Best Tips When Appealing Your Denied Disability Claim
Social Security disability (SSDI) benefits serve as an important safety net for U.S. workers who become disabled before retirement age. Unfortunately, most claims for Social Security disability benefits are initially denied. In other words, when you file for SSDI benefits, you should be prepared to have to work your way through the process. That means:
If your claim is still denied after reconsideration, request a hearing before an administrative law judge (ALJ), which will offer you the opportunity to share additional information and present witnesses
If your claim is denied after the ALJ hearing, request a review of the hearing decision–however, the Appeals Council gets to decide whether or not to review your case
If your claim is denied by the Appeals Council or they opt not to consider your case, file a lawsuit in federal court
Of course, each stage means additional time. So, you’ll want to make sure that you set yourself up for the greatest chance of success at every stage. Ideally, that means working with an experienced disability benefits advocate to put together your original claim or to help with whatever stage of the appeals process you’re undertaking.
Increasing Your Chances of Winning in the Appeals Process After You’ve Been Denied
The very first step toward successfully appealing your SSDI denial is understanding the reason for your denial. Carefully review your denial letter, and consider contacting your local Social Security Administration (SSA) for more information or getting help from an experienced advocate.
It’s also very important that you meet the deadline for requesting reconsideration or appealing the decision. If you miss the deadline, you can reapply, but you will set your claim back by several months and may lose out on some benefits if you have to start over.
Regardless of whether you are submitting a request for reconsideration or appearing before an ALJ, you’ll want to supplement the record in any way you can. That may mean updated medical records, the results of testing you’ve undergone since you submitted your application, witnesses who observe your daily life, or other evidence that helps show you are disabled.
An Experienced Disability Benefits Advocate Can Help With Your Denied Claim
Perhaps the most important tip is to get the help you need. Part of increasing your chances of success in the SSDI appeals process is understanding what the SSA is looking for and how best to present that evidence. Our disability benefits advocates have extensive experience with Social Security disability claims and appeals and can help you put forth the strongest case possible.
To learn more about how we can help, call 800-800-3332 or contact us here for a FREE consultation.
Social Security disability benefits can provide stable income for a worker who is no longer able to work due to medical disability. But, not everyone who suffers from a medical condition is eligible for SSD benefits. If you are considering applying for SSD, or you have been denied Social Security disability benefits, it’s important to understand what is required to successfully establish your claim.
The Social Security Administration (SSA) considers different types of evidence to determine your eligibility.
Types of Evidence to Support Your SSD Application
Technical Eligibility
Most of the evidence considered by the SSA relates to your medical condition and your ability or inability to earn a living. However, there is a threshold issue. To qualify for Social Security disability benefits, you must have accumulated a sufficient number of work credits. Usually, you won’t need to submit evidence regarding work credits, because the SSA has access to your qualifying work history. However, mistakes occasionally happen. You’ll want to verify that your work credits are accurate, and, if necessary, submit evidence to correct the record.
Evidence of Disability
For most SSD applicants, the most significant evidence of disability will come from medical providers. This may include doctor’s notes, test results, and other medical documentation. But, reports from your doctors aren’t the only type of evidence that can help support your claim for disability.
Another common type of evidence the SSA considers is information provided by other people in your life, such as friends, family members, and others who have had the opportunity to observe how your medical condition has impacted your ability to carry on daily activities.
Inability to Engage in Substantial Gainful Activity (SGA)
To qualify for Social Security disability benefits, you must demonstrate that you are unable to engage in substantial gainful activity due to your medical condition or combination of conditions. To make that determination, the SSA will need information about the types of work you have done in the past, your educational level, your age, and other information that will help them determine whether you can perform work of the type you did in the past or adapt to new work.
Assembling Evidence for Your SSD Claim
Putting together a strong application for Social Security disability benefits requires an understanding of exactly what the SSA is looking for and how they use that information. Our disability benefits advocates have extensive experience with SSD claims and appeals and can help you submit the strongest application possible.
To learn more about how Disability Help Group can help, call (800) 800-3332 right now, or contact us here for a FREE case evaluation.
Can I Receive Disability Benefits for Fibromyalgia?
Fibromyalgia is a chronic, potentially disabling condition that scientists don’t yet fully understand. While medical treatment can help manage symptoms, there is no cure for fibromyalgia. Some of the key symptoms include pain in multiple sites in the body, fatigue, and difficulty sleeping. There is no conclusive diagnostic test for fibromyalgia, and the diagnosis is usually based on a combination of symptoms and exclusion of other possible causes.
Fibromyalgia is not listed in the Social Security Blue Book, and for a long time, the complex nature of the condition and the unknowns surrounding it made it very difficult to pursue Social Security disability benefits (SSDI) for the condition. However, in 2012 the Social Security Administration (SSA) issued guidance specifically for claims based on fibromyalgia.
Guidelines for SSDI Claims Based on Fibromyalgia
The SSA now says that fibromyalgia may be recognized as a medically determinable impairment (MDI) if certain criteria are met. There are two sets of criteria that may be employed: the 1990 American College of Rheumatology (ACR) Criteria for the Classification of Fibromyalgia and the 2010 ACR Preliminary Diagnostic Criteria.
