What do you if you get a disability claim denial?

When social security issues a decision on a claim (and this could be at the disability application level, reconsideration appeal level, or disability hearing level), a notice is sent to the claimant informing them of the decision. The decision letter will make vague reference as to why the claim was denied; but, it really won't explain in any reasonable amount of detail exactly why the person was given a denial.

As a former disability examiner, I can vouch for the relative uselessness of trying to extract any meaning from a notice of denial. These letters are basically boilerplate template letters that, for the most part, all look the same.

In nearly all cases, when a claimant receives a notice of denial on a claim, it is simply because the social security administration has reviewed the claimant's medical records and failed to find evidence of their inability to work due to one or more disabling conditions.

This, of course, happens more than seventy percent of the time when a disability application is reviewed, and the percentage for denial goes up even more sharply for individuals who are submitting requests for reconsideration (the first appeal level is the reconsideration).

What evidence will the social security administration need in order to approve a disability claim? The evidence must do the following:

1. It must show that the claimant has at least one severe impairment.

2. It must show that the impairment is limiting enough that the claimant cannot be expected to do their past work.

3. It must show that the impairment is limiting enough that the claimant could not be expected to find some type of other work that would provide for a substantial and gainful income.

4. The claimant's condition must be this disabling for a period no shorter than a year.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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

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Filing the application for SSD or SSI disability
Filing for disability - where to go
How to qualify for disability
Qualifying for disability
Winning disability benefits, how to win
Winning disability for a mental condition
Social Security Disability Back pay, SSD, SSI
Disability Criteria and requirements
If you apply for disability in Massachusetts
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Getting a Disability Lawyer in Massachusetts