Recently on our disability forum a user wrote, “I have a severe back condition, and I cannot perform any work. I have medical information to support my disability. I applied for SSDI benefits and was denied because the SSA said I did not have enough work credits to qualify and I was not insured. I then applied for Supplemental Security Income (SSI), but I was told my resource and income limit was too high. Can you explain this denial to me? Is there a way I can qualify if I appeal the denial?
Denied SSI benefits for a back disorder
Disability applicants can be denied SSDI and SSI benefits for a variety of reasons, even if they have a severe condition which does not allow them to work and perform substantial gainful activity for at least 12 continuous months.
The first thing you mentioned was that you did not have enough work credits for SSDI benefits. Unfortunately, assuming the SSA did not miscalculate your work history and your credits earned, this denial cannot be challenged. You do, however, have the option to return to work and generate more work credits. This may or may not be an option depending on the severity of your back condition.
Next, you mentioned you applied for Supplemental Security Income benefits. Let’s talk a bit about SSI and the requirements to qualify.
Qualifying for SSI benefits for a severe back condition
SSI benefits have the same disability requirements as Social Security Disability Insurance. If you have a severe back condition you will have to prove that your condition either meets or exceeds a listing on the SSA listing of impairments or you lack the residual capacity to work.
To review the listing for a severe back condition you can read 1.04 Disorders of the spine. This listing includes most of the major back disorders including the following: herniated nucleus pulposus, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, and vertebral fracture.
The listing also outlines the symptoms and limitations that you must meet or exceed to automatically qualify for benefits. If you do not meet this listing it will be much more difficult to win benefits and you may need to discuss your case with a disability lawyer.
At issue, however, is not whether or not you are disabled and cannot work, which it sounds like you are, but rather the fact that you do not meet the nonmedical requirements to qualify for SSI benefits. So let’s discuss why you were denied SSI and whether you can appeal the denial.
SSI qualification and winning SSI benefits for a severe back disorder
Supplemental Security Income or SSI is only offered to claimants who are determined to be disabled but also have very limited income and resources. Unfortunately, if you or your spouse’s income is above the allowable limit or if you have too many resources, you will not qualify for SSI benefits.
There are certain resources which are exempt and will not be counted against the limit.
Generally, you cannot appeal this denial, although there may be legal ways to help you get under the allowable income and resource limit. If you have questions talk to the SSA or a disability lawyer for more information.