Your Application for Disability Benefits Was Denied. Now What?
Social Security doesn’t only provide benefits for retirees. For those who are unable to work, Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), and/or Disabled Widow/Widower benefits are relied upon for many who would otherwise be unable to care for themselves financially. Consequently, when benefits have been denied, many applicants become dismayed and feel like they are at the end of their rope. Fortunately, there are things that can be done if you have been denied SSDI benefits.
Denials Are Common
Social Security Disability Insurance applicants are often denied on first submission. Social Security has very stringent conditions when it comes to criteria that make someone “disabled.” These requirements are extremely narrow and the application process complicated. Consequently, people who really need benefits often receive denials instead of the benefits they so desperately need.
Reasons for SSDI Claim Denials
Over 2 million people applied for Social Security Disability Insurance benefits in the year 2019. Of those who applied, only 723,900 were awarded benefits. The balance of these applicants either were not insured for disability benefits or were denied. Typically, around 30 percent of applicants are approved at the initial level of the process. Why are so many of these claims denied?
SSDI denials typically fall into a few categories:
- Lack of adequate medical evidence for the disability — Applicants must have hard evidence proving a disability, making an applicant unable to work. A physician must document how you are disabled and how it impacts your ability to work.
- Previous denials — filing a new claim instead of appealing the original one can send a red flag up for a reviewer, often leading to another rejection. Because of this, the appeals process is more advantageous than filing a new claim.
- Your income — If you make more than what Social Security calls “substantial gainful activity” you may be denied. In 2021 that figure is $1,310 per month or $2,190 if you are blind.
- You have failed to follow treatment plans — If you fail to follow the treatment that your physician has set out for you, you have demonstrated yourself unwilling to cooperate with treatment. This will get you denied for SSDI.
- Failure to cooperate with Social Security — It is always in your best interest to cooperate with Social Security when they make requests for documentation or medical exams.
Appealing When Your Disability Benefits Are Denied
Fortunately, you can appeal your denial under specific guidelines set out by the Social Security Administration.
When you appeal a decision made by Social Security, your initial request goes back before the Social Security Administration with any new or additional supporting evidence. At that time, they will review new supporting documentation. Unfortunately, most denials are not overturned at the initial appeal process, with the average appeal success rate at less than 14 percent.
A Disability Hearing
You have a better chance for appeal success at the disability hearing level. Here you will be questioned by an administrative judge who will ask questions regarding your medical condition, the treatments you are receiving, and your past employment and education. You will be able to discuss your issues and bring expert witnesses who can support your claim.
If you bring a lawyer to the hearing, he or she can speak on your behalf and argue for your claim. The judge then has the authority to uphold or to overturn a denial. In most cases, you will receive the results of the judge’s decision within 30 days of the hearing. The average success rate at this level is over 60 percent.
You may also request an appeals council review if your denial does not get overturned at the hearing level. However, the council only looks for mistakes made by the administrative judge at the hearing level. If no errors are found, the denial is unlikely to be overturned.
Getting Professional SSD Help
The entire process of applying for SSDI benefits can be complicated and overwhelming for most people. Getting the assistance of a skilled Social Security Disability (SSD) lawyer can help an applicant navigate the complexities of the process.
An experienced SSD benefits attorney will advise and guide an applicant through the appeals process, ensuring that each step is completed correctly in accordance with Social Security guidelines and rules. He or she will understand the deadlines involved, know what information must be included, ensure that all documents are completed correctly, and know what added information may strengthen the case. An SSD lawyer can be brought in at any point in the application or appeals process.
If you need professional assistance with your application for SSDI benefits or you have received a denial for benefits, the disability benefits lawyers at Walner Law can help. Contact us for a free consultation to discuss your claim or call us at (480) 508-8800.