When Your Social Security Disability Claim Is Denied…Don’t Give Up!
Securing either Social Security Disability or Supplemental Security Income benefits is not simple. Even if you believe you are disabled because you are suffering from a serious illness or injury, the process is complicated, intimidating, and discouraging. Don’t give up. Our expert advocates may be able to get you set on the path toward the better life that you deserve.
How To Get Approved For Social Security Disability Benefits
Getting approved for disability is not as simple as proving that you cannot work your current or past jobs. The challenging aspect of a Social Security claim is that you generally have to prove that you cannot work any job that is available nationwide.
According to the Social Security Administration (SSA), 53 percent of disability claims are denied and nearly 80 percent of consequent appeals are also denied.
At Disability Help Group, we understand the specific reasons for initial application denials and can help you avoid the common mistakes and pitfalls of the disability claims process.
If your application for Social Security benefits has been denied, don’t be discouraged. Contact our expert disability advocates for a FREE consultation today.
What Might Qualify You For Social Security Disability Benefits
Through the years, our expert disability advocates and their supporting resources have assisted Social Security disability claimants suffering from many severe ailments.
Qualifying impairments for SSD benefits may include:
- Back Pain
- Diabetes
- Fibromyalgia
- COPD
- Heart Disease
- Cancer
- Traumatic Brain Injuries
- Hypertension
- Crohn’s Disease
- Asthma
- Schizophrenia
- Bipolar Disorder
- ADHD
- HIV / AIDS
- Spinal Cord Injuries
- Joint Swelling
- Reflex Sympathetic Dystrophy
- …and many other conditions
SSDI (Social Security Disability Insurance)
To qualify for SSDI, you must have built up enough “work credits” and also meet the SSA’s definition of disability. According to the Social Security Administration, You must not be able to engage in any substantial gainful activity (SGA) because of a medically determinable physical or mental impairment(s) that is expected to result in death or that has lasted or is expected to last for a continuous period of at least 12 months.
Your eligibility for SSDI benefits also may depend on your age, work history, medical history, and even the type of disability that you are dealing with.
Most importantly, getting approved for SSDI relies on the information presented in your application. Make sure your application is as complete as possible and includes clear details of how your impairment affects your life. Provide any/all documentation to support what you state.
Medicare
Medicare is a health insurance program, usually (but not always) for the 65 and older group. It is paid for by taxes, along with monthly premiums deducted from their disability checks. The main benefits of having Medicare include basic medical insurance, hospital insurance, prescription drug coverage, and Medicare Advantage plans. If you have been receiving disability benefits for at least two years, you might automatically qualify for Medicare.
SSI (Supplemental Security Income)
SSI is calculated simply by comparing one’s income with their necessary expenses. The program was created to lighten the burden of health expenses for disabled people who have a low or nonexistent income. Your application must be submitted in person, however, some interviews can be done over the phone. In certain cases, children may also qualify.
Of course, in a Supplemental Security Income claim, you or your child’s impairments, income, and health expenses must be proven to the SSA.
If you need to apply for SSI, we want you to know that it is your right to have assistance in doing so, Disability Help Group is happy to do this for you and can inform you of other rights you have when it comes to SSI (such as your right to appeal an unfavorable decision). Equally important, you also have certain responsibilities as a recipient of SSI benefits, such as reporting any change in your income or disability.
Medicaid
Medicaid is a health insurance program for lower incomes. The program provides health coverage to almost 9 million people who are not elderly but are disabled. The majority of states provide Medicaid to people who have already been approved for SSI, but this is not guaranteed as the rules vary per state.
The Process of An SSD Claim
Initial Application
Your first step toward a successful disability claim is to perfect the contents of your initial application. This is where you will provide details about your disability and how it relates to your daily life. You will need to include details about all of your medical treatments, in addition to your work history. It’s best to submit any available supporting documents.
Your application is given to the Disability Determination Services (DDS). They will look further into your records and decide on your residual functional capacity (RFC). This is a professional opinion on your capabilities, and your approval/denial is widely based on it.
Reconsideration
If your initial application is denied, the process to appeal that decision can begin. You only have 60 days to appeal, and if it’s not done on time, you must start the process all over from the beginning. To appeal, you can start with a request for reconsideration. DDS receives your claim again and reviews it once more, this time by a different examiner. If the claim is denied again, don’t give up! This happens almost 80% of the time.
Several states have decided to get rid of the reconsideration level and now go straight to the hearing level.
Hearing Level
This stage has the longest wait time, although can have a better result. Be patient, because this level can sometimes take even more than a year or two to get past. New evidence, if there is any, can be submitted to an Administrative Law Judge (ALJ) who reviews your claim. Medical evidence is especially valuable. If you have an attorney, he or she may join and assist you. The hearing is private but is recorded in case you need to refer back to it later. The judge will provide a written decision after the hearing.
Appeals Court
If the judge has provided you with an unfavorable decision (a denial), the next step is to turn to the Appeals Council. This must be done within 60 days of your most recent denial. Otherwise, your appeal might be completely dismissed. The Appeals Council reviews your claim and will either reverse or agree with the judge’s decision. They may decide to return your case to the judge to have it reconsidered by him/her. Like the hearing, this stage in the process could require a wait anywhere between 6 months to 3 years.
Federal Court
If the Appeals Court confirms the ALJ’s decision, you may decide to take your claim to Federal Court. Like other appeals, you have 60 days to do so. Simply put, a lawsuit is filed against the Social Security Administration (SSA) for mishandling your claim.
Once you have decided to take your case to Federal Court, the official complaint and summons must be mailed via registered or certified mail to the SSA’s Office of General Counsel that oversees your area. In court, both you and the SSA will have lawyers present. There is a fee for filing this civil action, and it is not a good idea to make this decision without consulting the advice of an attorney first.
