In the United States, millions of people currently receive social security disability insurance (SSDI). The benefits for SSDI exist for individuals who are no longer able to work due to a physical or mental disability. While this seems like a cut and dried process on the surface, there are quite a few stipulations that go along with receiving SSDI benefits.
To start, the Social Security Administration (SSA) does not approve every case that is filed – far from it. Due to a variety of factors, approximately 70% of SSDI claims are denied the first time. Luckily, this doesn’t mean the end for disability applicants. With the help of a Milwaukee disability attorney, individuals who were initially denied can often get approved for benefits by appealing. As many as 50% of applicants are ultimately approved, meaning the appeals process does work.
Why are SSDI Cases Being Denied?
The reasons for a disability case being denied by the SSA are many. The most basic answer to why an SSDI case is rejected is that the person applying doesn’t meet the criteria laid out for receiving disability benefits.
Often, the proper documentation hasn’t been provided to the SSA to support the claim of being disabled to the point of being unable to work. When the documentation within an application doesn’t prove that benefits are needed, the SSA has no choice but to deny the case.
Documentation is key to getting approved for benefits. Some of the documents that can be provided include:
- Written diagnosis from a doctor
- Hospital visit information
- Testing results
- Treatment history
- Medication history
Another apparent reason that the SSA may deny SSDI benefits is that the person may not have accumulated enough work credits to qualify for benefits. Simply put, they haven’t worked enough in the past to be able to get paid back in disability.
Every worker’s check has a portion taken out for social security. In the case that the individual needs to take these benefits early, they would have needed to have paid in a certain amount. The more someone paid into the system, the more they will receive in monthly disability benefits.
Someone may also be denied benefits if they are able to perform work that qualifies as substantial gainful activity. The current rate of what is considered substantial gainful activity is $1,260 per month. Anyone that is able to perform work that provides income above this threshold will automatically be denied benefits.
While it is possible to earn some income while receiving disability benefits, earning above the threshold is not allowed.
What Else Does the SSA Use To Determine if you are Disabled?
In addition to the medical documentation provided in a case, the SSA has guidelines that it uses to determine if a disability qualifies for SSDI benefits.
As mentioned, someone has to be unable to perform work that gains you more than $1,260 per month. Placement in different jobs is possible, but the person will not be expected to perform a job that they are completely unfamiliar with, in which they would have to learn a new skill.
Other than being unable to earn the minimum threshold wage, the SSA will look at other limitations, including:
- Inability to hold the same position that was held before becoming disabled. While other forms of work are possible at the same company or another, there is no expectation to perform a job outside of someone’s knowledge or skill base.
- The disability is expected to last at least one year. The SSA considers someone eligible for benefits if they have more than a temporary condition – with the threshold being 12 months, or potentially leading to their death.
How Are Work Credits Earned?
To be eligible for SSDI, someone will have needed to essentially have “paid in” to the system through a regular social security deduction in their paycheck. Every time a certain amount of money is earned, someone earns a work credit. The current amount of money earned that results in a work credit is $1,410. But, there is a limit to the number of work credits that someone can earn per year.
The number of required work credits to qualify for SSDI also depends on age. The older someone is, the more required work credits they would need to have a chance at approval. The system rewards time worked and consistency of work, in addition to the amount earned during work.
Anyone who does not have the work credits to apply for SSDI may be eligible for Supplemental Security Income (SSI) payments, depending on their current situation.
A Skilled Disability Attorney in Milwaukee
If you need assistance applying for SSDI the first time or have already been denied benefits, don’t hesitate to call the professionals at Tabak Law at 800-245-1430. Tabak Law has experience getting people approved for disability benefits in Milwaukee and throughout the nation, with a large network of lawyers available.