Two of the three criteria are the same under either set of standards:
A history of widespread pain (in both sides of the body, above and below the waist, and spinal) that has lasted for at least three months, and
Evidence that other possible explanations for the symptoms have been excluded through appropriate medical testing
In addition to these two requirements, the SSDI claimant must also show either:
Medical testing found at least 11 “tender points” among 18 listed locations on the body, or
Repeated manifestations of six or more fibromyalgia symptoms, such as fatigue, memory problems, cognitive issues, waking tired, anxiety, depression, or irritable bowel syndrome
Evidence of Disability
If you’re pursuing Social Security disability benefits for this condition, you’ll need objective medical evidence stating so. Diagnosis from your physician is not sufficient, and the SSA will want to review your medical history and the tests used to exclude other possible causes. In addition, you may submit additional information from non-medical sources, including those who have had the opportunity to observe your medical limitations over time.
Submit the Strongest Possible SSDI Claim
Most SSDI applications are denied at first. The more clear, complete, and on-point your application and supporting documentation are, the better your chances of approval. At Disability Help Group, we have extensive experience with disability benefits claims and appeals. We know what type of evidence is necessary to support your claim, and how to present it effectively.
To learn more about how we can help you pursue disability benefits for fibromyalgia, call (800) 800-3332 right now, or contact us here for a FREE case evaluation.
– Matt Sauerwald, President, Disability Help Group
Matt Sauerwald has been a dedicated advocate for people seeking disability benefits for over a decade. He’s represented thousands of clients and thoroughly knows the disability application and appeals processes.
Matt knows that most Social Security disability applications are initially denied and that understanding the most common reasons for denial can help you improve your chances of submitting a successful application.
Common Reasons for SSDI Claims Denial
Many people assume that Social Security disability denials are generally based on how the Social Security Administration (SSA) views the medical documentation submitted. However, many SSDI claims are denied before the SSA ever reaches the point of assessing the applicant’s medical condition. In the most recent year reported, the SSA denied more than 39% of workers’ claims for disability benefits for technical reasons.
Non-Medical Denials in SSDI Cases
Some of the most common non-medical reasons claims for SSDI benefits might be denied include:
Insufficient work credits: to qualify for Social Security disability benefits, you must have earned a certain number of work credits. The number of total credits and recent credits required depends on your age at the time you became disabled.
Making too much money: disability benefits are intended for people whose medical conditions prevent them from engaging in substantial gainful activity (SGA). So, if you earn above the SGA threshold, you won’t qualify.
Not providing sufficient information or failing to cooperate: to be granted disability benefits, you must provide all required information and be responsive to any requests from the SSA.
Medical Denials
To receive SSDI benefits, you must show that your medical condition or combination of medical conditions renders you unable to earn a living. Your claim may be denied if:
You’ve provided insufficient medical documentation to prove your condition.
The SSA determines that your condition isn’t severe enough to prevent you from engaging in substantial gainful activity.
You aren’t following medical recommendations that could improve your condition.
The disabling condition is not suspected to last for at least one year.
The SSA determines that there is still work you can perform, despite your medical limitations.
Submit the Strongest SSDI Application Possible
Many SSDI denials happen due to innocent mistakes or missing information. The best way to avoid those missteps that could result in denial or delay your claim is to work with an experienced disability benefits advocate from the beginning. To learn more about how we can help, call 800-800-3332 or contact us here for a FREE case evaluation.
Matthew Sauerwald is one of the top disability benefits advocates in the nation. He fights for the rights of people pursuing Social Security disability or VA disability benefits. Currently, he leads Disability Help Group, one of the most successful disability advocacy organizations in the United States.
The Social Security Administration (SSA) provides benefits to certain survivors of deceased workers. That’s true whether the deceased was still working, was retired, or was receiving SSDI benefits at the time of their death. But, not every survivor qualifies for widows’ benefits or other survivor benefits. The surviving spouse will typically be entitled to benefits based on the deceased worker’s work history if:
The widow or widower has reached full retirement age
The widow or widower is at least 60 but below full retirement age (benefits will be reduced)
The widow or widower is at least 50 years old and disabled (benefits will be reduced)
The widow or widower does not qualify based on age and/or disability but is caring for a child of the deceased who is under the age of 16 (benefits will be reduced)
Note, though, that there are complications, potential disqualifications, and choices to be made. For example, if you’ve reached retirement age yourself, you can choose between your deceased spouse’s benefit and your own, but you can’t collect both. And, if you’re receiving a pension from work that didn’t pay into Social Security, such as a city government employer, that may impact your widows’ benefits.
It may seem that widows’ benefits would be almost automatic since the criteria are so cut-and-dried. But, you will actually be required to provide quite a bit of documentation when applying for survivors’ benefits. That’s true in any case but can be especially challenging if you are claiming benefits between the ages of 50 and 59 because you are disabled. You cannot apply for widows’ benefits online.
Be Sure to Explore all Available Benefits
Though this post is focused on widows’ benefits, other relatives, including minor children, adult children who are disabled, and–in some cases–dependent parents may also be entitled to benefits. Make sure to explore all available benefits before applying.
Applying for Disability Benefits as a Widow
If you’ve been widowed and your spouse qualified for Social Security benefits, you may qualify for benefits on your spouse’s work record. But, it doesn’t work that way for SSDI. To qualify for Social Security disability, you must have accrued sufficient work credits of your own. Pursuing SSDI as a widow is no different from pursuing the same benefits as a single person or a married person–except that you may have to choose between your own benefits and the benefits you are entitled to as a surviving spouse.
Don’t Take Chances with Your Widows’ Benefits
As you can see, the process of securing benefits for yourself and your children after the death of a spouse can be trickier and more time-consuming than you might have expected. And, survivors’ benefits can be denied and appealed just like any other Social Security application.
At Disability Help Group, we put our experience to work for people like you every day. To learn more about how we can help you, call 800-800-3332 or contact our team of experts here.
