Raleigh SSDI Attorneys

Understanding Social Security Disability Income

Social Security Disability Insurance (SSDI) is a federal program designed to provide financial assistance to individuals who are unable to work due to a qualifying disability. Administered by the Social Security Administration (SSA), SSDI is a critical safety net that offers financial support to those facing long-term disabilities.

To be eligible for SSDI, individuals must have earned sufficient work credits through their employment. Work credits are earned based on the amount of income subject to Social Security taxes.

Applicants must have a qualifying disability that is expected to last for at least 12 months or result in death. The SSA uses a strict definition of disability, considering both physical and mental impairments.

Here are common examples of disabilities that may qualify for SSDI benefits:

Musculoskeletal Disorders:

Neurological Disorders:

Cardiovascular Conditions:

Respiratory Disorders:

Immune System Disorders:

Mental Health Disorders:

Blood Disorders:

• Hemophilia
• Sickle cell disease
• Thrombosis or blood clotting disorders

Cancer: 

• Many types of cancer, including leukemia, lymphoma, and solid organ cancers

Applicants must have worked in jobs covered by Social Security, and they must have earned a specified number of work credits within a certain timeframe leading up to the onset of their disability. The exact number of required work credits depends on the age of the individual at the time of disability.

Individuals applying for SSDI must be unable to engage in substantial gainful activity (SGA) due to their disability. SGA is a measure of the ability to perform work that earns a certain income threshold set by the SSA.

Comprehensive medical evidence is required to support a disability claim. This may include medical records, laboratory results, physician statements, and other relevant documentation that establishes the severity of the disability.

The SSDI application process involves a thorough review by the SSA. The initial application may be followed by a reconsideration stage if the claim is denied. If necessary, applicants can request an administrative hearing before an administrative law judge.

Common Reasons for SSDI Claim Denials

The SSDI application process can be complex, and unfortunately, not all applications are approved on the first attempt. There are several common reasons why SSDI claims may be denied. Understanding these reasons can help applicants address potential issues and increase their chances of a successful application. 

Here are some common reasons for SSDI denials:

• Insufficient Medical Evidence: One of the primary reasons for denial is a lack of comprehensive and convincing medical evidence. The Social Security Administration (SSA) requires detailed documentation that clearly establishes the severity and duration of the disability. Incomplete or vague medical records may lead to a denial.
• Failure to Follow Prescribed Treatment: If an applicant fails to follow prescribed medical treatments without a justifiable reason, the SSA may deny the claim. This is because the SSA expects applicants to take all reasonable measures to improve their condition.
• Income and Resource Limits: SSDI is a need-based program, and there are income and resource limits that applicants must meet. If the SSA determines that an applicant’s income or resources exceed the allowable limits, the claim may be denied.
• Failure to Cooperate: Applicants are required to cooperate with the SSA throughout the application process. This includes providing requested information, attending medical exams, and participating in the disability determination process. Failure to cooperate may result in a denial.
• Non-Medical Reasons: The SSA considers both medical and non-medical factors when evaluating disability claims. Non-medical factors may include an applicant’s ability to perform other types of work, education, work history, and age. If the SSA determines that an applicant can perform other work, the claim may be denied.
• Disability Duration: To qualify for SSDI, the disability must be expected to last for at least 12 months or result in death. If the SSA believes that the disability is not expected to meet this duration requirement, they may deny the claim.
• Failure to Meet Technical Eligibility Criteria: SSDI has specific technical eligibility criteria, including work credit requirements and recent work history. If an applicant does not meet these criteria, the claim may be denied.
• Substance Abuse: If substance abuse is a contributing factor to the disability, the SSA may deny the claim. However, individuals with substance abuse issues can still qualify for SSDI if they would be disabled even if they stopped using drugs or alcohol.
• Prior Denials and Appeals: If an applicant has been denied SSDI benefits in the past and the same or similar medical conditions are presented in a subsequent application without significant new evidence, the SSA may deny the claim.
• Technical Errors in the Application: Simple mistakes or technical errors in the application, such as incomplete forms, missing information, or errors in the work history section, can lead to denials. It’s crucial to thoroughly review and accurately complete all application materials.

If an SSDI claim is denied, applicants have the right to appeal the decision. The appeal process involves several stages, including reconsideration, administrative hearing, and, if necessary, further appeals. Seeking the assistance of our Raleigh team at Lanier Law Group, P.A.. during the appeal process can significantly improve the chances of a successful outcome. We can help gather additional evidence, prepare a strong case, and represent the applicant at hearings before administrative law judges.