People who cannot work due to disabilities apply for monthly financial benefits through the Social Security Disability Insurance (SSDI) program. However, the majority of SSDI claims get denied on initial review. The Social Security Administration may deny SSDI claims for technical or medical reasons. But how do technical and medical denials differ?
What Is an SSDI Technical Denial?
An SSDI applicant may receive a technical denial when the Social Security Administration denies their application based on non-medical eligibility requirements. The SSDI program has several eligibility criteria, including having an adequate lifetime work history and a recent work history. A person may receive an SSDI technical denial for multiple reasons, such as:
- Having insufficient work credits
- Currently earning countable income above the substantial gainful activity threshold
- Not being a U.S. citizen or lawful permanent resident
A person may also receive a technical denial due to errors or deficiencies in their application paperwork. A technical denial means that the Social Security Administration never reached the step of evaluating the applicant’s medical information to determine whether they have a qualifying disability, which Social Security Administration regulations define as a medical condition that has lasted or will likely last for at least 12 months or result in death that prevents an individual from performing work that earns income above the substantial gainful activity threshold.
What Is an SSDI Medical Denial?
A person may receive an SSDI medical denial when the Social Security Administration determines that their medical condition does not meet the regulatory definition of a “disability.” Medical denials occur for various reasons, such as:
- The disability determination services office concluded that the applicant’s condition did not meet the “severe” threshold – in other words, the condition does not prevent the applicant from performing major life activities.
- The applicant’s condition will likely last less than 12 months and not result in death.
- The applicant can do previous work they have performed in their career, or can transition into other work that exists in substantial numbers in the economy, either with or without work accommodations.
Key Differences Between Technical and Medical Denials
Some of the primary differences between technical and medical denials of SSDI applications include:
- Timing in the Review Process – Technical denials occur before the Social Security Administration reviews medical information, as the Administration first evaluates applicants’ technical qualifications. Medical denials happen after the Social Security Administration determines that an applicant meets the technical criteria for SSDI benefits and forwards the application for medical review.
- Focus of Review – Technical denials focus on an applicant’s work history and financial circumstances, whereas medical denials focus on the applicant’s health condition and functional limitations.
- Applicant’s Next Steps – A technical denial may require an applicant to correct errors on their application forms or submit additional evidence to demonstrate that they meet the technical requirements for SSDI benefits, such as having sufficient work credits. Conversely, a medical denial will require an application to gather additional medical information and documentation to prove their condition qualifies as a disability under Social Security Administration regulations.
What to Do After a Denial?
Steps to take after a denial include:
- Technical Denials – Correct errors on application forms, check work credits to ensure the Social Security Administration has your complete work history, and consider applying for the Supplemental Security Income program if you have low or no income.
- Medical Denials – File an appeal within the deadline and gather additional medical information to supplement the evidentiary record.
Applicants should also consider consulting an experienced Social Security disability attorney about how to respond to a denial notice.
Contact an SSDI Lawyer Today
When you file an SSDI claim, the Social Security Administration may deny it for various reasons. Understanding the basis for the denial can help you plan your next steps. Contact Wambach Disability Law today for a free, no-obligation consultation with an SSDI attorney to learn more about the differences between technical and medical denials of SSDI claims.