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How could the SSA deny my claim after only a week?

Many claimants are denied in less than a week for disability benefits and are concerned that the Social Security Administration (SSA) did not bother to pull their medical records and actually review their Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) claim.

The Social Security Administration makes their disability determination based on nonmedical and medical criteria. If your SSI or SSDI claim was denied within a few days or weeks it may be because you did not meet the nonmedical criteria of the disability program. Let’s take a closer look at what nonmedical criteria the SSA considers prior to requesting your medical records.

Nonmedical Requirements for SSDI



SSDI is only awarded to disabled claimants who have worked and have attained an “insured” status. To be ensured you must have worked and earned enough “work credits” to be considered eligible for SSDI.

According to the SSA website (www.ssa.gov), how many credits you need for disability benefits depends on how old you are when you become disabled.

• If you become disabled before age 24, you generally need 1½ years of work (six credits) in the three years before you became disabled.

• If you are 24 through 30, you generally need credits for half of the time between age 21 and the time you became disabled.

• If you are disabled at age 31 or older, you generally need at least 20 credits in the 10 years immediately before you became disabled.

If you do not have enough work credits for SSDI benefits the SSA will deny your claim right away. This is considered a technical denial, and if this occurs, the SSA does not have to pull your medical records to review your health status.

What if you are denied because you do not have enough work credits? You can see if you qualify for Supplemental Security Income (SSI), which does not require claimants to have a work history, or you can return to work to accumulate more credits. Workers can receive one credit for each $1,120 of earnings, up to the maximum of four credits per year (in 2011).

Nonmedical Requirements for SSI



Supplemental Security Income is provided to the aged (65 years or older), blind or disabled who have not worked and who are not considered “insured” by the Federal Government but need cash assistance each month to pay for their minimum monthly expenses. Supplemental Security Income is a “needs” based program, and unlike SSDI, if a claimant's income and resources are too high, they will not qualify for SSI benefit.

First, the SSA will evaluate your income which can be earned income (wages), unearned income (Social Security benefits, pensions, state disability payments, unemployment benefits, and cash from friends and family), in-kind income (any food or shelter that you receive which is less than the fair market value), or deemed income (income from your spouse or parents).

Not all types of income are counted as “income” for the SSI program, but in general, the more income you receive, the less Supplemental Security Income benefits will be paid to you. If your countable income is higher than the amount allowed, you will be denied SSI benefits, regardless of the severity of your health conditions.

Next, the SSA will evaluate your resource levels. According to the SSA, resources can include land, vehicles, personal property, bank accounts, United States’ Savings Bonds, life insurance, and cash (information found at www.ssa.gov). The current limit for 2011 is $2000 per individual and $3000 per couple.

Not all resources are counted by the Social Security Administration. Currently, the SSA exempts the following resources:

• Your primary residence and land
• Personal effects and household goods.
• Burial plots for your immediate family members
• Burial funds for you and your spouse up to $1,500
• Life insurance policies for $1500 or less
• One vehicle
• Grants, fellowships, or gifts which are set aside to pay for educational costs within 9 months after their receipt
• Retroactive SSI or Social Security benefits for up to nine months after you receive them

(Information provided by the SSA at www.ssa.gov)

If you have been denied benefits within a few days, chances are that you have not met the nonmedical requirements for either the SSI or SSDI program.