Most Social Security Benefits Denials are Successfully Appealed
Common Reasons Your Application Could be Denied
A denial of your application for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) can be confusing, particularly when you have been diagnosed with a serious medical condition. But, getting approved for Social Security involves more than a medical diagnosis.
Here are three things you need to know about common Social Security denials and how the system works:
Your claim could be denied based on the date you last worked
Many SSDI denials are based on “qualifying quarters of coverage.” This means that you did not pay enough or have not paid recently enough into the Social Security system to qualify for benefits. If you were not employed very long or have not worked in the last few years, you may not eligible for SSDI. In most cases, you will not be eligible for SSDI if you did not work five of the past ten years—in other words, 20 of the 40 quarters (seasons) of the past ten years. And, in order to claim your Social Security benefits, you must prove that your disability began on or before the date your coverage ended—not when you quit working. This date is called the Date Last Insured (DLI). For most cases, if you worked up until five years ago today, your DLI would be today. If you worked up until four years ago today, your DLI would be one year from today. If you worked up until six years ago today, your DLI (meaning the date your disability must have began to qualify for SSDI) would have to be one year ago today. As you can see, your work history as well as the dates you stopped working and your disability began will have a huge impact on your eligibility for SSDI. However, even if you are denied SSDI based on your employment history and an expired DLI, you may still be eligible for Supplemental Security Income (SSI).
A medical diagnosis is not enough; you must prove you cannot do ANY type of work
For many, this is hard to understand because you have been diagnosed with a serious medical condition. What more is there to dispute? Generally, the Social Security Administration (SSA) needs to know how, exactly, that diagnosis affects your ability to work, a consequence of your diagnosis which is often not included in the diagnosis itself. Since Social Security disability benefits are based on your inability to work enough hours to support yourself because of your disabling condition, you must prove that you are unable to do any type of work. That includes work that might be unrelated to your career field. An experienced Social Security attorney will be able to get qualified doctors to prove your disability limits your ability to do any type of work.
If you can do work different than your current occupation, you may be denied
Often clients come in with a denial letter that says they are unable do activities related to their job, but that they can still work. The simple fact that you cannot do what your current job requires does not mean you are automatically eligible for SSDI. A judge might determine that you are unable to perform the job that you had before you became disabled, but if he decides that there are jobs in the economy that you can do, your application for benefits may be denied.
Social Security is confusing and involves a lot of red tape. You need an experienced Social Security attorney to help you appeal your denial and understand the issues. The dedicated Social Security attorneys at Taylor, Warren, Weidner, Hancock & Barnes, P.A. have successfully handled thousands of Social Security cases that were initially denied. We can answer your questions about Social Security denials and we never charge any fee or cost to inform you of your rights.
Helpful Links and Resources
Read the Social Security Disability SSI Resource Center's Overview of Disability, Questions and Answers guide here.
Read frequently asked Social Security SSDI and SSI questions from ssa.gov here.
Learn whether you can return to work after getting disability benefits.
Read about the eligibility requirements to qualify for Social Security disability benefits.
Find out how long it generally takes to get a decision after you apply for Social Security benefits.
Learn whether unemployment benefits will affect your Social Security benefits.
Read the American Association of Retired Persons (AARP's) Social Security Question and Answer Toolkit here.
Learn more about your disability and the best options for your future.
Helpful AARP article on how Social Security works.
Read Social Security Disability Income (SSDI) Answers to Frequent Questions from TheLaw.com.
COPY from previous “Disability Denials” home page:
Are You Disabled?
Know whether you have a disability or are disabled. Under Social Security Administration rules, you have a “disability” if you: 1) cannot do work that you could do before; 2) cannot adjust to other work because of your medical condition; and 3) your condition has lasted, or is expected to last, for one year or is expected to cause death. This may include what is commonly referred to as a “sitting disability” where you are unable to sit without pain due to a back injury, sciatica, piriformis syndrome, coccydynia, myofascial pain syndrome and pudenal neuralgia, just to name a few. Complications from diabetes, such as diabetic retinopathy and nephropathy, cardiovascular diseases, poorly healing skin and bacterial infections can also qualify as a disability. These represent a mere handful of recognized disabilities, among hundreds. The bottom line is, if you feel a long-term mental or health condition is preventing you from working, you should consider filing for disability benefits.
Apply for Benefits Immediately
Apply for benefits as soon as you are unable to work full time. It can take many months to process your application for social security or long-term disability benefits, so you should file an application or claim as soon as your physical or mental condition prevents you from working full time. If you do not get a phone call or a letter within two weeks of submitting your claim, follow up to ensure your claim was received and is being processed. Contacting a disability law attorney at the early stages of filing can also greatly increase your chance for receiving disability benefits.
Understand Most Claims Are Initially Denied But Usually Successfully Appealed
No one expects a legitimate claim to be denied. But it happens more than you might imagine. We fight insurance companies every day for people just like you who have had valid claims for benefits denied. Most of the successful disability benefits cases we handle originate from an application or claim for disability benefits that was initially denied. Do not let the initial denial be the end for you. You need a team fighting for you to appeal that denial and make sure you get the benefits you deserve.
Contact a Disability Attorney as Soon as Possible
Navigating the ins and outs of social security and long-term disability law can be complicated. You need someone skilled and experienced in fighting the government and disability insurance companies on your behalf to ensure you are paid the benefits you are rightfully owed. Bringing a disability law attorney on board early on can help alleviate your stress and frustration with the process and ensure you are doing the right things to protect, and not waive, any of your rights. At Taylor, Warren, Weidner, Hancock & Barnes, we have years of experience fighting wrongfully-denied disability claims. We know the law and the type of evidence you need to prove your case. Let us put our knowledge and resources to work for you.