Before the Social Security Administration’s (SSA) disability examiners determine if your health impairments are severe enough to prevent you from working, they ensure you qualify based on a list of technical criteria. They deny many applications during this process because the applicants are not eligible for benefits for one reason or another unrelated to their disability.
For help after a denial, work with the claim denial attorneys at Berger and Green today. We can help you understand if a Social Security Disability (SSD) technical denial is standing between you and your benefits.
What Is a Technical Denial?
A technical denial occurs when the disability examiner issues a denial of benefits based on a non-medical requirement for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). For this reason, technical denials are also sometimes called non-medical denials.
If this happens to you, the SSA will send a letter of denial and they will not evaluate your claim any further. Since they evaluate these technical qualifications before delving into your medical history, this means there is no medical determination in your case.
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What Are the Non-Medical Reasons for a Denial of SSI Benefits?
SSI is a need-based program with strict income and asset limits. As a result, a technical denial for SSI most likely stems from an income or assets above the limit. This can be a mistake. The SSA may have failed to allow you to exempt your home, car, or business-related assets. We can help you understand the current limits for this program and fight for the compensation you deserve.
What We Do After an SSI Denial
Technical denials based on mistakes by the SSA or due to missing paperwork or errors can be appealed. That means even if you face a non-medical denial for SSI, you still have options. At Berger and Green, our attorneys can help by compiling evidence of errors or assisting you in supplying any missing paperwork.
For example, imagine you apply for SSI benefits, but the records show you earn just above the 2022 income limit of $841 per month. If we can show you have impairment-related work expenses to deduct and this brings your income under the limit, you may qualify for benefits.
What Are the Non-Medical Reasons for a Denial of SSDI Benefits?
Both SSI and SSDI require that you have a qualifying disability and income limits, but the evaluation of your SSDI claim will focus on your work history and what you have paid into Social Security, whereas SSI eligibility is based on your income and assets.
Consequently, the three most common reasons applicants receive a technical denial for the SSDI program include:
- Not enough work credits
- Not enough work credits from recent work
- Earning above the substantial gainful activity maximum
Denials Based on Work Credits
Unlike the SSI program, drawing SSDI benefits requires you to work and pay into the Social Security system for a number of years before qualifying for disability. If you do not have the required number of work credits for your age or have not earned these credits recently enough, you may receive a technical denial. Most workers need a minimum of 20 credits earned in the last decade.
Think of it like this—your car insurance would drop you and not provide coverage if you stopped paying your premiums prior to you attempting to file a claim. In the same way, the SSA will “drop” you (deny your claim) if you haven’t worked and paid into Social Security.
Denials Based on Income
While SSDI is not a need-based program like SSI, there is an income limit for applicants in both programs. Known as the substantial gainful activity limit, exceeding this monthly income amount from working a job triggers a technical denial.
It is important to note, however, that this only considers earnings from a job you work. Income from investments, for example, does not count. In addition, if you are self-employed there are some other requirements.
Determining what should count toward your substantial gainful activity and what should be exempt can be challenging for laymen. Consulting one of our Social Security Disability attorneys can help clarify this part of your application or denial.
What We Do After an SSDI Denial
Much like private insurance, an SSDI coverage denial based on these technicalities doesn’t mean you are immediately out of luck. Errors made by the SSA or paperwork mistakes could be rectified in an appeal.
For instance, for an income-based denial, we may also be able to deduct certain impairment-related work expenses. We can help you evaluate your situation and determine if you qualify for benefits even after a technical denial.
What Are the Other Reasons the SSA Might Deny My Claim?
Some technical denials are due to very specific situations, such as the death or retirement of the claimant. You may also face a technical denial if you are the disabled survivor of someone who had Social Security benefits. The SSA may even issue a technical denial because they can’t find a way to contact you; providing accurate contact and location information is therefore crucial.
Other Grounds for Claim Denial
In reality, many initial applications for SSD programs receive a denial. Only a fraction of these is due to a non-medical technicality. Other reasons for a denial could include:
- Failure to provide enough medical evidence of a qualifying disability
- Your disability isn’t considered severe enough
- Your disability won’t last at least 12 months
- Failure to undergo a required medical examination
- Refusing to follow medical advice or receive treatment
Some of these reasons may not be accurate, and you may feel frustrated at seeing one of them as the grounds for your claim denial. These issues can also potentially be appealed.
How We Combat Other Denials
While the technical qualifications are very important, we often spend much of our time and resources focused on ensuring your medical condition and impairments fit the SSA’s definition of disabled. This includes having a condition that prevents you from working for at least one year or is likely to cause your death.
We will also need to ensure your medical records clearly document a condition included in the Blue Book, the SSA’s impairment listings. If not, we can rely on your residual functional capacity to show you are not able to work your previous job, any other job you qualify for, or a job that requires only unskilled labor.
Medical denials are the most common reason for disability benefit denials. We have the resources and skills needed to give you the best chance of approval when you apply initially and can help you fight a medical denial if it occurs.
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Can I Appeal an SSD Technical Denial?
If you receive a technical denial of disability benefits, we can discuss that with you. SSA will not evaluate your medical impairment and rule on your claim until the technical problems in your case are resolved.
The appeals process typically involves these aspects:
- Reconsideration of your claim by an individual who did not review your original claim
- Hearing overseen by an Administrative Law Judge, either over the phone, via video, or in person
- Review of your appeal by the Appeals Council, in which they may agree with the Administrative Law Judge’s ruling or issue a new decision
- Review of your case by the Federal Court
Your appeal could be settled with the first option, or you may need to continue to appeal your case. We can represent you at any and every stage.
Get Help with the SSD Technical Denial Appeal Process
If you received a technical denial of your benefits or another reason for denying your claim, the disability lawyers at Berger and Green offer free consultations. Call us today.