Maintaining eligibility for Social Security Disability Insurance (SSDI) presents challenges due to its complex requirements. Similar to other U.S. states, California has specific actions and situations that can result in the end of your disability benefits. Recognizing possible obstacles helps maintain ongoing assistance. An Elk Grove Social Security disability lawyer can inform you, “What are three ways a person may become ineligible for disability benefits?”
Exceeding Income Limits
One of the most common ways to become ineligible for disability benefits is to exceed the income limit. Substantial Gainful Activity (SGA) represents a work activity and earnings level that prevents individuals from qualifying for disability benefits, according to the SSA. The SGA limit for 2025 is $1,620 monthly for people who are not blind and $2,700 monthly for blind people.
People living in California need to carefully track their income because the high cost of living demands it. When your work results in income that goes beyond specific limits, this could lead to the loss of your benefits, even if done unintentionally. The SSA states that the SSDI program guidelines permit beneficiaries to earn as much as the SGA level.
According to research findings, 70% to 82% of working disabled SSDI beneficiaries have work-related overpayments, with the average amount being $9,282. The need to report earnings precisely and comprehend SGA limitations becomes evident through these findings.
To ensure that you meet the income requirements, keep track of your monthly earnings to make sure they remain below the SGA threshold. If there are any changes, report them to the SSA. This includes any changes to your income or employment status.
Your Condition is Not Severe Enough
SSDI eligibility requires that your medical condition prevents basic work activities for over 12 months or is expected to lead to death. The SSA could either deny your application or stop your current benefits if your condition falls short of the required severity standard. The SSA determines if your medical condition creates substantial limitations in performing basic work activities. When the impact exceeds minimal levels, it qualifies as severe.
Maintain comprehensive and current medical documentation that explicitly shows both the severity and anticipated duration of your medical condition to avoid losing eligibility. Follow your treatment plan and keep up with medical appointments to demonstrate your disability status.
Failing to Cooperate with the SSA
The application and review procedures require active cooperation with the SSA. Not following their requests can cause your benefits to be suspended or terminated. Examples of non-cooperation include:
- Missed consultative examinations. Not showing up for medical examinations that the SSA arranges can be considered non-compliance.
- Incomplete information. Not supplying the required information about your medical state or income constitutes non-cooperation with SSA documentation requirements.
- Ignoring communications. This involves failure to reply promptly to SSA inquiries or notifications.
Responding promptly to SSA communications helps prevent benefit termination by avoiding misunderstandings and missed deadlines. Always maintain copies of every correspondence and document you submit for future reference. Seek assistance from a disability attorney or advocate to understand SSA requests to maintain compliance.
Temporary Ineligibility vs. Permanent Termination
Not all ineligibility is permanent. If you briefly exceed the earnings limit or miss a consultative exam, the benefits suspension will be temporary, and benefits can usually be restored if you address the problem.
When the SSA determines that your condition has improved or that you have failed to cooperate multiple times, your benefits could be terminated permanently, which requires you to submit a new application. Understanding which situation you are facing determines the correct action you should take.
What To Do If You Lose Your Benefits
Always remember that you can appeal if your disability benefits stop unexpectedly. To start the appeal process, you must submit a reconsideration request within 60 days after you receive your notice. If the reconsideration request is denied, you have the option to request a hearing with an administrative law judge (ALJ).
The Office of Hearings Operations (OHO) monitors these hearings through its offices based in Los Angeles, San Diego, Sacramento, and Oakland throughout California. At the hearing, you will be allowed to submit medical documentation, along with witness statements and legal points of argument. An experienced disability attorney boosts your success rate by managing paperwork, representing you in court, and enhancing your case.
FAQs
Q: What Would Disqualify Me From Disability?
A: Disability benefits can be denied if your income exceeds the Substantial Gainful Activity (SGA) threshold of $1,620/month for non-blind people in 2025 or if your medical condition lacks sufficient severity. Additionally, failure to follow treatment plans or cooperate with SSA requirements can disqualify you. Disqualification often occurs as a result of short-term health conditions and impairments lacking proper documentation.
Q: What Is the Common Reason for Not Being Approved for SSDI Benefits?
A: The most common reason for denial stems from the assessment that the medical condition does not make it impossible for the applicant to work. Inadequate medical documentation and missed deadlines, combined with paperwork mistakes, frequently lead to application failures. SSDI applicants in California receive denials because they frequently fail to provide definitive disability evidence.
Q: Why Would Someone Not Qualify for Disability?
A: SSDI eligibility may be denied when an individual has not worked enough to accumulate sufficient work credits or earns income above the SSA threshold while their condition fails to meet SSA’s disability criteria. Failing to follow treatment protocols or providing missing paperwork, along with ignoring SSA inquiries, could lead to losing qualification.
Q: What Illness Automatically Qualifies for Disability?
A: Automatic approval does not apply to any illness, but the SSA keeps a “Compassionate Allowances” list that expedites severe condition approvals. The SSA “Compassionate Allowances” list contains severe conditions, including ALS and certain advanced cancers, as well as early-onset Alzheimer’s disease. Applicants must present medical documents and fulfill non-medical requirements to obtain benefits despite having qualifying conditions.
Contact Gade & Parekh, LLP Today
If you have concerns about your eligibility or need assistance navigating the complexities of SSDI, contact Gade & Parekh, LLP, to help guide you through the process.
