A Social Security Disability denial letter can be difficult to understand when it uses technical language. The reason for the denial identifies the issue SSA found with your claim and helps determine what you need to address on appeal.
What does ‘insufficient medical evidence’ mean?
This generally means SSA did not have enough evidence to determine whether you meet its disability requirements. Medical records, test results and information about your functional limitations can help show how your condition affects your ability to work. A diagnosis alone does not establish disability. SSA also requires the condition to have lasted or be expected to last at least 12 months.
What does an SGA denial mean?
A substantial gainful activity (SGA) denial means SSA determined that your work activity met the SGA standard. SSA sets a monthly earnings threshold for SGA and adjusts it periodically. Part-time work can still count as SGA depending on your earnings and the circumstances of the work.
What does a ‘not disabled’ denial mean?
SSA uses a five-step process to evaluate disability claims. Even when medical evidence establishes an impairment, SSA may determine that you can perform past relevant work or adjust to other work. The agency considers factors such as your age, education, work experience and ability to perform work.
What does a technical denial mean?
A technical denial involves an eligibility requirement rather than whether your medical condition meets SSA’s disability standard. For SSDI, issues can include insufficient work credits or failing to remain insured when the disability began. Unlike medical denials, a technical denial cannot be overcome by submitting additional health records – the eligibility issue must be addressed directly.
What should you do after a denial?
Read the denial notice carefully and identify the specific reason SSA gave. You generally have 60 days after receiving the notice to file an appeal. SSA presumes you received the notice five days after the date printed on it, unless you show otherwise.
Gather the medical, work or eligibility information that addresses the stated reason before filing. The appropriate response depends on why SSA denied the claim and the evidence in your record.