Understanding the Reasons for Technical SSI and SSDI Denials and Your Next Step

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Social Security benefits denials are not uncommon. In fact, a denial is the most common result for initial filings for disability benefits. Of the more than 2 million applications for disability benefits, at the outset, only just under 70 percent will even be analyzed under the Social Security Administration’s (SSA) 5-step sequential review process. 31 percent of initial filings are denied solely due to technical, non-medical problems with the application. Of the 69 percent that make it through the initial screen, only about 38 percent will be approved for benefits. The more than 60 percent of claimants denied must engage in the appeal process or forego benefits.

However, one must understand the reason for denial before an effective appeal can be filed. We can analyze several common reasons for denials on medical grounds and on technical program grounds. If you have questions or concerns about a denial notice you have received contact the Law Practice of Ken Kieklak by calling (479) 251-7767 or contact us online.

Common Reasons for a Technical Denials of Social Security Disability Benefits

There are a myriad of reasons as to why one might receive a technical denial in response to a SSDI or SSI application. Some of the more commonly reported reasons for a denial include:

  • The applicant has an insufficient work credits –   For SSDI benefits only, an applicant must show that he or she can satisfy both the overall work credit requirement and the recent work requirement. Older workers typically require a greater number of credits than a younger worker would. As for the recent work requirement, workers must generally show that their recent work history satisfies program requirements.
  • You earn too much money – Both SSI and SSDI are subject to monthly income limits. This limit is referred to as substantial gainful income (SGA) by the Social Security Administration. While all disabled individuals are subject to monthly limits on SGA, those who are legally blind face a greater limit on average monthly earning before becoming ineligible for benefits.
  • You exceed asset limits – The SSI program is intended for benefits applicants with limited assets and resources. Those who apply for SSI benefits are subject to household asset means testing.
  • You fail to follow doctor’s orders or are otherwise uncooperative – While there are good reasons for failing to follow through on a treatment regimen, an administrative law judge may decide to interpret such actions negatively. An experienced Social Security disability attorney can that you had good reason, for your failure to follow treatment such as being unable to afford the medication or treatments.

The foregoing captures some of the more commonly proffered reasons behind a technical denial. To be clear, technical denial do not mean that you are not disable or are not suffering from a severe condition. What they do mean is that the SSA has not even looked at your medical evidence or performed an analysis.

What’s Next After a Technical Denial?

Following a technical denial, a disability benefits applicant is entitled to several levels of administrative appeal. Should the administrative appeal options not produce a satisfactory result for the claimant, appeal to federal court is possible. However, in practice, it is rare to go beyond the administrative appeal levels unless there appears to be an inherent issue with the SSA’s decisional process or an issue of first impression.

At the first level of appeal is the reconsideration level. At reconsideration your appeal will be looked at once more. It is extremely rare for an appeal to be successful at the initial level so most applicants will need to appeal once more. At the next hearing level, an administrative law judge will review the matter for errors. Furthermore, the applicant is entitled to an in-person hearing. While court hearings can be intimidating, much of the unknown can be eliminated by working with a trusted SSI or SSDI representative.  Furthermore, the in-person hearing can be the applicant’s best opportunity to put a face to an application and, in his or her own words, demonstrate the extent of his or her severe impairments. At the Appeals Council level, a panel of adjudicators will look at not only factual errors, but also potential errors of law made by the administrative law judge. Because errors as a matter of law can turn on dense, technical regulations and agency manuals, one’s chances for a successful appeal can be greatly aided by an experienced SSD representative at this stage.

Put our Social Security Disability Experience to Work for you

For more than 20 years, Ken Kieklak of the Law Practice of Ken Kieklak has fought on behalf of hard-working Arkansans who have been forced to cease their life’s work due to serious injuries and impairments. If you are thinking about filing for benefits or have already received a denial, the Law Practice of Ken Kieklak can help. To schedule a private and free Social Security disability consultation call us at (479) 251-7767 or contact us online.

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