Recently on our disability forum a user asked, “I broke my back on the job when a large beam fell from a crane. I applied for workers’ compensation which I am currently receiving. I then tried to apply for SSDI benefits, but I was told that I did not qualify. Something about insufficient work credits. Can you help me understand why I was denied and what options I have to receive the benefits I think I deserve?”
SSDI benefits and a broken back
Social Security Disability Insurance benefits (SSDI) are awarded to workers who have a serious health condition and who are not able to perform substantial gainful activity for at least 12 continuous months. The SSA also requires claimants to have worked and earned work credits, thus insuring them for injuries.
SSDI benefits are similar to car insurance. Claimants pay “premiums” and are covered for a period of time if they are injured. SSDI benefits are not guaranteed. Claimants may also lose the right to benefits if they stop working for too long and their insured status expires.
Why were you denied SSDI benefits for your broken back?
Without more information about your claim it’s impossible to say for sure why you were denied. If your case was denied before it was sent to the Disability Determination Service’s Office (DDS)– which is the state agency which determines disability for SSDI- then it’s safe to assume that you did not meet one of the nonmedical requirements for SSDI benefits. With this in mind, we’ll take a look at some the nonmedical requirements for SSDI benefits.
- Claimants lack sufficient credits to be insured for SSDI benefits.
The most common reason claimants are denied SSDI benefits is that they do not have enough work credit to be insured for SSDI. Claimants may earn one credit in 2016 if they earn $1,260 in qualified earnings. Claimants may a maximum of 4 work credits per year.
How do you know how many work credits you have or how many you need to qualify for SSDI benefits? You can contact the SSA. In general, however, the SSA states “claimants need 40 credits, 20 of which were earned in the last 10 years ending with the year you become disabled. However, younger workers may qualify with fewer credits.”
- Claimant’s condition is not expected to last 12 continuous months.
Another reason you may have been denied SSDI benefits for your broken back is that the SSA does not believe that your broken back will keep you from working for at least 12 continuous months. Now, the SSA is not always right, and you don’t have to wait the full 12 months to apply, but you will need evidence from your treating doctor to substantiate your claim that your condition will last 12 months.
If your condition does not last that long or you do not have any evidence that it will last that long, don’t expect to be approved for SSDI benefits. An option, however, if you do end up being disabled for at least 12 months, even if you do not go back to work, is to apply for closed period benefits for your broken back.
Bottom line: There are several reasons your case may have been denied. Review your denial letter and discuss your case with the SSA.
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