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Difference Between Technical Denials and Informal Denials in a Disability Case

February 18, 2022

young man in wheelchairTechnical denials and informal denials both result in a disability claim being denied prior to a medical determination. This means the Social Security Administration (SSA) did not have a chance to make a medical decision about whether or not you are disabled. These denials can be given after an initial application is filed or during the appeals process at the reconsideration and hearing stage.

However, that is where the similarities end. Our attorneys further discuss the key differences between a technical and informal denial. If you need help with your disability claim, schedule a free consultation. You are not obligated after this meeting to hire us, but if you do, there are zero upfront fees involved.

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What Are Informal Denials in a Disability Case?

Informal denials are typically seen with claimants seeking Supplemental Security Income or SSI. If the SSA determines that you earn too much (beyond the SGA limit) or have too many resources (i.e. bank accounts, stocks, bonds and property), you may receive an informal denial for disability.

An informal denial saves you time from having to provide all of the information required for a disability claim or interview. It is important to note that you are within your right to request a formal denial for SSI benefits based upon your income or resources. However, this will require having a full disability interview with a claims representative whose job it is to verify the factors of your claim.

What Are Technical Denials in a Disability Case?

Technical denials – also known as non-medical denials – are a lot more common than informal denials. These denials can happen with claimants seeking Social Security Disability Insurance (SSDI) and/or SSI.

You may also receive a technical denial for SSI due to your substantial gainful work activity. You cannot be working and earning over the monthly SGA amount set each year by the SSA.

SSD technical denials on the other hand may happen if you have not earned sufficient work credits or have not worked enough in the last decade to meet the non-medical requirements of the program. For instance, you may receive a technical denial if you have only worked four of the previous ten years.

An SSD technical denial may also happen for failure to cooperate. For instance, not providing the necessary information required by the claims representative. It is considered a non-medical denial if the claims representative denies your disability claim before sending it to the state agency for a decision.

Technical denials are difficult to appeal, but not impossible. You have a certain amount of time to request that a denial be reconsidered. In these situations, we recommend working with an experienced lawyer. He or she can help you navigate the appeals process to help you get the disability benefits you need.

What About Receiving a Medical Denial?

Only after meeting the non-medical eligibility requirements can a disability claim be sent for a medical determination. If the disability examiner reviewing your claim determines that you do not meet the definition of being disabled, a medical denial can be issued. This often happens due to insufficient medical evidence. Your medical records must show a complete and accurate picture of your condition.

Appealing a Denied Disability Claim

If your disability claim is denied, you have the right to appeal the decision within 60 days. If you appeal an initial application, your claim will go to the reconsideration stage of the appeals process. Another claims representative will be appointed to review the evidence submitted and make a decision.

If you appeal a reconsideration denial, your claim will go to the next stage. This is the point where you will be able to present your disability case before an administrative law judge. If you do not agree with the decision, you may appeal to the Appeals Council. The final appeal option is a Federal Court review.

It is important to not be discouraged if your disability claim is denied in the early stages. This is quite common and may be due to incomplete information provided. Having an experienced attorney on your side can help increase your chances of getting your claim approved and receiving disability benefits.

Call Today to Schedule a Free Consultation

If you need help with a recent disability denial, we are here to help. Our Social Security Disability attorneys in Phoenix are well-versed in the appeals process and are ready to file an appeal on your behalf.

An initial consultation with a member of our legal team is 100 percent free and confidential. It costs nothing upfront to have us represent you.

Call 1-800-503-2000 to get started today.

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