The unfortunate reality of applying for Social Security Disability benefits is that the majority of claims are not initially approved. While there are many reasons your SSDI claim may be denied, this blog post covers two common reasons SSDI claims are not successful.
Lack of Work Credits
The Social Security Disability Insurance (SSDI) program has strict regulations governing who is and who is not eligible to participate in their programs. One of the most important rules is that you have to have sufficient work credits to be eligible for SSDI.
Social Security measures the work you have done in the past in the form of work credits. Claimants must have a sufficient number of work credits to be considered eligible
Social Security work credits are based on your total yearly wages or self-employment income. You can earn up to four credits each year. The amount needed for a work credit changes from year to year. In 2020, for example, you earn one credit for each $1,410 in wages or self-employment income. When you’ve earned $5,640, you’ve earned your four credits for the year.
The number of work credits you need to qualify for disability benefits depends on your age when you become disabled. Generally, you 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.
While the concept of work credits is relatively straightforward, many claimants who apply for disability benefits without a lawyer fail to consider their basic qualifications for the program before applying and have to re-apply or may not qualify altogether.
Not ‘Disabled” by Social Security’s Definition
In addition to meeting Social Security’s standard for work credits, claimants must also meet the program’s definition of disability.
SSDI defines a qualifying disability as “the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”
Proving you are disabled by Social Security’s standards requires a substantial amount of evidence and effort. It is common for people to find that although their medical impairments are serious, they are not severe enough to limit their ability to return to work in some capacity.
Similarly, it is common for individuals who have severe medical impairments to lack the treatment record and evidence to substantiate their claim. Social Security requires impairments to be ‘medically determinable.’
This means that claimants are required to prove their medical problems are severe, ongoing and chronic. Claimants with strong claims prove that by working with the medical providers who have monitored or cared for their medical problems over the years. In many cases, successful claimants provide Social Security with doctors’ notes, medical tests, visit history and sometimes even personal letters from their providers that support their claim for disability.
Unfortunately, some claimants lack a consistent treatment record or guiding evidence from medical professionals. In those cases, even with severe medical problems preventing them from working, claimants are not likely to be approved for benefits.
There are compassionate exceptions to this rule for particularly severe and advanced medical conditions. If you are working with a qualified disability lawyer, they will help you identify if you have one of these conditions and can help you expedite an approval accordingly.