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Learning that you have been denied Social Security disability benefits can leave you with a sinking feeling in the pit of your stomach. Many people rely on their benefits to make ends meet, and being denied may leave you wondering where to turn. Know that you are not alone. More people are denied benefits than granted them. Thankfully, you can appeal a denial of benefits in most circumstances.
If you have received a denial from the Social Security Administration (SSA), Gerling Law can help. Our experienced Social Security disability lawyers know how the system works and can advise you about what to do when you are denied Social Security disability. For over 50 years, we have been fighting to get justice for our clients.
What Programs Allow Disabled Individuals to Claim Social Security Disability?
When we talk about Social Security disability benefits, we may be referring to two different programs: Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). Many people may qualify for both SSI and SSDI.
You can get SSI if you have:
- A qualifying disability,
- Limited income, and
- Limited resources.
The SSA defines what types of disability qualify and what it means to have limited income and resources.
Depending on your work history, you may also be able to get SSDI benefits. You can qualify for SSDI if you have a qualifying disability and have worked enough time at a job covered by Social Security. The length of time you need to have worked depends on what age your disability began.
How Does the Social Security Administration Decide Whether to Award Benefits?
Whether you receive benefits depends on whether the SSA or a designated state agency determines that you meet the criteria for SSI or SSDI. Although you can apply for both on the SSA’s webpage, most initial decisions are made by local SSA field offices or state Disability Determination Services (DDSs).
What Is a Qualifying Disability? (SSI and SSDI)
SSI and SSDI use the same definition of a qualifying disability. Mainly, to receive benefits under either program, you must have a total disability. Having a total disability means you have a condition that:
- Is considered to be severe;
- Prevents you from performing “substantial gainful activity”; and
- Has lasted or is expected to last for 12 months or longer.
A condition is severe if it significantly limits your ability to complete basic work-related tasks. How much you can earn in a given month defines whether you can perform substantial gainful activity. In 2024, you must earn less than $2,460 if you are blind or $1,550 if you are not.
The SSA maintains lists of qualifying conditions, separated between adults and children. Some conditions may qualify for expedited processing through the Compassionate Allowances (CAL) or Quick Disability Determinations (QDD) programs.
What Are Limited Income and Resources? (SSI)
Whether you have a qualifying disability often depends on several complicated medical factors. Whether you have limited income and resources is much more clear-cut.
To have limited income as an individual, you cannot earn more than $1,913 per month from working or $934 from non-work sources. For a couple, you cannot earn more per month than $2,827 from work or $1,391 from non-work sources.
To have limited income, an individual cannot own more than $2,000 worth of property, excluding certain properties like your home. A couple cannot own more than $3,000 combined.
How Do You Accrue Work Credits? (SSDI)
To receive SSDI, you must have earned enough work credits from a job covered by Social Security. You can accrue four work credits per year. You earn credits based on your earnings, which increase each year. In 2024, you will gain one credit per $1,730 earned.
Unless you are legally blind, you must have enough overall credits and enough recent credits. If you are legally blind, you only need enough overall credits. You usually need to have earned two credits per year between the age of 21 and when your disability began to qualify.
What Happens If You Are Denied Social Security Disability Benefits?
If you have been denied social security disability, appeal may be an option. There are four potential levels of appeal, which you can climb if unsatisfied with the decision at the lower level:
- Level 1—requesting the SSA or DDS reconsider your application;
- Level 2—requesting a hearing with an administrative law judge;
- Level 3—requesting review of the administrative law judge’s decision; and
- Level 4—filing a lawsuit in a federal court.
At each level, you have 60 days from receiving notice of the denial to appeal.
Where Do You File Your Appeal?
When your decision comes from a state agency acting as a DDS, you can become confused about where to appeal. Regardless of which agency made the decision, you can generally appeal online at the SSA webpage until you reach the federal court stage. If you prefer to submit physical documents, you can locate the nearest SSA office and mail or fax the documents there.
If you reach the filing stage with a federal court, where you file depends on where you live. An experienced attorney can help guide you through the filing process.
What Do You File to Appeal?
What form you submit depends on the denial. If the SSA denied your claim because it concluded that you did not have a qualifying disability, you submit a Disability Appeal. If the SSA denied your claim for reasons unrelated to having a qualifying disability, you submit a Non-Medical Appeal.
These appeal types can inspire confusion in light of SSI’s applicability to individuals over age 65 as well as those with disabilities. The reason for the denial, not the basis for the benefit request, controls. In other words, you submit a non-medical appeal if your SSI or SSDI claim was denied because the SSA concluded:
- You do not have limited resources (SSI);
- You do not have limited income (SSI); or
- You have not earned enough work credits (SSDI).
You submit a disability appeal only if your claim was denied based on a finding you are not sufficiently disabled.
Gerling Law Can Help
Being denied Social Security disability can leave you feeling stuck with few options. However, you may be able to appeal your denial. The attorneys at Gerling Law can guide you through what to do if your Social Security disability claim is denied, fighting to get you justice. Reach out for a free consultation today.