13]

We measure the 12-month period from any date [14] the claimant's MDI(s) first prevented the claimant from performing

SGA. [15] We do

not consider any period during which an MDI or combination

of MDIs did not prevent the claimant from performing SGA

when measuring duration. The duration period may begin

before, but cannot end before, the period during which we

can establish entitlement or eligibility. [16] For example, the duration period may begin before the date first insured

(DFI) in Title II disability insurance benefit (DIB)

claims, before the date of a spouse's death in Title II

disabled widow(er)'s benefit (DWB) claims, prior to the

potential onset date in Title II childhood disability

benefits (CDB) claims, or prior to the filing date in Title

XVI claims.

Unless the MDI(s) is expected to result in death,

duration continues through the earliest of the following dates:

- When the MDI(s) no longer prevents the claimant

from engaging in SGA; or

- When the MDI(s) is no longer expected to prevent

the claimant from engaging in SGA. [17]

When the MDI(s) no longer prevents the claimant

from engaging in SGA; or

When the MDI(s) is no longer expected to prevent

the claimant from engaging in SGA. [17]

How does the duration requirement affect the

five-step sequential disability evaluation process?

he claimant

from engaging in SGA; or

- When the MDI(s) is no longer expected to prevent

the claimant from engaging in SGA. [17]

When the MDI(s) no longer prevents the claimant

from engaging in SGA; or

When the MDI(s) is no longer expected to prevent

the claimant from engaging in SGA. [17]

How does the duration requirement affect the

five-step sequential disability evaluation process?

We consider the duration requirement at multiple

steps of the five-step sequential evaluation process we use

to evaluate disability in initial claims under Title

II, [18] age

18 redeterminations, [19] and adult claims under Title XVI. [20] At

step one, if the claimant is currently performing SGA we

will generally find that the claimant is not disabled.

However, if the claimant is not currently performing SGA,

or if the claimant is currently performing SGA but during

the period covered by the current application they did not

perform SGA for at least 12 continuous months, the duration

requirement could be met (as discussed in Question 1) and

the sequential evaluation process would proceed to step

two.

At step two, if the claimant does not have a severe MDI,

or combination of MDIs that is medically severe, and has

lasted, or is expected to last, for a continuous period of

not less than 12 months or is expected to result in death,

the claimant cannot meet the duration requirement and we

will find the claimant is not disabled. [21]

uential evaluation process would proceed to step

two.

At step two, if the claimant does not have a severe MDI,

or combination of MDIs that is medically severe, and has

lasted, or is expected to last, for a continuous period of

not less than 12 months or is expected to result in death,

the claimant cannot meet the duration requirement and we

will find the claimant is not disabled. [21]

Further, we do not combine two or more successive,

unrelated impairments to meet the 12-month requirement in

initial claims. [22] For example, a claimant

involved in a bicycling accident on January 1, 2022,

suffered a pelvic fracture for which they underwent

immediate surgery. The fracture completely healed by August

1, 2022. The same claimant injured their rotator cuff in a

fall on July 1, 2022. With treatment, the rotator cuff

injury resolved completely by February 2, 2023. The MDIs

were unrelated and neither MDI lasted 12 months. We will

find the claimant not disabled at step two because there is

no severe MDI that could meet the duration

requirement. [23]

Because of the duration requirement, we will not

consider an MDI that completely resolves in less than 12

months after step two of the sequential evaluation process.

Consider, instead, a case where the individual sustained a

pelvic fracture that resolved completely within nine months

but had a subsequent rotator cuff injury that remained

severe for 12 continuous months. Sequential evaluation for

the rotator cuff impairment would continue but we would not

consider the pelvic fracture beyond step two.

If the analysis proceeds to step three, we will

consider: (1) whether an MDI(s) meets or medically equals a

listing in the Listing of Impairments (listings), according

to the set of medical criteria in the listing; and, if so

ere for 12 continuous months. Sequential evaluation for

the rotator cuff impairment would continue but we would not

consider the pelvic fracture beyond step two.

