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.
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.
Can I Receive Unemployment While Collecting Long-Term Disability?
The short answer is “probably not.” While there may be exceptions, long-term disability (LTD) and unemployment insurance are usually mutually exclusive. That’s because LTD benefits are intended for people who are disabled–that is, unable to work. The same is true for Social Security Disability. But, state unemployment insurance programs typically require that recipients be willing, able, and available to work. In other words, it’s usually impossible to fulfill the requirements for both LTD and unemployment insurance.
In fact, applying for both could be risky legally. The two applications might require you to attest to conflicting claims. If you believe you may be qualified for both long-term disability benefits and unemployment, it’s in your best interest to talk to an experienced disability benefits advocate right away, before you file an application for either benefit.
Unemployment Insurance v Long-Term Disability Benefits
How Does Unemployment Insurance Work?
In nearly all U.S. states, employers are required to pay unemployment insurance premiums or pay into a state unemployment program. Employees earn access to these benefits by having sufficient recent earnings from employment. To be eligible, the employee must also have been terminated from employment or quit for one of a small number of acceptable reasons. In most states, an employee terminated for cause will not be eligible.
How Does Long-Term Disability Work?
Long-term disability is a type of insurance, which may be purchased directly or provided by your employer. A long-term disability policy typically pays a percentage of your regular income if you become disabled–usually 50-67%. To qualify, you must meet the policy definition of disabled. LTD policies often include offset provisions, meaning that if you receive SSDI or certain other benefits, your LTD payout may be reduced.
Who May Be Eligible for Both LTD and Unemployment?
The narrow exception that might allow a small percentage of disabled workers to receive both LTD and unemployment hinges on the policy definition of “disabled.” Usually, it will mean that the insured is unable to engage in gainful employment. However, some policies may have more specific definitions, such as being unable to perform your current job duties or being unable to work in a particular industry.
In that case, the disabled worker may technically qualify for both LTD and unemployment insurance. But, it’s important to carefully review the criteria and any set-off provisions or exclusions. For example, a long-term disability policy may include a provision that allows the insurer to reduce benefits if you are receiving certain other types of compensation.
Contact Disability Help Group
To avoid any missteps, consider working with an experienced disability benefits advocate from the beginning.
Disability Help Group was founded by experienced disability experts who have been representing people with disabilities for over 15 years. Our team understands how to work with the Social Security Administration (SSA) in the best interest of the disabled person.
Social Security Disability claims require patience from the claimant, which can be tough when a person’s finances are in question. We understand, and we are here to help.
We have representatives across the country to ensure that your rights are being protected and the disability process is being properly followed.
To learn more, be sure to call one of our Disability Advocates now at (800) 800-3332, or fill out the contact form on this site.
How to File a Social Security Disability Application
You have multiple options for filing an SSDI application. The Social Security Administration (SSA) recommends filing online and treats the online application as the default method. Here are a few reasons you may want to use the online application process:
You can apply any time it’s convenient for you, rather than having to wait for an appointment and then apply during business hours
The SSA says that online applications are typically processed more quickly than other application types
You can stop and start the online application, meaning that the process won’t be derailed if you’re missing some information
With the average wait time for an initial determination crossing the 7-month mark in February of 2023, it makes sense to take the most efficient route possible. However, if you can’t apply online or just don’t want to, you have other options.
Alternative Ways to Apply for Social Security Disability Benefits
Apply at Your Local Social Security Office
You can apply for disability benefits in person. One advantage to this approach is that you’ll have an SSA staff member available to answer questions or provide other assistance. You can find your local office through the SSA’s field office locator tool.
If you choose to apply in person, be sure to call ahead for an appointment. And, make sure you have all of the required information gathered.
Apply by Phone
Applying by phone is similar to applying at your local office. You’ll have an SSA representative to assist you, and they’ll ask you questions to collect the information you would fill in when completing the application. The SSA offers a starter kit to help you prepare to complete your application and interview, whether you apply online, by phone, or in person.
Need Help with Your SSDI Application?
Most Social Security disability benefits applications are initially denied. You can improve your chances of being among those applications approved in the first round by ensuring that your application is completed properly and that you have provided adequate supporting documentation to fully establish your claim. Working with an experienced disability benefits advocate can help ensure that you put together the best application possible. To learn more about how Disability Help Group can help, call (800) 800-3332 right now, or fill out the contact form on this site.
Top Mistakes That Will Get Your Disability Claim Denied Every Time.
– Matt Sauerwald, Vice-President, Disability Help Group
Matt Sauerwald is one of the top Disability Advocates in the U.S. Matt has a wealth of knowledge and expertise in Social Security Disability law and has devoted his professional life to helping those who are unable to work due to a disability. Matt has successfully represented thousands of clients throughout their benefits claims.
Below, Matt shares the top mistakes that will get your claim denied every time.
Failing to cooperate with the process.
If you fail to give SSA what they are requesting, they will deny your case.
Working before you get an initial decision.
When SSA makes the initial decision (which normally takes 6 – 9 months) there is no hearing. You don’t get to testify, and an advocate does not get to argue your case. Everything is paperwork and medical records. Social Security has its own doctors, who you never get to meet, review your file, and determine if you are disabled.
Given the fact that only one-third of individuals applying for disability get approved at the initial stage, this means the doctors are clearly biased towards saying individuals are not disabled.
If you are working at a full-time level or even if a part-time level (if the job is hard or stressful), you are virtually guaranteeing denial.
Failing to attend your hearing.
Disability Help Group wins thousands of disability awards each year. This is the most important day in your case. Social Security is now offering phone and video hearings.
Failing to attend your hearing is a huge mistake because this is the one part of the process where you get to tell your story and have someone advocate for you and argue your case. Show up!
Working and not disclosing the work.
There are special rules about working Social Security disability. You can attempt work for 6 months and continue your case so long as you have to stop because of a medical condition. This is called an unsuccessful work attempt.
If you have already been out of work for 12 months or longer due to a medical condition and returned to work, you can still get paid for the period of time you were out of work. This is called a closed period.
If you are working, don’t hide it. Talk with your advocate about it and Social Security.
Not appealing a decision.
Many people get denied at the initial stage of the process and give up. This makes no sense unless you are back to work full-time.
Most people who get approved for disability do so at their hearing. Even if you are not sure about the case, until you are back to work full-time, you should appeal.
Working with an advocate can ensure your appeal gets filed and processed quicker too.
For individuals approaching age 62 or on early retirement, many don’t think of disability as even an option.
This is a mistake. When you take early retirement, you are penalized. You get less money on a monthly basis than if you waited for full retirement age.
If you are on early retirement and can prove you were disabled prior to the election of early retirement you can eliminate the early retirement penalty. This could mean tens to hundreds of thousands of extra dollars in your pocket.
If your claim has been denied or you are currently working through the appeal process and need help, contact Mr. Sauerwald and the team at Disability Help Group at 800-800-3332 today and see how we can help get your claim approved.
Since 2010 Matthew Sauerwald has been a leading voice for the disabled community in seeking compensation from the Social Security Administration and the Department of Veterans Affairs. Mr. Sauerwald has led one of the nation’s most successful disability advocacy organizations Disability Help Group since 2015 and has litigated thousands of hearings resulting in hundreds of millions of dollars of disability awards. Learn more about Matt here.
