Social Security uses their medical rules to determine whether you have a medical or mental impairment that qualifies for a disability benefit.
However, they also have "non-medical rules," which have nothing to do with your impairments or medical or mental conditions. These rules are sometimes called "technical rules."
Non-medical requirements for SSD benefits include income requirements, marital status, age, citizenship or permanent residency status and work credits. Social Security must also confirm that the claimant is not currently working at substantial gainful activity. Non-medical criteria must be provided by you and, in some cases by your employer, then verified by the Social Security Administration. Non-medical disability criteria are not tied to mental health or medical health conditions.
These non-medical rules will vary slightly between Title 2 claims (Social Security Disability or SSDI) and Title 16 claims (Supplemental Security Income or SSI). For instance, there is no income restriction for SSDI but there is for SSI.
It is possible that a claimant can meet the medical rules (he/she is disabled) but fail to meet the non-medical rules.
Most of time, however, the medical rules are the most difficult to meet. Once a claimant meets the medical rules, it's unusual to be denied because of the technical or non-medical rules.
What are examples of some technical, non-medical rules that could deny a claim--even when the claimant has been found to be disabled?
1. In an SSDI claim, there are not sufficient work credits.
2. In an SSI claim, there is too much household income or resources.
3. The appeal was not filed within the deadline (timely filing).
4. A claimant is not a US citizen or have permanent residency status.
5. The claimant was working at substantial gainful activity during the same period that the disability benefits would cover.
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