What is the Application Process for Social Security Disability and SSI?
How do you Win Benefits under Social Security Disability or SSI?
If I am determined disabled, how far back will Social Security pay benefits?
How do you prove your disability case if you have a mental condition?
What Can I Do to Improve My Chances of Winning Disability Benefits
Common Mistakes after Receiving a Denial of Social Security Disability or SSI Benefits
How to File for Disability - Tips for Filing
If You Get Approved For SSDI Will You Also Get Medicare?
How much does a Social Security disability attorney get paid?
Social Security Disability SSI Criteria and the Evaluation Process
How long does it take to be approved for SSI or Social Security disability?
What do you Need to Prove to Qualify for Disability Benefits?
Social Security Disability SSI and Fibromyalgia
Social Security Disability SSI and Degenerative Disc Disease
Can I Qualify For Disability and Receive Benefits based on Depression?
Answers to questions about SSD and SSI disability
What Disabilities Qualify for SSI and Social Security Disability Benefits?
Social Security Disability Status
Social Security Disability Tips — how a claim gets worked on
Social Security Disability, SSI Disability - Terms, Definitions, Concepts
What is a Social Security Disability Denial based on?
How to prove you are disabled
and win disability benefits
There are plenty of misconceptions as to why denials on social security disability and SSI claims happen. To some extent, this may be due to the wording of notices of denial, which are largely template-assembled letters (meaning that if you lined up ten "notices of disapproved claim" from ten separate claimants, the letters would tend to look very much the same).
Claimants will often assume that one of a variety of factors may have been responsible for why they were denied on their disability application or appeal for disability benefits. But, in every single case, a denial happens because the claimant, through the information presented in their medical records, has failed to prove that they have an inability to work at a substantial and gainful level and that this inability will last for at least one full year.
This is basically the social security administration definition of disability: that, to qualify for disability, a condition, or set of conditions (which may be physical, mental, or a combination of either) must be all of the following:
B) Severe enough to make it impossible for the claimant to engage in work activity at what is considered to be a substantial and gainful level
C) Severe enough to last at least a year.
Translation: to meet the social security definition of disability, a claimant's overall condition must result in enough physical and/or mental limitations that they cannot be able to work for a full year while earning a substantial and gainful income (which is defined here: SGA, substantial activity level). This includes, of course, the job that they last did, any work that they have done previously in the last fifteen years (their relevant past work), as well as any job that their skills and training might qualify them for and which their age and various restrictions might not disqualify them for.
Denials on disability applications and denials on disability appeals, therefore, occur because either--
1. The claimant's rated limitations, or residual functional capacity (measured on something known as a residual functional capacity form, which is completed by a disability examiner and the examiner's unit medical consultant at DDS, or disability determination services) is not enough to rule out their ability to go back to their former job or to do some type of other work. OR
2. The claimant has managed to return to work activity for which they earn a substantial and gainful wage while their disability application or disability appeal was pending.
Most claimants and potential claimants will assume that the outcome of a disability case will simply boil down to the information that may be found in the medical records. However, claims are as much focused on the claimant's work history as on the medical history. Therefore, the claimant's ability to engage in work activity, as well as the perception of the ability to engage in (or return to) work activity (while earning a substantial and gainful income) can determine whether or not a disability claim is approved or denied.
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SSD and SSI are Federal Programs
The title II Social Security Disability and title 16 SSI Disability programs operate under federal guidelines and, therefore, the program requirements--medical and non-medical--apply to all states:
Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming
Recent approval and denial statistics for various states can be viewed here:
Social Security Disability, SSI Approval and Denial Statistics by state
Special Section: Disability Lawyers and unnecessary claim denials