This is the most serious stage in the appeals process, and most claims do not require such actions.
Reasons Your SSD Claim Might Be Denied
More often than not, a disability claim will be denied on the first attempt. It happens to almost 3 out of 4 applicants. Having your Social Security disability claim denied can be discouraging, but we urge you to persevere. The journey to success when it comes to disability is not an easy one, but with the right knowledge, resources, and assistance, there is hope.
Below, you can learn about a few of the common reasons that disability claims are denied (assuming that you provide them access to all of your medical records and information).
- You have not been seeking the recommended treatment: It is only fair that your part is done to improve your health, and if the SSA does not find proof that you have gone to the doctor or followed his prescriptions, they may decide to deny your claim.
- Your income is too high: Generally, you might still be allowed to work with limits if you are receiving Social Security benefits. However, your income cannot surpass what the SSA considers “substantial gainful activity” (SGA). As of 2015, the limit is $1,090, but the figure is subject to change each year.
- Your disability is not expected to last long: The SSA might deny a claim if they feel that your condition will not last 12 months (or become fatal).
- Your disability is not considered severe enough: Your impairment must cause you to have extreme limitations to qualify for SSI or SSDI.
- They were unable to contact you: If the SSA and/or DDS (Disability Determination Services) is unable to reach you, they may decide to deny the claim.
- Your disability is due to addiction: Unfortunately, the SSA does not approve claims that are based on drug, alcohol, or other addictions. They may decide otherwise if they think your disability would continue without the addiction.
There are several other reasons why a denial happens that are not mentioned here. Whatever the case may be, we encourage you to stay positive. Feel free to rely on The Disability Help Group for support and advice.
Free Consultations Anytime, Every Time
Don’t spend another day worrying about how you will pay your medical bills and support your family. Don’t continue to think that you are not entitled to disability benefits because your application has been denied. Our disability advocates and the many experts that they work with are ready to help you now.
Depending on what type of benefits you are applying for, the reasons to be denied are seemingly endless. Call us today at 1-800-800-2009 or fill out our contact form for a FREE consultation.
Additional Conditions and Resources
- Additional Benefits for Veterans
- Amputation
- Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig’s Disease
- Asthma
- Attention Deficit Hyperactive Disorder (ADHD)
- Back Pain
- Bipolar Disorder
- Blindness
- Burns
- Cancer
- Cardiomyopathy
- Chronic Fatigue Syndrome (CFS)
- Chronic Obstructive Pulmonary Disease (COPD)
- Cognitive-Behavioral Therapy
- Common Diagnoses
- Common Diagnoses for Veterans
- Coronary Artery Disease
- Crohn’s Disease
- Cushing’s Syndrome
- Depression
- Diabetes
- Diabetic Neuropathy
- Disability Benefits for Children
- Disability Insurance Benefits (DIB)
- Dysgraphia
- Exposure to Radiation
- Extra Work Credits Given to Military Service Members
- Filing Your Adult Social Security Disability Report with Form 3368
- Garnishment of Disability Benefits for Child Support and/or Alimony
- Hearing Loss
- Heart Attack
- Heart Failure
- HIV/AIDS
- How Many Work Credits Do You Need to Qualify for Disability Insurance Benefits?
- How Social Security Defines Substantial Gainful Activity (SGA)
- How to Simplify the VA Disability Compensation Process
- Hypertension
- Increasing the Odds: Tip #1 – Follow Your Doctor’s Orders
- Information on Social Security Disability & Veterans Disability Compensation
- Interpersonal Psychotherapy for Depression
- Ischemia
- Joint Swelling
- Knee Disability: When to File for Social Security Disability Benefits
- Medical Experts Can Support Your Social Security Disability Claim
- Miami-Dade: Office of Disability Adjudication & Review (ODAR)
- Multiple Sclerosis (MS)
- Musculoskeletal Impairments and Social Security Disability
- Obesity
- Osteoporosis
- Overview of the VA Disability Claim Backlog
- Panic Attacks
- Physical Disabilities
- Post-Traumatic Stress Disorder (PTSD)
- Prisoner of War (POW)
- Quick Disability Determination (QDD) – Part 1 of Fast-Track Disability Process
- Reflex Sympathetic Dystrophy (RSD)
- Schizophrenia
- Sleep Apnea
- Social Security Disability Claims Process
- Social Security Disability Conditions: Malignant Neoplastic Diseases
- Social Security Disability Help
- Social Security District Offices
- Spinal Cord Injuries
- Suicide Warning Signs
- Supplemental Security Income (SSI) Eligibility Guidelines
- Survivor Benefits: Spouse, Dependent Children and Parents
- The Complete Guide to Winning Your Veteran Disability Claim
- The Process of a VA Claim
- The Process of An SSD Claim
- The Social Security Administration’s definition of alleged onset date (AOD)
- Title II benefits can be garnished for child support/alimony
- Traumatic Brain Injury (TBI) | Head Trauma
- Types of SS Disability
- Understanding the Adult Disability Report (SSA Form 3368)
- VA Focuses on Disabled Veterans Suffering from Military Sexual Trauma
- Veterans and Social Security Disability by the Numbers
- Veterans Disability
- Veterans Disability Compensation Program – Eligibility Requirements
- Veterans Disability Compensation: Qualifying for Benefits
- Veterans Disability Help
- Veterans’ Disability Compensation Claims Process
- Veterans’ Disability Compensation: Benefits Package
- We fight for your rights Disability Benefits: Secrets Social Security Won’t Tell You
- What is Fibromyalgia?
- What to Do When a Loved One Receiving Disability Benefits Dies
- Why Your SSD Claim Might Be Denied