On July 23, 2021, the Social Security Administration (SSA) published a temporary final rule in the Federal Register (86 FR 38920) that will allow disability claims examiners and judges to award benefits to more individuals whose healthcare has been interrupted by the COVID-19 pandemic.
When Social Security reviews a claim to determine if an individual is disabled, the agency first considers whether that individual meets any of its "impairment listings." The listings are broken into categories of impairments, such as musculoskeletal disorders (spine disorders, joint disorders, amputations, and so on). Each category contains specific impairment listings with detailed criteria which, if met, will qualify a person for disability benefits.
For many of the musculoskeletal disorders, all of the required criteria must be present simultaneously or within a "close proximity of time" of each other to meet the requirements of the listing. The criteria usually include signs and symptoms pointing to the condition as well as medical imaging (like x-rays or MRIs) or other diagnostic tests.
Social Security previously defined "close proximity" as being within a four-month window, but the agency will now allow evidence of symptoms and other criteria that are all present within a 12-month window.
For instance, for listing 1.22, for nonhealing fractures of a lower extremity or pelvic bone, the criteria are 1) imaging showing that the bones didn't join together, 2) a physical limitation lasting a continuous period of 12 months, and 3) the need for a walker, bilateral canes or crutches, or a wheelchair. Before this rule change, an MRI that was more than four months old might not have helped meet the listing.
The change from a 4-month window for medical evidence to a 12-month window means that Social Security is more likely to approve claims that might otherwise have been denied solely because applicants were unable to get new x-rays or imaging, or go in for a physical examination, during the COVID-19 pandemic.
This new 12-month rule applies to the following listings:
Unless Social Security or Congress extends this rule further, it will expire six months "after the COVID-19 national public health emergency no longer exists." This likely means the rule will last until late 2022 or 2023. Social Security will publish a document in the Federal Register announcing the official expiration date of this rule, once it is known, and we will update this page accordingly.