Why Do Some SSDI Applications Get Denied?

Key takeaways:

  • SSDI applications often get denied due to insufficient medical evidence proving a disabling condition preventing substantial work.
  • A sufficient work history with enough recent Social Security tax contributions is essential; lacking this can lead to denial of benefits.
  • Exceeding the SSA's set income limits may indicate an ability to engage in gainful activity, resulting in application rejection.

Why Do Some SSDI Applications Get Denied?

On this page, we’ll discuss the reasons behind the denial of some SSDI applications, how to determine eligibility, who qualifies to file an SSDI Lawsuit, and much more.

Intro To SSDI Lawsuit

Navigating the complexities of Social Security Disability Insurance (SSDI) can often feel like a maze with no exit for many applicants.

While SSDI serves as a critical lifeline for disabled workers who have paid into the system through social security taxes, not all applications result in awarded benefits.

Why Do Some SSDI Applications Get Denied

A startling fact is that many initial SSDI applications are denied; insufficient medical documentation is one major stumbling block.

This article promises to unravel the reasons behind denials and what steps you can take if your application hits a wall.

Table of Contents

The Application Process for SSDI

Gaining SSDI benefits requires a structured approach where applicants must navigate through a series of definitive steps, ensuring that their disabilities and work histories are comprehensively documented.

Steps to File an SSDI Application

Before diving into the complexities of applying for Social Security Disability Insurance (SSDI), it is important to understand the key phases.

Here, we lay out the pivotal steps that pave the way toward submitting an application:

  1. Verify Eligibility: Confirm that your medical conditions meet the SSA’s definition of disabilities.
  2. Gather Necessary Documentation: Compile all relevant medical records, work history, and personal information.
  3. Create an Account: Set up an account on the Social Security Administration’s website to facilitate online application and tracking.
  4. Review the Checklist: Use the Adult Disability Checklist to ensure all required steps and documents are in order.

These steps represent the groundwork required to launch your application process for SSDI benefits. Following them precisely can significantly influence the outcome of your application.

Submitting Your SSDI Application

After preparing with the initial steps, submission is the next crucial phase in the application process.

Focus on the following approaches to submit your SSDI application:

  • Apply Online: Complete the Disability Benefit Application through the SSA’s secure website.
  • In-person or Over the Phone: If internet access is a barrier, applications can be completed by calling the SSA or visiting a local office.
  • Check Your Application Status: Use your established account to monitor the progress and status of your application.
  • Stay in Contact: Maintain communication with the SSA and promptly respond to any inquiries regarding your application.

It is imperative to use meticulous care in completing the application to ensure accuracy and completeness.

Submitting a well-prepared application is key to navigating the SSDI benefits process with confidence.

Expected Timeline of SSDI Benefits

The process of applying for Social Security Disability Insurance (SSDI) and receiving benefits follows a structured timeline, from the initial waiting period after filing to the arrival of the first payment.

This sequence helps applicants set realistic expectations for their financial planning.

Waiting Period After Filing Your SSDI Application

Upon submitting an SSDI application, claimants encounter what is often referred to as the five-month waiting period.

This time frame represents an essential consideration for applicants, as it influences the onset of their monthly payment.

Below is a detailed breakdown of what applicants should expect during this initial waiting period:

  • Application Processing: After filing, applicants now typically wait over seven months for a decision on their initial application, which has substantially increased.
  • Determining Onset Date: The SSA determines when the applicant’s disability began, impacting the overall timeline.
  • Five-Month Waiting Period: Regardless of the approval time, SSDI includes a mandatory five-month waiting period wherein no benefits are payable. This period begins from the established onset date of disability.
  • Potential for Delays: Various factors, like the need for additional evidence or appeals, may elongate the waiting period.

Receiving Your First Social Security Disability Insurance Payment

After overcoming the hurdles of the application review period and the five-month waiting time, receiving that first SSDI payment becomes the next focal point.

Here’s how the payment timeline generally unfolds:

  • Estimated Timeline: On average, following approval, it might take about one to two months for the Social Security Administration to process and commence the monthly payments.
  • Back Pay: Successful claimants may receive back pay dating back to the end of the five-month waiting period or later, determined by the application date and disability onset date.
  • Regular Monthly Payments: After the initial payment, beneficiaries should expect consistent monthly payments.
  • Adjustments & Retroactive Payments: Sometimes, the first payment might be higher to adjust for the accumulated amount during the waiting period since the disability began.

Financial Aspects of Disability Benefits

The financial elements of Social Security Disability Insurance (SSDI) is crucial for applicants as it encompasses income limits, the application of resources in determining eligibility, and the monthly payments one might expect upon approval.

SSI Benefits: Income Limits and Resources

Navigating the financial requirements for SSDI, applicants should be aware of the income and resource limits that can affect their eligibility.

Here’s a breakdown of the critical parameters for the programs:

  • Individuals must earn less than a specific monthly amount, known as Substantial Gainful Activity (SGA), to qualify for SSDI. Exceeding this limit may indicate to the Social Security Administration (SSA) that an individual can engage in significant work, affecting their eligibility.
  • The determination of SGA involves considering the type and amount of work performed, which in 2021 was set at $1,310 per month for non-blind individuals and $2,190 for those who are blind.
  • SSDI does not count assets towards eligibility; it focuses on income generated through work, distinguishing it from Supplemental Security Income (SSI).
  • Resources such as a primary home, one vehicle for transportation, and certain other assets are not considered in determining SSDI eligibility.
  • To have paid into the FICA tax system for typically five to ten years is a fundamental requirement, ensuring you have the necessary “work credits”.

The financial assessment for SSDI eligibility is complex, with income from work being the primary focus rather than possession of resources.