If the analysis proceeds to step three, we will

consider: (1) whether an MDI(s) meets or medically equals a

listing in the Listing of Impairments (listings), according

to the set of medical criteria in the listing; and, if so

(2) whether the MDI(s) meets the duration

requirement. [24] Once the claimant establishes that their

MDI(s) is severe enough to meet or equal a listed

impairment, the claimant must also show that this level of

severity lasted, or is expected to last, for a continuous

period of at least 12 months, or that the impairment is

expected to result in death. [25]

Some listings specify a period of time we will consider

the claimant under a disability if their MDI(s) meets all

the criteria of the listing. This listing specification

does not change, supersede, or establish that the MDI(s)

meets the duration requirement. We use this listing

specification in certain instances to establish the

appropriate timeline for our continuing disability review

process as it relates to that impairment. The evidence of

record must show that the MDI(s) also meets the duration

requirement. For example, listing 6.04 (chronic kidney

disease, with kidney transplant) states that we will

consider an individual who has a kidney transplant due to

chronic kidney disease to be under a disability for one

year from the date of the transplant due to the potential

for complications, such as rejection episodes and post-

transplant functioning. Thereafter, we will evaluate any

residual limiting effects of the impairment. If the

claimant engages in SGA within 12 months from the date the

MDI(s) first prevented them from performing SGA we

generally will find them not disabled under the Act (as

discussed in Question 7). [26]

lant due to the potential

for complications, such as rejection episodes and post-

transplant functioning. Thereafter, we will evaluate any

residual limiting effects of the impairment. If the

claimant engages in SGA within 12 months from the date the

MDI(s) first prevented them from performing SGA we

generally will find them not disabled under the Act (as

discussed in Question 7). [26]

Other listings contain criteria with temporal

requirements during which certain findings must be present.

These temporal requirements do not establish that the

MDI(s) met the duration requirement but instead serve as a

specific indicator of listing-level severity. For example,

listing 11.02 (Epilepsy, generalized tonic-clonic seizures

or dyscognitive seizures) states that the seizures must

occur at least once a month for at least three consecutive

months, despite adherence to prescribed treatment. The

frequency of seizures outlined in the listing criteria

establishes that the impairment is of listing-level

severity but is distinct from the duration requirement. To

meet the duration requirement, the evidence must show the

MDI(s) lasted at listing level or is expected to last at

listing level for 12 continuous months and that the

claimant's resulting inability to perform SGA by reason of

the MDI(s) has lasted, or is expected to last, for not less

than 12 months without interruption or stopping.

If we cannot find the claimant disabled at step three,

the sequential evaluation process continues. [27] We assess the claimant's residual functional capacity (RFC), which is the

most an individual can do despite their impairment-related

limitations. [28] Because of the duration

requirement, we will not include limitations in the RFC

assessment that completely resolve, or that we expect to

completely resolve, within 12 months.

step three,

the sequential evaluation process continues. [27] We assess the claimant's residual functional capacity (RFC), which is the

most an individual can do despite their impairment-related

limitations. [28] Because of the duration

requirement, we will not include limitations in the RFC

assessment that completely resolve, or that we expect to

completely resolve, within 12 months.

If the analysis proceeds to steps four or five of the

sequential evaluation process, we consider the claimant's

RFC when determining whether an individual can perform past

relevant work, or other work that exists in significant

numbers in the national economy.

How does the duration requirement affect the

three-step sequential evaluation process for Title XVI

claimants who have not yet attained 18 years of age?

For Title XVI disability claimants under age 18, we

will consider the child disabled if the child does not

perform SGA and has a medically determinable physical or

mental impairment, or combination of impairments, that

causes marked and severe functional limitations and has

lasted or can be expected to last for a continuous period

of not less than 12 months, or is expected to result in

death. [29] In

these cases, we use a three-step sequential evaluation

process, and the duration requirement for disability

applies throughout the sequential evaluation process for

children. [30]

At steps one and two of the sequential evaluation

process for Title XVI children, we will apply the same

rules discussed for steps one and two of the adult

sequential evaluation process (as discussed above in

response to Question 4). If the child satisfies the

requirements for both steps one and two, we will proceed to

step three where we consider whether the child's MDI(s)

meets, medically equals, or functionally equals a

listing. [31]

ess for Title XVI children, we will apply the same

rules discussed for steps one and two of the adult

sequential evaluation process (as discussed above in

response to Question 4). If the child satisfies the

requirements for both steps one and two, we will proceed to

step three where we consider whether the child's MDI(s)

meets, medically equals, or functionally equals a

listing. [31]

At step three, to establish that the child has an MDI(s)

that meets, medically equals or functionally equals the

listings, the evidence must show that the MDI(s) has

lasted, or is expected to last, for a continuous period of

at least 12 months at listing level severity or is expected

to result in death. [32] If a child's MDI(s) is severe

but does not meet or medically equal any listing, we will

determine if the MDI(s) functionally equals the

listings. [33] We will decide that the

MDI(s) functionally equals the listings if it results in

marked limitations in two domains of functioning, or an

extreme limitation in one domain of functioning for a

continuous 12-month period. [34] If the child's MDI(s) does not meet, medically equal, or functionally equal the

listings, or does not meet the duration requirement, we

will find the child is not disabled.

How do we consider the duration requirement when

the claimant has a new, severe MDI(s) in CDRs

cases?

