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Denial on a disability application in Missouri - What comes next?



 
A question was recently broached in a medical issues forum, one that I've seen more times than I can count, but almost always feel compelled to address. The question was "I've been denied on the disability application, what do I do next?

My answer to this question usually spells out two different scenarios. The first involves something known as a technical denial. What is a technical denial? A technical, or informal, denial occurs when a claimant applies for disability but is clearly ineligible at the very outset. In such an instance, the claim is never assigned to a disability examiner and medical records are never gathered. In other words, the case is never processed.

What is the basis for a technical denial? Here are several possibilities. One, a claimant who applies for Social Security Disability in Missouri but is working and earning more than the limit for substantial gainful activity. Obviously, there is no reason to process such a claim because the claim will not meet the social security definition of disability. Two, a claimant who is only eligible for SSI but has too much in assets (SSI is based on need and individuals who have more than two thousand dollars in countable assets, known as resources, are not eligible). Three, a spouse with a very limited work history applies for SSI but is ineligible because her spouse earns too much (for SSI, a spouse's income can be deemed, or partially counted, and can make an SSI applicant ineligible).

Resources:

1. Denied on the disability application, file a new claim?
2. Filing a second disability claim
3. What if my SSI or Social Security Disability Application is denied?
4. Social Security Disability and SSI Denials
5. What makes you eligible for SSI?
6. Can you Be Eligible For SSI And Social Security Disability At The Same Time?
7. SSI Benefits - who is Eligible and How do I apply for them?

Technical denials are simply denials that are made because there is no reason to evaluate a claimant's medical records. Consequently, there is never a reason to appeal a technical denial. Why? Because no medical determination has been made, i.e. there is nothing to appeal.

Cases that have been denied following a medical determination are a different matter entirely. In this scenario, a claimant has filed for disability, their claim has actually been sent to the state agency and assigned to a disability examiner, and medical records have been requested and then evaluated. In other words, there is something to appeal, which is the denial decision that was based on the disability examiner's reading of the medical evidence.

Aside from the filing of a frivolous claim, I really can't think of a single reason for a claimant to not file an appeal following a denial on a disability application. Unfortunately, many claimants do (choose not to appeal). Why this happens is something nebulous, but in my years of contact with disability claimants I've learned that many claimants fail to appeal for the following reasons:

1. They have confused filing a new application with the act of appealing. Let me state that starting a new disability application is NOT the same as appealing. And in nearly all cases, it will be extremely counter-productive and will typically result in a long string of denials.

2. They have missed the deadline to appeal. Yes, social security does give you 60 days to appeal (and even five more days to allow for mailing the appeal forms). Yet, just the same, many many claimants miss the appeal deadline. Why does this happen? In cases involving cognitive disorders, affective disorders, or mood disorders, the cause may be fairly apparent. However, in many instances, a claimant who has waited several months without income for an answer on a claim and then has been denied will feel despondent and dejected. In other words, they may give up. This is understandable. However, it is a terrible mistake to make in handling one's claim.

In the vast majority of all situations, there is only one practical and logical path to follow after receiving a denial on a disability application. And that is to file a request for an appeal, which in Missouri is a disability hearing.








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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.