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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. Otherwise, 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.
Medical records and being 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.
The odds of winning increase with appeals
However, about 11% 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.
Social Security Disability and SSI Resource Center
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More Social Security Disability SSI Questions and Answers
Common Questions about Social Security Disability and SSI
Winning Social Security Disability or SSI Benefits
The SSI Disability Benefits Program
Medical exams for disability claims
Applying for Disability in various states
Social Security Disability SSI and Doctors - Yours and Theirs
Social Security Disability and SSI Claim Reviews
Social Security Disability SSI System and Benefits for Children
Denials, Appeals, and Getting a Disability Lawyer or Representative
What you should know about Social Security Disability and SSI Denials
Questions about Disability Lawyers and Hiring a Disability Attorney
Frequently asked questions about getting Denied for Disability Benefits
FAQ on Disability Claim Representation
Disability hearings before Judges
Selecting and hiring Disability Lawyers
Various Types of Benefits including SSI, Mental, and Child benefits
Social Security and SSI based on Mental Disability
Social Security Disability or SSI Benefits for Children
Disability Benefits through Social Security
Filing for Social Security Disability or SSI Benefits
Social Security Disability SSI: Medical Evidence and Records
Filing your claim for disability benefits
Eligibility for receiving disability benefits
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
Resources on this site
Social Security Disability, SSI Terms and Definitions
Previously answered questions regarding SSD and SSI
About the Author of SSDRC, Tim Moore
For Individuals living in North Carolina
Applying for Disability in North Carolina
North Carolina Disability Lawyer
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
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
What questions does Social Security ask during your annual SSI review?
When will I know if disability does an on the record review?
What should I do, I was denied Social Security disability for the second time?