What is a Technical Denial in Disability Claim?

What is a Technical Denial?

By: Disability Group

If you are disabled and applying for Social Security disability benefits, often you will apply for both Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) at the same time in a concurrent claim.  It is common for claimants to receive a technical denial for one of the benefits.

Technical denials—unlike medical denials, which are based on Social Security’s definition of disability—vary greatly between SSI and SSDI (see Do I Qualify?).  While DIB technical requirements are based on how much you’ve worked and paid into the system, SSI requirements are welfare based— meaning it’s based only on your income and resources.  You have to meet both medical and technical requirements in order to qualify for benefits under Social Security’s rules.

Requirements for SSDI

The technical requirements for SSDI are based on work credits.  For 2011, one work credit amounts to $1,120 worth of wages, and it is possible to earn a maximum of four work credits a year.  The amount of work credits necessary to qualify for SSDI varies with age; for example, while a 31 year old only needs a total of 20 work credits, someone who is 62 or older needs 40 in order to qualify.

Generally, 20 of these 40 work credits need to be earned in the last ten years; therefore, one must have worked 5 out of the last 10 years in order to meet the technical requirements for SSDI.  The applicant also must be found disabled within their date last insured (DLI), which is the end of this ten year period.

In contrast, SSI is a need-based benefit which bases its technical requirements on the income and resources of the applicant.  When calculating income, Social Security includes not only income you earn from working, but also food and shelter; but they don’t count income such as food stamps or home energy assistance.  The income limits vary from state to state and are based on the Federal Benefit Rate.

In the case of resources, individually you will be denied for SSI if you have more than $2,000 in resources available to you; while the resource limit for a couple is $3,000. SSI does not count the home in which the applicant lives or the primary vehicle, among other technicalities.  Only those who live in the US or the North Mariana Islands are eligible, and these applicants also must be US citizens or nationals to qualify.

Appealing a technical denial

While a medical denial can be appealed, it is most often very difficult to appeal a technical denial.  If  you’re denied SSDI due to a lack of work credits, the application cannot be appealed.  If the denial is due to a DLI issue, you must furnish relevant records that prove your disability existed before the DLI.  SSI, on the other hand, can be re-filed when/if your resources and income dip below the required limits. Appeal disability denial today.