What to do if Your Social Security Disability Claim is Denied?

By | October 10, 2016

Only a few social security disability claims are accepted by the Social Security Administration (SSA), and as many as 65 percent of applications are denied in the very first step. This means only a few lucky ones get their social security disability claims approved. In fact, the Social Security Administration might keep rejecting your request until you make an appeal.

So, if you are seriously and permanently disabled and are considering applying for social security disability, there are high chances that your request might be denied. However, before you consider hiring a social security disability lawyer to help you with the re-application, you must understand what leads to the denial.

Reasons Why Social Security Disability is Denied

More than 37 million people in the U.S. (almost 12 percent of the total population) are classified as disabled, according to U.S. Census Bureau. While the social security disability (SSDI) is designed to help the disabled people sustain their lives (until they can get back to work), they seldom get the benefits. Oftentimes, people have to find other ways to sustain their lives since their social security disability is often denied.

However, by knowing the reasons why the social security disability is denied, you can make sure that your application does not get rejected.  The most common reasons for the rejection include:

  • Considerable Income

The major reason why social security requests get denied is that the applicant earns more than the limit where it is considered “substantial gainful activity (SGA).” In simple words, you are considered capable of sustaining your life and you earn too much money to be considered for benefits. The SGA limit for 2016 is $1,130 per month; so if you earn more than that, your application would be denied.

  • You Have Minor Disability

In order to qualify for social security disability, you must have severe impairment that will last at least 12 months or result in death, with an exception for the blind SSI applicants. Another factor that is considered while approving social security disability is that your medical condition should impose severe limitations.

  • Fit Enough to Do a Different but Related Job

Your application might be rejected if the SSA determines that you are fit enough to perform a job that is related to what you used to do.  An examiner will evaluate your situation and ability to work, and the final decision will be based on the employment history and scope of your work. While these constitute the major reasons, other reasons for denial include:

  • Improper explanation
  • Failure to submit the necessary documents
  • Failure to follow prescribed therapy
  • Disability based on alcoholism or drug addiction

What to Do After the Request is Denied?

The chances of approval for those who have been denied the SSDI increase if they take time to appeal in court. They get the opportunity to explain their situation in front of the administrative law judge and get a chance to win disability benefits.

So, if your SSDI application has been denied, you should first try to understand how the appeals process works to increase the chances of approval. Here is how the appeals process works:

  • Request a Reconsideration: You can request the initial application to be reviewed again. However, some states skip this stage and require the claimants to appeal for a hearing straight away.
  • Administrative Law Judge (ALJ) Hearing: If your request for reconsideration is denied, you get a chance to appeal further. A hearing must be requested before an ALJ within 60 days from the receipt of your denial. ALJs work for SSA’s Office of Disability Adjudication and Review (ODAR); almost 67 percent of the claims that reach them are granted the benefits.
  • Appeals Council: If your application does not get approved at the ALJ hearing, you can take your appeal further by requesting an Appeals Council review. The Appeals Council randomly selects cases and has the right to grant, deny, or dismiss your request for review. However, the chances of winning at the Appeals Council are very thin.
  • Federal Court Review: This is your last chance to try and get your SSDI application approved. This is also when you need to be represented by a social security disability lawyer. Almost a third of the cases that reach the federal court get approved. However, this can be time consuming and expensive, so be ready.

Why You Need a Lawyer to Represent You?

There is no hard and fast rule that you need to be represented by a social security disability lawyer to assist you at the hearing; however, the chances of winning increase greatly if you hire one. In fact, claimants who are represented by lawyers are twice as likely to get approved. Once you get in touch with a social security disability lawyer, he or she would do the following to help you win the case:

      • Gather all the required medical records to prove you are severely disabled. Applications often get rejected since medical records are incomplete, or there are inconsistent reports or gaps in the treatment history. The lawyer would get in touch with the physicians and medical facilities to obtain the records quickly.
      • A doctor’s opinion often proves to a deciding factor whether your application should be accepted or rejected. A lawyer would get opinions from established doctors and get their statements in writing to prove the severity of your disability.
      • Another major reason why applications get rejected during the hearing is that the claimants fail to explain their situations clearly. People often get nervous and mess up. A lawyer would help you prepare to face the questioning and tell you what to expect at the hearing.

Established social security disability lawyers have a lot of experience in social security disability cases and they know how the decision-making processes of the ALJs work. Thus, they can challenge the decisions and play up your strengths to help you get the application approved.

Owing to the fact that almost 70 percent of all social security disability applications get rejected, it is important that you prepare well before placing your own application. Understand the factors that are considered when reviewing application and the reasons why applications get rejected.

If your application gets rejected in spite of your best efforts, then it is a must that you hire an experienced social security disability lawyer to help you make an appeal. Even though it is not absolutely required, the chance of winning increases if you hire a lawyer. So, it is best to get assistance from a lawyer as soon as you received the denial receipt.

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