Thousands of workers just like you are denied Social Security Disability (SSD) benefits each year. But a denial from the Social Security Administration (SSA) doesn’t have to stop you from trying to get the benefits you need. At Fields Law Firm, we can review your initial claim and help you file a strong disability appeal.

If you have questions about why your claim was denied by the Social Security Administration, our Social Security Disability lawyers can help.

It costs nothing to get answers to your questions – get a free consultation today!

Common Reasons Disability Claims Are Denied

Your Social Security Disability claim may be denied because of:

• Income and Resources

To get disability benefits, you must be unable to engage in substantial gainful activity (SGA) – meaning your monthly income has to fall below limits set by the SSA. Your claim will be denied if your monthly income exceeds SGA limits, which vary depending on the nature of your disability. The SSA’s most current SGA limit is $1,550 per month gross wages.

• Failure to Follow Prescribed Therapy

The SSA can deny your disability claim if you fail to follow a doctor’s prescribed treatment for your medical condition when that treatment is expected to restore your ability to work. That’s why going to your doctor is vital if you want the SSA to approve your disability claim.

• Recovery Time

Social Security Disability benefits are intended for people with disabilities expected to last at least one year or result in death. Some conditions expected to heal within weeks or months, such as bone fractures, may not qualify you for disability benefits.

• Failure to Provide Information

Claim will be denied if you fail to provide Social Security Disability with requested information.

• Work Credits and Date Last Injured

Social Security claims can be more complex than people realize. There is a lot that goes into the analysis of whether a claimant is disabled or not under Social Security’s standards. Occasionally, claimants will apply for Social Security Disability Insurance (or SSDI) and get told that they are not eligible because of their date last insured or because they do not have enough work credits in the system. These determinations are based on the prior years worked before becoming disabled. The claimant’s date last insured is the last date that the individual is eligible to receive SSDI. This is based on the amount of work credits an individual has accumulated.

To determine whether or not you have enough work credits, Social Security looks at the age you became disabled and how much time you worked in the years leading up to your disability. If you’re over 30, you have to have worked 5 of the last 10 years. If a claimant has not worked in many years, they are more likely to be denied SSDI for that reason. In those cases, however, the claimant may still be able to apply for Supplemental Security Income (or SSI).

These are just a few of the reasons your claim may have been denied. Our Social Security Disability lawyers know what successful disability claims look like, and we’ll work hard to help you get the benefits you need to support your family.

Qualifying for Supplemental Security Income

In order to qualify for SSI, Social Security does not require that the claimant worked in the past. In fact, claimants who have never worked can apply for SSI. Social Security looks at the claimant’s assets and then determines if their disability would qualify them for receipt of SSI. If a claimant owns too much property, including vehicles, houses, motorcycles, etc., then they will likely not be approved for SSI. Social Security’s medical requirements for SSDI and SSI are the same.

Proving You Qualify for Social Security Disability

If a claimant does not have an issue with work credits or their date last insured, and the claimant still gets denied, it is likely due to lack of medical support for their disability. In order to qualify for disability, the claimant needs to show that they either meet a listing or fall within the grids.

The listings are a list of defined disabling conditions with measurable or specific standards for establishing whether or not the individual meets the standard or listing for the described condition. For example, a common listing is 1.04 for disorders of the spine. People with back issues would try to meet this listing. If the medical evidence or the claimant’s doctor don’t support that the claimant meets or equals this listing, they probably will not be found disabled unless the judge determines that they meet the grids.

The grids are a comprehensive assessment of an individual’s age, education, past work and residual skills that can also be used to determine disability if an individual does not meet a listing. If an individual is 55, hasn’t graduated from high school and has only done construction work, they would qualify for disability under the grids. Younger individuals are those considered to be 49 or younger. Those in the range of 50-54 are considered to be approaching advanced age.

Disability Denial Letter

Many people who apply for Social Security Disability and Supplemental Security Income are denied benefits at the initial application level. This could be for any number of reasons. Typically, however, claimants are told that the “evidence shows” one or more of the following, and they are therefore not disabled under the Social Security’s rules:

1. You have been treated and evaluated for the above condition(s).
2. You have enough energy to do many activities and tasks.
3. You have the ability to stand and walk without assistance.
4. You have the ability to use your hands and arms to perform tasks.
5. The pain caused by your condition is not severe enough to keep you from doing your basic activities.
6. Your condition has responded to treatment.
7. Your depression and anxiety do not severely affect your thinking abilities.
8. You are able to understand, remember, and carry out daily activities.
9. You are able to get along with other people for short periods of time.
10. In combination, your impairments are not severe enough to be disabling.

These reasons may or may not be true. Even if they are true, they do not typically accurately describe a person’s disabilities. If this is the case, those persons should appeal. Claimants have 60 days from the date of their denial letter to file an appeal.

The first appeal is called a Request for Reconsideration. At this stage, a claimant’s file is given to a different disability examiner, who works with a physician to evaluate the claim. Claims can be appealed by mail or online. Either way, a claimant must file a “Disability Report – Appeal” with the Request for Reconsideration. The “Disability Report – Appeal” asks for any changes since the Disability Report – Adult was completed.

Claimants who receive a second denial notice also should appeal if they feel their case is warranted. The appeal at this stage is called a Request for Hearing. Claimants also have 60 days from the date of their denial letter to file the appeal.

At the hearing stage, the matter is assigned to an Administrative Law Judge. The claimant can appear before the judge and bring any witnesses to testify on the claimant’s behalf. Claimants often have success at this stage because they are able to explain their disabilities in person to a judge.

Most disability claims are denied at the initial application and the initial appeal levels. Claimants should appeal if they are truly not able to work.

If you have additional questions on whether or not you qualify for disability under either a listing or the grids, or why your claim was denied by the Social Security Administration, our injury and disability law firm can help.