Recently on our legal forum a user asked, “I have severe migraines. Most days I can hardly get out of bed. I have been having issues for several years and have had difficulty working. I applied for SSDI three times, but they have denied my case. I am wondering why I have been denied and what I can do to win Social Security Disability Insurance benefits?”
Overview of Social Security Disability Insurance (SSDI)
Workers who have suffered a severe injury or have a mental or physical health condition may find it difficult to work. The good news is the Social Security Administration (SSA) provides wage replacement benefits to qualifying workers. Specifically, workers who have a health condition which is so severe it does not allow them to work for 12 continuous months, who meet other nonmedical requirements, and who have worked and earned sufficient work credits to be considered “insured” for benefits.
Why would your SSDI case be denied?
Millions of workers apply for SSDI benefits each year. Unfortunately, most of them are denied SSDI benefits. In fact, it’s not unusual for applicants to be denied multiple times with some of them never qualifying for SSDI.
Now, whether you will qualify will depend on several different factors, including the reason you were denied. With that in mind, let’s review the steps you need to take to determine if you actually qualify for SSDI.
Steps to determine whether you qualify for SSDI benefits:
- Review your denial letter.
After you submit your Social Security Disability Insurance application to the SSA, they will review it and within 30- 90 days they should send you either an acceptance or denial letter (they may also request additional information or request that you attend a consultative examination prior to making their decision).
After you get the letter you need to review it and make sure you understand why you were denied. If you have any questions contact the SSA.
- Determine if your claim can be appealed.
Next, if you received a denial letter, you will need to determine whether your denial can be appealed.
Claims can be denied for technical and nontechnical reasons. In some cases, disability applicants will not even meet the most basic nonmedical requirements for SSDI benefits. For example, the SSA may determine you do not have enough work credits to qualify for benefits. If this occurs, this is considered a technical denial, and although it can be appealed, overturning this type of technical denial will require proving that the SSA made an error in their calculations, did not have all your work information, or made a mistake.
Another common technical denial occurs if you are working or making too much money when you apply for SSDI. If this is the case, it does not matter how disabled you might be, if you are performing substantial gainful activity (SGA) the SSA will deny your case.
Finally, if you meet the nonmedical requirements for Social Security Disability Insurance, you can still be denied for medical reasons. Specifically, the SSA can deny your claim because they do not think your condition is severe, they do not believe it will last 12 months, or they do not believe it will keep you from working.
Your SSDI claim can be denied for a variety of reasons. If you have been denied multiple times for medical reasons but you do not believe you can work, it might be time to talk to a disability lawyer.
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