Why Was My SSDI Claim Denied?
If you have recently been denied Social Security Disability Insurance (SSDI) benefits, you may be wondering why. There are several reasons why SSDI applications are denied, including financial resources, work history, medical conditions, or disabilities. Let’s get into some of the reasons. Remember that just because your claim has been denied, doesn’t mean that you cannot be eligible. Oftentimes, the denial is from an error in the application process. Consult with a Social Security disability attorney who is experienced with claim denials and appeals.
Financial Resources and Income Level
SSDI has specific financial criteria. If your income exceeds the Substantial Gainful Activity (SGA) limit, your claim may be denied. This threshold changes yearly and considers earnings from work and other income sources. For more information, visit the SSA Substantial Gainful Activity page.
Work Credits
To qualify for SSDI benefits, you must have enough work credits. Generally, you need at least 40 credits if you’re over the age of 31, and 20 of those must have been earned in the last 5 years. For younger applicants, fewer credits are required. On average, working full-time earns you 4 credits per year. Learn more about work credits on the SSA Credits page.
Medical Condition and Severity
Your disability must be severe enough to prevent you from working for at least 12 months or be terminal. If your condition is expected to improve within a year, your application will likely be denied. However, severe cases might qualify for the Compassionate Allowances program, which expedites processing. More details can be found on the SSA Compassionate Allowances page.
Failure to Follow Prescribed Therapy
If you fail to follow the prescribed medical treatment without a valid reason, your claim may be denied. The SSA requires that you follow treatment plans to confirm the persistence and severity of your disability. For more information, visit the SSA Medical Treatment page.
Insufficient Medical Evidence
Many claims are denied due to a lack of adequate medical evidence. It’s crucial to provide comprehensive documentation from healthcare providers that detail the extent of your disability and its impact on your ability to work. Learn more about the medical evidence required on the SSA Medical Evidence page.
Options After an Application Denial
More than 60 percent of initial SSDI claims are denied. If your application is denied, you can appeal the decision. Although the appeals process can be challenging, success rates improve during the hearing phase. Consult an experienced Social Security Disability Lawyer. They can assist in gathering additional evidence, navigating the appeals process, and representing you at hearings.For more information on the appeals process, visit the SSA Appeals page.