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Why Might Someone Be Denied Social Security Disability Benefits?

Legally Reviewed and Edited by: Terry Cochran

The U.S. Social Security Administration (SSA) offers Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) as separate benefits to disabled individuals. Although each benefit type’s eligibility criteria seem clear, many people find themselves unfairly denied aid due to several factors.

Getting the financial help you need can be time-consuming, especially if you’re already juggling your busy family’s needs. The SSA can be slow to process your initial application for benefits and any appeals you have to file if you are denied.

If you’ve applied for Social Security disability benefits and have been denied, a disability lawyer at our law firm can help you determine why you were denied benefits. An experienced attorney can help you navigate the appeals process and maximize your chances of successfully proving your disability claim.

Income Limits and Other Restrictions

SSDI is awarded based on your disability and the number of work credits you have accumulated throughout your life. If you worked very little or not at all, you may be ineligible for SSDI, even if you were disabled from a young age. Not all jobs pay into the Social Security system, which means you could be denied benefits even if you worked most of your life.

SSDI is intended only for people who are disabled and unable to work for a year or more. You may have difficulty winning your claim with a temporary disability.

SSI benefits are awarded based on your disability and your income. It is intended only for individuals who are unable to work due to their disability. If you are making more than $1,260 per month when you apply for SSI, your claim may be rejected.

Proving Your Disability

One of the most common reasons for rejection is a lack of medical evidence proving you are disabled. Unfortunately, fraud is a concern for the SSA, so they review each case for inconsistencies and exaggerations. If they notice even the slightest indication that you may be able to work or that your disability is not as severe as you claim, they may reject your application.

This is most frequently an issue with invisible disabilities, like brain injuries, hearing loss, or mental illness. You may have a hard time proving your hearing level or type of mental illness, for example. You will need detailed medical records, including those from your primary care physician, to successfully prove that you cannot do any type of work.

An attorney can help you understand the threshold of proof required for your type of injury or condition. You may need to see a specialist or get a second opinion to make your case to the SSA, especially if you have an unusual condition or invisible illness.

Proving Your Disability

Seeking Treatment

It’s important to understand that you need to be seeking treatment for your disability, and following all doctors’ orders to the extent possible. Failure to take prescribed medication, attend appointments, or follow other orders may result in the SSA denying you benefits.

In some cases, the SSA may try to claim you weren’t following doctors’ orders appropriately, when, in fact, you followed them to the best of your ability. If a dispute arises over your treatment plan and its impact on your benefits, you need to consult with an experienced disability attorney as soon as possible. You may need input from expert witnesses or other professionals with extensive medical knowledge to win.

Your Legal Rights

If your initial claim is rejected, you still have the right to appeal the decision. Appealing a decision is typically a better option than filing a new claim, because the person reviewing a new claim may reject it when they see your previous claim was rejected.

The appeals process is designed to give you a chance to detail your disability and medical needs more thoroughly. However, it’s easy to make mistakes in presenting your case, especially in terms of the amount of evidence required.

The SSA is not required to provide you with any type of personalized medical advice or legal aid to help you qualify for benefits. Instead, you’ll need to seek legal assistance from an attorney who can fight for your SSI or SSDI application to be taken seriously and ultimately approved. Your attorney can help you get the medical documentation, work and income records, and other evidence you need to prove your right to benefits.

Winning on Appeal

Appealing a case sharply increases your chances of winning. There are four different levels to the appeals process, but only the last three involve review by an entity outside of the SSA. The steps are:

  • Reconsideration by the SSA
  • Review by an Administrative Law Judge
  • Review by the Appeals Council
  • Review by a Federal Judge

Unfortunately, the chance of winning on appeal, especially during the first three steps of the process, has dropped significantly in recent years. Reviews are getting even stricter, and there is a high burden of proof even if you’re clearly disabled, and it’s hard for you to get to doctors’ appointments.

For your case to be handled fairly, you need someone with experience and knowledge fighting on your side. Although you may think you have enough medical documentation to win on appeal, an experienced disability attorney can tell you what you’re missing and make sure you’re really ready for your appeal hearing.

Getting the Financial Help You Need

No matter which step in the appeals process you’re at, time is not on your side. Winning your case can take weeks, but you need your benefits as soon as possible to provide for yourself and your family.

Choose an experienced and caring lawyer who will work hard to prove your medical condition to the SSA and cut through the red tape delaying your case. Cochran, Kroll & Associates, P.C. disability lawyers are experienced in dealing with the legal issues surrounding disability benefits.

Because we operate on a contingency basis, we don’t charge a fee until we win your case, so you can have peace of mind knowing that we’ll do our best to get you the benefits you deserve. Even if you’re early in the appeals process, give us a call today at 866-MICH-LAW to schedule your confidential free consultation with our team.

Disclaimer : The information provided is general and not for legal advice. The blogs are not intended to provide legal counsel and no attorney-client relationship is created nor intended.

Hannah Johnson has her Bachelor of Arts in Public Affairs with a specialization in civic engagement. Her career has focused on labor-related research, including unions, workers' compensation, and contract law. She is now broadening her career to include research and policy analysis in East Asia, specifically in countries like South Korea and Japan where the aging population is creating a new frontier in economic trends and public policy innovation.



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