In CDR cases, the beneficiary or recipient has already

satisfied the duration requirement and established

disability. As a result, we only consider the duration

requirement when the impairment for which the claimant was

originally found disabled has improved, and disability

ended.

How do we consider the duration requirement when

the claimant has a new, severe MDI(s) in CDRs

cases?

In CDR cases, the beneficiary or recipient has already

satisfied the duration requirement and established

disability. As a result, we only consider the duration

requirement when the impairment for which the claimant was

originally found disabled has improved, and disability

ended.

How we consider duration when evaluating a new severe

MDI(s) depends on whether the new MDI(s) is disabling and,

if so, when it became disabling. To be disabling, the new

impairment(s) must be so severe as to prevent SGA. [35] If the previously established MDI(s) is no longer disabling but

the new, severe MDI(s) is disabling, and if the new

disabling MDI(s) begins in, or before, the month in which

the previously established MDI(s) is no longer

disabling, [36] we

do not consider duration and will find that disability

continues. [37] If,

however, the claimant has a new disabling MDI(s) that

begins after the month in which the last impairment(s) was

no longer disabling, we consider the duration requirement

and determine whether to establish a new period of

disability using the rules for initial claims.

What if we find that the claimant's MDI(s) meets

the duration requirement based on an expectation of

continued severity, but the claimant returned to SGA within

12 months?

A claimant who recovers their ability to engage in SGA

within 12 months is not disabled under the Act. [38] How we evaluate

an actual return to work that is SGA depends, in part, on

whether we have already approved an award of benefits.

the claimant's MDI(s) meets

the duration requirement based on an expectation of

continued severity, but the claimant returned to SGA within

12 months?

A claimant who recovers their ability to engage in SGA

within 12 months is not disabled under the Act. [38] How we evaluate

an actual return to work that is SGA depends, in part, on

whether we have already approved an award of benefits.

If we have not issued a final determination or decision

that the individual was disabled and entitled to benefits,

and we determine the individual returned to work within 12

months of the first date the individual's MDI(s) otherwise

met the definition of disability, we deny the claim. If we

issued a final determination or decision that the

individual was disabled, and we later find that the

individual has returned to SGA after an award of benefits,

but within the 12-month period after onset, we do not

reopen and reverse the determination or decision. This is

because once disability payments begin, individuals might

be entitled to a trial work period (Title II), or to

continued Supplemental Security Income payments under

section 1619(a) of the Act. [39]

If we issued a final determination or decision that the

individual was entitled to disability insurance benefits

and we later determine the individual returned to SGA

during the 5-month waiting period for Title II, we may

reopen and revise the determination or decision to issue a

denial. These individuals are not entitled to any

disability benefit payments. If we later determine the

return to work was an unsuccessful work

attempt, [40] we may reopen

and revise the denial to issue an allowance. However, we

can only reopen the determination or decision within the

time limitations under the rules of administrative

finality. [41]

[1] See 20 CFR 404.1520(a)(2) and 416.924 .

[2] See 20 CFR 404.1594 , 416.994 , and 416.994a .

[3] See

section 1619(a)-(b) of the Act. See also 20 CFR 416.260 and 416.262 .

work

attempt, [40] we may reopen

and revise the denial to issue an allowance. However, we

can only reopen the determination or decision within the

time limitations under the rules of administrative

finality. [41]

[1] See 20 CFR 404.1520(a)(2) and 416.924 .

[2] See 20 CFR 404.1594 , 416.994 , and 416.994a .

[3] See

section 1619(a)-(b) of the Act. See also 20 CFR 416.260 and 416.262 .

[4] See 20 CFR 404.1592a and 404.1592b .

[5] We will

use this SSR beginning on its applicable date. We will apply this SSR

to new applications filed on or after the applicable date of the SSR and

to claims that are pending on and after the applicable date. This means

that we will use this SSR on and after its applicable date in any case

in which we make a determination or decision. We expect that Federal

courts will review our final decisions using the rules that were in

effect at the time we issued the decisions. If a court reverses our final

decision and remands a case for further administrative proceedings after

the applicable date of this SSR, we will apply this SSR to the entire

period at issue in the decision we make after the court's remand.

[6] Title

XVI claimants under age 18 are disabled if they are not performing SGA

and their medically determinable physical or mental impairment(s) causes

marked and severe functional limitations and can be expected to cause

death or has lasted or can be expected to last for a continuous period

of 12 months. See section 1614(a)(3)(C) of the Act and 20 CFR 416.906 .

[7] See sections 216(i) , 223(d) , 1614(a) of the Act. See also 20 CFR 404.1505 , 404.1521 and 416.905 , 416.921 .

