If you were recently denied Social Security Disability benefits, you are not alone. According to the Social Security Administration’s (SSA) own data, only about 22% of initial applications for disability benefits are approved. The good news is that there are several stages at which you can appeal a decision and fight for the benefits to which you are entitled. An experienced Social Security disability benefits lawyer from Bruce L. Weider, PC can explain your options and give you advice about what to do next. Consider contacting us at (734) 485-0535 to learn more.
Common Reasons for Denial
Many people are denied Social Security Disability benefits. Some of the most common reasons for denials include the following:
Insufficient Work Credits
SSDI eligibility and the amount for which an individual may qualify are both based on an individual’s work history. An insufficient work history can mean that an applicant who meets the medical criteria may still be denied Social Security disability benefits.
Too Much Income
SSI is a needs-based program. Therefore, an application can be denied if the individual’s income or resources go beyond strict federal limits, according to the SSA. While SSDI is based on your work history and payments into the Social Security system, you can still be denied benefits if you earn more than the substantial gainful activity limit established by the SSA or can perform work you have done before.
Failure To Update Information:
The SSA needs to be able to reach applicants as it is reviewing their requests. If someone moves, changes their phone number, or otherwise become unavailable via the means they have listed, and they do not notify the SSA, that individual’s claim can be denied. Likewise, if the SSA requests additional information and the applicant does not provide it, or if they refuse to attend a consultative exam ordered by the SSA, their application can be denied.
Lack of Medical Evidence
You may not have enough medical evidence to show you meet the SSA’s definition of disability. The SSA standard requires individuals to be “totally” disabled to be eligible for benefits, and the criteria for this determination are far stricter than those in place for other types of disability accommodations.
Not Meeting the Duration Requirement
To qualify for disability benefits, an individual must be able to show that their qualifying medical condition has lasted for at least one year or is expected to last that long. The only exception to this requirement is for terminal conditions.
Prior Denials
If an SSA representative sees that someone has applied for Social Security disability benefits before and been denied, the SSA examiner may rubber stamp a denial. A Social Security disability lawyer may be able to help you determine how to file an appeal and what evidence you may need to provide.
Failure To Follow Doctor’s Orders
Individuals applying for SSDI must be able to show that they have followed their medical providers’ advice to mitigate the effects of their disabling condition. In the absence of clear documentation, the SSA examiner can reason that it is not possible to determine whether an individual has a disability if they are not receiving medical treatment or following the prescribed treatment plan.
Understand Why Your Application Was Denied
Understanding why an application was denied is essential to determining the most effective response. An application that has been denied for a technical rather than medical reason may require a different response on appeal from a Social Security disability claim denied because of doubt about the severity of the medical condition.
Definition of Disabled
For many people, disability benefit applications are denied because the Social Security Administration finds that they do not meet its definition of disabled. The SSA has a Compassionate Allowance program for people with certain medical conditions like acute leukemia and Lou Gehrig’s disease. Social Security also uses computer screening to identify cases that are likely to be approved for benefits in order to make a quick disability determination. However, for many applicants, the denial is based on the lack of medical evidence or a finding that they do not meet the program’s definition of disabled.
Initial Denial vs. Grounds for Appeal
Nonetheless, it is important to keep in mind that simply because a claim is denied does not mean the applicant does not qualify for benefits. As the opening statistics indicate, most applications are rejected at their initial filing. Therefore, there may be some confirmation bias for examiners who are more likely to deny an application rather than approve it. There are many legitimate claims that the SSA does not initially approve but later approves after appeal.
Next Steps
Carefully read through the denial letter for specifics. Try to see if there are any factual inaccuracies, such as diagnosis dates, conditions, or incorrect names. Try to understand why the examiner says you do not qualify for benefits. If you have any trouble understanding the reasoning, consider scheduling a consultation with an experienced disability lawyer who can explain the more technical aspects of a Social Security disability benefits denial.
A strong understanding of the reason for denial helps to determine next steps. Depending on the situation, you may wish to:
Hire A Lawyer
Someone who was not represented by a lawyer during their initial application may wish to consider hiring one at the appeal state. A Social Security Disability lawyer from Bruce L. Weider, PC can review your case and help you to determine if you have grounds for an appeal.
File An Appeal
Some people make the mistake of thinking that if their claim was denied, they can simply fill out a new application and a new examiner might approve it. However, the Social Security Administration maintains records on all applications and can review the initial determination letter to see why you were not approved. Therefore, the next examiner might simply deny the new application on the same basis.
Instead, you might consider filing an appeal. An appeal states that there was a mistake in the determination, and you are asking for the original decision to be revisited so that your application can be approved. There are several levels of appeal for Social Security determinations, including the following:
- Request for Reconsideration
- Request for Hearing
- Appeals Council Review
- U.S. District Court case
Collect Additional Evidence
Applicants pursuing the SSDI appeals process are often asked to gather additional evidence in support of their applications. New evidence can be submitted at the administrative hearing.
Contact Bruce L. Weider, PC for Help With Your Appeal
If you were denied Social Security Disability benefits, consider contacting an experienced lawyer from Bruce L. Weider, PC for help with your appeal. You can reach us at (734) 485-0535 to schedule a free one-time consultation to review your case.
