Overview of Disability
Disability Back Pay
Requirements for Disability
Applications for disability
Tips and Advice for Disability Claims
How long does Disability take?
Winning Disability Benefits
Common Mistakes after a Denial
Mental Disability Benefits
Denials for Disability
Appeals for denied claims
Disability Benefits from SSA
Child Disability Benefits
Qualifications and How to Qualify
Working and Disability
Disability Awards and Notices
Disability Lawyers, Hiring Attorneys
Social Security List of Conditions
What Social Security considers disabling
Medical Evidence and Disability
Filing for Disability Benefits
Eligibility for Disability Benefits
SSD SSI Definitions
SSDRC authored by Tim Moore
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Social Security Disability Denied — The Reasons Why
If you have been denied social security disability (SSD) benefits, you are probably wondering what went wrong. Chances are, you are, or feel that you are, suffering from considerable physical or mental limitations as a result of your condition, or you would never have gone through the process of filing in the first place. You may feel, as many others do, that SSD denies as many claims as possible, regardless of the claimants’ physical condition, to save the federal government money.
While it is true that it is difficult to win social security disability benefits, the fact is that many applicants are not approved for disability benefits for two primary reasons: 1) they do not have sufficient medical documentation to back up their claim; and 2) they do not take full advantage of the appeals process if their initial application is denied.
Let’s look at the first reason most claims are denied; namely, lack of medical evidence. Many individuals who seek disability do not see a doctor for regular treatment of their condition. Not only does this put them at a disadvantage because they have few medical records or physician notes to back up the disabling nature of their condition, but it also limits the social security administration (SSA) disability examiner’s ability to make a determination in their case.
All disability cases are decided, fairly or unfairly, on the basis of medical evidence. The more you have, the more your disability examiner must consider when making his or her determination, and the more likely you are to be approved for benefits.
Of course, it is true that if you have not recently (within the past couple of months) seen a doctor your SSA claims examiner will send you for a consultative medical exam with a physician who has been hired by social security to perform examinations. Yet these exams are very brief and shed little light if any on the claimant’s physical limitations or symptoms. Their sole purpose is to give disability examiners a recent medical opinion on which to base their decisions, and they are a poor substitute for a visit to an impartial physician who will advocate for the claimant’s best interest.
So, if you are unable to afford insurance or to pay out-of-pocket medical expenses, you must do the best you can with all of the resources at your disposal—free clinics, physicians who treat on a sliding-scale fee basis, and even trips to the emergency room. Any medical history that you amass on your own behalf will be more beneficial to your case than that provided by a physician hired by SSA.
Now, as previously stated, the second reason many SSA applicants do not receive benefits is that they are either unaware or unwilling to appeal their denial of benefits. This is really a mistake, and it’s so important to keep in mind if you are denied for disability benefits that you are well within the majority—nationwide, a whopping 70 percent of all disability claims are denied upon their initial application.
However, about 15% of all of those who appeal their disability decisions to the social security disability office (called a request for reconsideration) are approved for benefits. If your reconsideration appeal is denied, should you give up? Absolutely not, because up to 60% of those who file a second appeal (a request for a hearing before a federal administrative law judge) are approved for benefits! In short, the more you appeal, the greater your chances of receiving benefits.
There is one other point to make when considering the reasons why disability claims are so often denied, and it probably bears mentioning, here: The social security impairment manual, commonly referred to as the “blue book.” The SSA blue book lists many physical and mental conditions which it recognizes as disabilities, and the criteria that must be met to prove that an applicant is suffering from a listing in the book. Does your medical condition have to be listed in the blue book in order for you to collect disability benefits for it?
The answer is no, and in fact most disability benefits are awarded for conditions not listed in the blue book on the basis of a medical vocational allowance. In short, if you have a disabling condition that is serious enough to prevent you from earning a certain amount each month, and the condition is expected to last for at least twelve months, you could collect benefits provided you have the necessary medical documentation to demonstrate that your condition is both serious and ongoing in nature.
Which brings us back to square one: The only way to be sure of winning disability benefits is to provide enough medical documentation to prove your claim, and to keep fighting through the disability appeals system if you feel your claim has been wrongly denied.
Return to: Social Security Disability Resource Center, or read answers to Questions
How to apply for disability and where to apply Filing an Application for Disability Benefits under SSD or SSI - Step by Step
Tips on how to file for disability
What is the Application Process for Social Security Disability and SSI?
What happens after I file my disability claim with Social Security? What happens after a Social Security Disability or SSI Claim has been taken and is Pending
If you get denied on a disability application do you have to file a new application?
How the Decision on a Disability Application or Appeal Under SSDI or SSI is Made
Information on the following topics can be found here: Social Security Disability Questions and in these subsections:
Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI
These pages answer some of the most basic questions for individuals who are considering filing a claim.
Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
How to Apply for Disability - What medical conditions can you apply and qualify for?
Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
What happens if I file a disability application and it is denied by a disability examiner or Judge?
How to Prove you are disabled and qualify to win disability benefits
How do you prove your disability case if you have a mental condition or impairment?
Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
Social Security Disability SSI - Eligibility Requirements and Qualifications Criteria