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, 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.