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Why does social security deny strong disability claims?
The fact is, SSA routinely denies exceptionally strong claims. As a disability examiner (former), I particularly recall one case in which an individual was denied at the disability claim application level. The DDS (disability determination services) physician who signed off on the case did so using the rationale that the victim's burns did not cause enough stricture (narrowing of tissue resulting in limitations in movement) to prevent a return to work activity.
But...the individual had suffered 2nd and 3rd degree burns to 25 percent of the body, confined mainly to one side and the Director of the Hospital Burn Center had taken it upon himself to write a letter explaining that, with injuries so severe, the patient would not be able to return to work. In fact, the patient had very recently been released from the hospital, had gone into shock and renal failure, and then been re-admitted to the hospital for a long, extended period.
Very good disability claims are routinely denied by social security. That is without question. And the question then becomes "Why does social security deny strong disability claims?".
It has a lot to do with how the federal disability system is structured. Bad decisions are made at all levels of the system. However, they (bad decisions) tend to be made most often at the lower levels of the system, which would be the initial claim and reconsideration appeal levels. These are the levels at which SSD and SSI claims are decided by disability examiners and the physicians and psychologists and psychiatrists who work with them as consultants.
Of course, it's not surprising that this occurs. Why? Well, all you have to do is consider how different the system operates at these levels in comparison to the hearing level.
1. Disability examiners are often pressured to make decisions on disability claims that conform to the decisional patterns of the disability determination services agency they work in. And very often that even includes the decisional patterns of their immediate supervisors. In other words, disability examiners are not exactly independent decision makers.
2. Disability examiners really do not give proper weight and consideration to the statements provided by a claimant's treating physician when such statements have been obtained or delivered.
3. The social security process at the lower levels of the system does not allow an opportunity for the claimant and his or her chosen representative to take an active part in the disability claims process.
At the hearing level, of course, things change considerably. Administrative law judges who rule on social security disability and SSI claims operate independently, tend to give proper consideration to the opinion of a claimant's treating physician, and, if a claimant is represented, will receive the efforts of the claimant's designated representative, either a disability attorney or a non-attorney representative.
Return to: Social Security Disability Resource Center, or read answers to Questions
Individuals denied at the disability application but who continue through appeals
Denied Twice For disability - What do you do?
Why are disability claims denied?
How many times do you get denied before you get approved for disability?
Why will a disability application get denied?
Tips for Social Security Disability Psychological and mental testing
How Long does a Social Security Disability Determination take After Seeing the Psychologist?
Social Security Disability Mental Psychological Exam and Questions that get Asked
Does social security deny strong disability claims?
Social Security Disability is different from VA disability
Why are you denied the first time you are denied for disability?
What Happens To Social Security Disability Benefits After Divorce?
Can I do What I want with my Social Security Back Pay?
How much information should you put on a disability application?
What disability claimants get angry about - Part I
Social Security and not getting the medical records
Social Security Disability will sometimes order X-rays but never an MRI
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 provide answers to basic questions about pursuing disability benefits
How to file for disability, filing tips
What to Prove to Qualify for Disability Benefits
Applying for disability benefits, SSI and SSDI
What Disabilities Qualify for SSI and Social Security Disability?
Will you get disability back pay?
Social Security Disability And SSI Qualifications
Permanent Disability Qualifications for SSD and SSI
Social Security Disability SSI status
Disability lawyer representation, finding lawyers
Who will qualify for disability and what qualifying is based on
Qualifications for Disability Benefits
Important points about filing for disability
How long does it take to get disability after applying?
Am I Eligible For Social Security Disability?
Who is eligible for SSI disability?
How to get disability in Florida