How are decisions/rulings made on SSDI and SSI claims?

When you file a disability claim for SSDI or SSI benefits, the Social Security Administration makes their initial determination generally on the non-medical disability aspect of your claim. If you are working over the Substantial Gainful Activities (SGA) hours per month, this indicates that you can still work enough to support yourself, and that you do not need the help from Social Security. This is referred to as a “technical denial,” and it is usually issued more quickly than other decisions.

A technical denial can be issued when you are earning too much to qualify for Social Security disability, or if you have not paid enough into the system. In addition, if you have too many assets or too much income, you may not be eligible for SSI benefits, since this program is need-based.

If your claim meets the Social Security Administration’s non-medical criteria, then your claim will be sent to your state's agency that is responsible for disability decisions. The will then make a medical determination. The state agency will use vocational experts, disability examiners, and physicians in order to make their medical decisions. This agency must follow strict guidelines that have been set forth by Congress in order to determine whether you are eligible for disability.

Generally, when you submit a claim for SSDI or SSI benefits, a Social Security disability examiner studies all the facts about your case before coming to a decision. You will want to be sure to send along all medical information that may help them make a decision in your favor. If some information they need is missing, it often results in their ruling against your claim. Of course, this decision is not final, and it will go to a Social Security disability quality review board, which may overturn it. The quality review board may send you to one of their own doctors to gather pertinent information. Part of the process also includes looking into other factors, like your age, schooling, and whether you can pursue other occupations that aren't affected by your disabling condition.

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