While there is no duration requirement for

statutorily blind individuals under Title XVI, the duration requirement

applies to statutorily blind individuals under Title II. See generally 216(i) and 1614(a) of the Act. See also 20 CFR 404.1581 and 416.981 .

[8] 20 CFR 404.1509 and 416.909 .

ections 216(i) , 223(d) , 1614(a) of the Act. See also 20 CFR 404.1505 , 404.1521 and 416.905 , 416.921 .

While there is no duration requirement for

statutorily blind individuals under Title XVI, the duration requirement

applies to statutorily blind individuals under Title II. See generally 216(i) and 1614(a) of the Act. See also 20 CFR 404.1581 and 416.981 .

[8] 20 CFR 404.1509 and 416.909 .

[9] For

title XVI claimants under the age of 18, duration is the period of time

during which the claimant is not performing SGA and experiences marked

and severe functional limitations because of a medically determinable

physical or mental impairment, or a combination of impairments. See 20 CFR 416.906 and 416.924 .

For these claimants, we generally measure

duration from the first date the claimant's MDI(s) results in marked and

severe functional limitations. An impairment(s) causes marked and severe

functional limitations if it meets or medically equals the severity of a

set of criteria for an impairment in the listings, or if it functionally

equals the listings. See 20 CFR 416.924 .

[10] 20 CFR 404.1509 and 416.909 .

[11] See Barnhart v. Walton , 535 U.S. 212 (2002).

[12] 20 CFR 404.321 .

[13] See Barnhart v. Walton , 535 U.S. 212 (2002).

[14] For detailed guidance on how we determine whether a claimant meets the

statutory definition of disability, and if so, when the claimant first

met that definition, see SSR 18-1p Titles II and XVI: Determining the Established Onset Date (EOD) in Disability Claims.

[15] For

Title XVI claimants under age 18, we generally measure duration from the

first date the claimant's MDI(s) results in marked and severe functional

limitations. See 20 CFR 416.924 .

[16] See Walton , 535 U.S. 212 (2002).

[17] For

Title XVI claimants under age 18, duration ends when the child engages

in SGA or no longer has marked and severe functional limitations. See 20 CFR 416.924 .

[18] See 20 CFR 404.1520 .

[19] See 20 CFR 416.987 .

[20] See 20 CFR 416.920 .

first date the claimant's MDI(s) results in marked and severe functional

limitations. See 20 CFR 416.924 .

[16] See Walton , 535 U.S. 212 (2002).

[17] For

Title XVI claimants under age 18, duration ends when the child engages

in SGA or no longer has marked and severe functional limitations. See 20 CFR 416.924 .

[18] See 20 CFR 404.1520 .

[19] See 20 CFR 416.987 .

[20] See 20 CFR 416.920 .

[21] See 20 CFR 404.1509 , 404.1520(a)(4)(ii) and 416.909 , 416.920(a)(4)(ii) .

[22] See 20 CFR 404.1523(a) and 416.923(a) .

[23] Id.

[24] See 20 CFR 404.1520(a)(4)(iii) and 416.920(a)(4)(iii) .

[25] See 20 CFR 404.1520(d) and 416.920(d) .

[26] See sections 216(i) , 223(d) , 1614(a) of the Act. See 20 CFR 404.1505 , 404.1509 , 404.1520 and 416.905 , 416.909 , 416.920 .

See also Walton, 535 U.S. at 217-22.

[27] See 20 CFR 404.1520(a)(4) and 416.920(a)(4) .

[28] See 20 CFR 404.1545 and 416.945 .

[29] See section 1614(a)(3)(C) of the Act. See also 20 CFR 416.906 .

[30] See 20 CFR 416.924 .

[31] See 20 CFR 416.924(d) .

[32] See 20 CFR 416.924 .

[33] See 20 CFR 416.924(d) and 416.926a .

[34] See 20 CFR 416.926a(d) .

[35] Or,

in the case of a child under age 18 receiving Supplemental Security

Income payments, the new impairment(s) must be so severe as to result

in marked and severe functional limitations. See 20 CFR 416.998 .

[36] See 20 CFR 404.1594(g) and 416.994(b)(6) , 416.994a(g) , for how we determine

the month in which the individual's last impairment(s) is no longer disabling.

[37] See 20 CFR 404.1598 and 416.998 .

[38] See sections 216(i) , 223(d) , 1614(a) of the Act, 20 CFR 404.1505 , 404.1509 , 404.1520 and 416.905 , 416.909 , 416.920 .

See also Walton, 535 U.S. at 217-22.

[39] See 20 CFR 404.1592 .

[40] See 20 CFR 404.1574(c) and 416.974(c) .

[41] See 20 CFR 404.988 and 416.1488 .