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How to file for disability, Filing for SSI
Disability Requirements, Disability Status
How long is the wait?, Disability Application
The Social Security List of Impairments
Qualifying for Disability, Mental Disability
Disability Lawyer Info, Disability Back Pay

What is a Social Security Disability Denial based on?



 
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:



A) Severe

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

and

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.








Essential Questions

What is the Social Security Disability SSI list of impairments?

Can you work while getting or applying for Disability?

How Often Does Social Security Approve Disability The First Time You Apply?

Tips for getting Social Security Disability or SSI benefits approved

What medical conditions will get you approved for disability?

What kind of Mental Problems Qualify for Disability?

Receiving a Disability Award Letter

Conditions Social Security will recognize as a disability

Previously answered questions regarding SSD and SSI

Applying for disability in your state



Most popular topics on SSDRC.com

Social Security Disability SSI Questions

The listings, list of disabling impairments

Can a mental illness qualify you for disability?

Disability Lawyers prevent unnecessary denials

How much Social Security Disability SSI back pay?

How to apply for disability for a child or children

Filing a Social Security Disability SSI application

Filing for disability - when to file

How to apply for disability - where to apply

Qualifications for disability benefits

How to Prove you are disabled and Win your Disability Benefits

Qualifying for Disability - The Process

How to get disability for depression

Getting disability for fibromyalgia

SSI disability for children with ADHD

What is the Application Process for Social Security Disability and SSI?

Common Mistakes to avoid after being denied for Disability

Social Security Disability SSI Exam tips

More Social Security Disability SSI Questions

Social Security Disability SSI definitions

What makes you eligible for Social Security Disability or SSI?



New and featured pages on SSDRC.com

Who can help me file for disability?




Related pages:

How to Appeal a disability claim denial from Social Security
Common Mistakes after Receiving a Denial of Social Security Disability or SSI Benefits
What is a Social Security Disability Denial based on?
Are there ways to avoid being denied for SSI or Social Security Disability?
What does a Disability Denial Letter from Social Security say?
Reconsideration of a Social Security Disability denial- what does it involve?
What to do if you receive notification of a Social Security Disability or SSI claim denial
If you receive a Social Security Disability Denial quickly does that mean the case is weak?
What happens if my SSI or Social Security Disability Application is denied?
Social Security Disability Denied — The Reasons Why (medical denials)
Letter showing why I was denied for disability
How long does it take to get SSI Disability Benefits?
If you apply for disability in in Colorado
Getting a Disability Lawyer in Colorado



These pages answer some of the most basic questions for individuals who are considering filing a claim.

Can you get temporary Social Security Disability or SSI benefits?

Permanent Social Security Disability

What is the difference between Social Security Disability and SSI?

Who is eligible for SSI disability?

Can I Be Eligible For SSI And Social Security Disability At The Same Time?

What makes a person eligible to receive disability benefits?

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?









For the sake of clarity, SSDRC.com is not the Social Security Administration, nor is it associated or affiliated with SSA. This site is a personal, private website that is published, edited, and maintained by former caseworker and former disability claims examiner, Tim Moore, who was interviewed by the New York Times on the topic of Social Security Disability and SSI benefits in an article entitled "The Disability Mess" and also by the Los Angeles Times on the subject of political attempts to weaken the Social Security Disability system.

The goal of the site is to provide information about how Social Security Disability and SSI work, the idea being that qualified information may help claimants pursue their claims and appeals, potentially avoiding time-consuming mistakes. If you find the information on this site helpful and believe it would be helpful to others, feel free to share links to its homepage or other pages on website resource pages, blogs, or social media. Copying of this material, however, is prohibited.

To learn more about the author, please visit the SSDRC.com homepage and view the "about this site" link near the bottom of the page.