In-Depth Analysis: Monthly SSDI Payments

When it comes to monthly SSDI payments, several factors come into play that can influence the amount an approved applicant receives:

  • The average monthly SSDI benefit was around $1,280 as of April 2021, which aids those who cannot work due to a disability in meeting basic financial needs.
  • The calculation of monthly payments is primarily based on an individual’s lifetime average earnings covered by Social Security.
  • SSDI payments continue as long as the beneficiary cannot engage in substantial gainful activity and is still considered disabled by SSA’s standards.
  • Annual Cost-of-Living Adjustments (COLA) can increase SSDI benefits to account for inflation.

Monthly SSDI benefits are designed to align with the financial needs and earning history of the recipient, reflecting their contribution to the Social Security program during their working years.

Post-Application Follow Up

Once an individual has submitted their application for Social Security Disability Insurance (SSDI), the focus shifts to monitoring the application’s progress and understanding what steps to take in case of a denial.

The post-application phase is critical, involving a vigilant check on application status and an understanding of the appeals process if the application is not approved.

Checking SSDI Application Status

To stay informed about the application’s review, applicants should periodically check their SSDI application status.

Here’s how one can remain updated:

  • Sign In to Your Account: Securely log in to your Social Security account to view detailed status.
  • Expect Timelines: Review times can vary, but you will be able to see estimated dates for decisions.
  • Automated Services: Utilize the SSA’s automated telephone services for updates.
  • Personalized Support: If further clarification is needed, you can call the SSA’s toll-free number or visit a local office.

Appealing a Denial of Benefits

If an applicant receives a notice that their SSDI claim is denied, they have the right to an appeal.

Here are steps to take if faced with a denial:

  • Understand the Reason: Carefully read the denial notice to understand why the application was not approved.
  • File Promptly: The appeal must be filed within 60 days from the date of the denial notice.
  • Document Preparation: Gather new or additional evidence to support the claim for the appeal process.
  • Seek Assistance: Consider consulting with a disability attorney or advocate for guidance through the appeals process, and check the SSA guidelines for more details.

A proactive approach to following up on the SSDI application and preparing for a potential appeal can help applicants manage the process with confidence.

TruLaw: The #1 SSDI Benefits Attorney

When seeking assistance with SSDI applications, it can be highly advantageous to consult with a specialized attorney. TruLaw stands as a formidable ally in navigating this complex legal terrain.

They provide expert guidance through every step of applying for SSDI benefits and contesting denials

SSDI application services we offer include, but are not limited to:

  • Instant access: Utilize TruLaw’s online chat for immediate case analysis.
  • Eligibility assessment: Determine if you have a viable claim for SSDI benefits.
  • Expert advice: Receive professional input tailored to your unique situation.
  • Strategic planning: Develop an actionable strategy for your SSDI application or appeal.

Considering the common challenges and setbacks in the SSDI application process, TruLaw equips clients with the necessary resources to fortify their claims.

Here is a few ways we can assist you if you’re SSDI application has been denied:

  • In-depth review: Examine the reasons behind SSDI application denials.
  • Evidence gathering: Help in collecting pertinent medical documentation and records.
  • Legal representation: Advocate on your behalf in court, if necessary.
  • Appeal assistance: Aid in the appeal process for reversing denied claims.

TruLaw’s lawyers are recognized for their commitment to securing fair benefits for their clients.

They emphasize the thorough preparation of every case, utilizing their extensive knowledge to enhance clients’ chances of a favorable outcome.

Their approach ensures that clients are both informed and supported throughout the SSDI litigation process.

Frequently Asked Questions

  • What are the common reasons for SSDI application denials?

    One frequent reason for SSDI denials is the lack of sufficient medical evidence to substantiate the disability claim.

    Furthermore, non-compliance with prescribed medical treatment and the ability to perform sedentary work can also lead to denials.

  • What are the usual indicators that an SSDI application may not be approved?

    Indicators that an application may not be approved include engaging in substantial gainful activity, a disability that is not long-term or expected to last for at least one year and a lack of cooperation during the SSDI process.

  • Can someone be eligible for SSI after being denied SSDI, and what determines this?

    Eligibility for Supplemental Security Income (SSI) after an SSDI denial depends on the individual’s income and assets.

    SSI is an alternative for those who may not qualify for SSDI due to insufficient work credits.

Written By:
Jessie Paluch
Jessie Paluch

Attorney Jessie Paluch has over 25 years of legal experience in personal injury lawsuits, mass tort litigations, and also spent the first decade of her career working as an international tax attorney at Deloitte. As the founder of TruLaw, Jessie collaborates with attorneys and legal experts across the United States on a daily basis — further expanding her legal expertise and enabling her to share reliable, up-to-date legal information with our readers!

This article has been written and reviewed for legal accuracy and clarity by the team of writers and attorneys at TorHoerman Law and is as accurate as possible. This content should not be taken as legal advice from an attorney. If you would like to learn more about our owner and experienced injury lawyer, Tor Hoerman, you can do so here.

TorHoerman Law does everything possible to make sure the information in this article is up to date and accurate. If you need specific legal advice about your case, contact us. This article should not be taken as advice from an attorney.

Written By:
Jessie Paluch
Jessie Paluch

Experienced Attorney & Legal SaaS CEO

With over 25 years of legal experience, Jessie is an Illinois lawyer, a CPA, and a mother of three.  She spent the first decade of her career working as an international tax attorney at Deloitte.

In 2009, Jessie co-founded her own law firm with her husband – which has scaled to over 30 employees since its conception.

In 2016, Jessie founded TruLaw, which allows her to collaborate with attorneys and legal experts across the United States on a daily basis. This hypervaluable network of experts is what enables her to share reliable legal information with her readers!

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