Why Your Social Security Disability Claim May Have Been Denied
When you’ve suffered an injury that results in a long-term or permanent disability, you will likely be unable to continue working at your job. You can be left wondering how you will manage financially or how you will support your family when this source of income vanishes. Filing a Social Security Disability (SSD) claim to the Social Security administration (SSA) is an option for those with disabilities that prevent them from working. Monthly benefits are distributed to support those with long-term or permanent disabilities who are unable to work.
Unfortunately, SSD claims are rarely approved and difficult to pursue on your own. In fact, nearly 70% of SSD claims are initially denied. Denials can occur for many reasons and it isn’t always clear why. The SSA receives a high volume of SSD applications, which often prevents them from being able to properly review and evaluate each claim. If your application for SSD has recently been denied, a social security disability attorney at Smith, Welch, Webb and White can help you understand why this denial occurred and if your claim was wrongfully denied, they may be able to assist you in the appeal process.
Notice of Denial
The SSA will mail a notice of denial that outlines why your claim was denied and where your claim was lacking in support. Included will be an explanation that addresses how any medical or work-related records that you provided were considered. The notice may even include a list of jobs that you may be able to physically perform based on information contained in the records provided. Carefully reviewing the explanations given in the notice of denial will help you understand what your options are moving forward and how to improve your claim if you decide to file an appeal.
It’s also important to understand that once the notice of denial is received, you cannot recover SSD benefits for any time prior to the date of the denial notice unless you file and win on appeal.
Rationales for Denial
Typically, the notice of denial should give a straightforward explanation as to why the claim was denied. Denials most commonly occur as a result of application errors, incoming or insufficient applications, and due to a lack of supporting documentation. Other common reasons for denials include:
- You make too much money. In order to be eligible for SSD benefits, you must be unable to engage in substantial gainful activity (SGA) as a direct result of a qualifying medical condition. In determining your eligibility, the SSA considers you and your spouse’s income, savings, and how your assets weigh against your liabilities. If you and your spouse are able to meet the basic needs of food, clothing, and shelter, then your claim may have been denied because your income is above the minimum threshold.
- Your condition must be qualifying and your disability long-term or permanent. An injury or medical condition is qualifying when it meets specific criteria established by the SSA. A long-term or permanent disability is any qualifying injury or condition that is severe enough to prevent you from being able to work in any meaningful capacity for at least a year. The likelihood of approval is higher if your application and supporting documentation clearly establish the qualifying criteria set by the SSA. The criteria used by the SSA to evaluate medical conditions and injuries is published on the SSA’s website and can be found at http://www.ssa.gov/disability/professionals/bluebook/index.htm . The SSA’s website is also regularly updated with tips sheets, checklists, and other valuable resources to help you prepare and submit a qualifying application. Providing all medical evidence such as documents, tests, prescriptions, or treatment records will also strengthen your application and the likelihood of an approval. However, even if you have a qualifying condition, if your medical records reflect that you may recover within a year, the SSA will likely deny your claim.
- You didn’t provide requested documents, respond to inquiries, or complete necessary tasks. You may be asked to provide additional information after submitting your application. If you do not send in requested information or documents, or if you do not send them within a deadline, your claim can be denied. As part of the application process, the SSA will often submit their own requests for your medical records and documentation, but you shouldn’t rely on the SSA to gather the necessary documentation and prove your claim for you. Requests for records and documents from the SSA are regularly ignored and often times the SSA may ask for you to gather and produce necessary documentation. The SSA may also require that you undergo an examination by one of their physicians. If you fail to obtain and produce requested documentation, respond to inquiries within the timeframe specified by the SAA, or fail to submit for a requested examination, your claim will likely be denied.
Even if you meet all qualifying criteria, follow the SSA’s guidelines and checklists during the application process, and timely complete any additional requests of the SSA during the evaluation period, there is no guarantee that your claim will be approved. The high volume of applications received and complex processing of applications often result in wrongful denials. An experienced social security disability attorney at Smith, Welch, Webb and White can help you understand your denied claim and make adjustments to file an appeal to recover your social security disability benefits.
Filing an Appeal
Many claimants give up after their initial denial and lose out on the benefits they rightfully deserve. Rather than filing a proper appeal of their denied application, claimants also frequently make the mistake of submitting a second SSD application containing the same mistakes as the first. Filing for an appeal is the most favorable option as about 50% of appealed denials are approved on appeal and result in the approval of monthly benefits and receipt of back payments.
Working with a social security disability attorney greatly increases your chances at properly and efficiently filing an appeal. There is only a 60 day window after your initial denial to file an appeal, so an attorney will act quickly to identify common mistakes in initial social security disability claims to help you move forward.
How A Social Security Disability Attorney Can Help
An attorney will review your denied claim and the notice of denial to begin assessing where your claim needs support. They will know if additional evidence should be submitted or how to properly address the shortcomings of your application and any supporting documentation during the appeal process. An attorney will work with your doctor, prior employer, witnesses, and any financial representatives to gather evidence and prove that you meet the qualifying criteria.
During your appeal hearing, you will be required to testify to an administrative law judge. An attorney will help prepare you for the hearing so you will know what to expect in advance. Witnesses, experts, or other representatives may be brought in to help determine if your condition truly prevents you from working or if there are other employment options available to you. If you work with an attorney during the appeal process, they will provide you with vital support during the hearing process. An experienced attorney knows what judges are looking for and can help you prepare to properly navigate their questions during the hearing.
From there, the decision of your denial can be upheld or overturned. If you have a knowledgeable social security disability attorney on your side, the chances of your denial being overturned during the appeal process greatly increase, giving you a better chance at recovering the social security disability benefits you deserve.
Call or contact the law office of Smith, Welch, Webb and White for experienced attorneys that can serve your legal needs. We have six convenient locations in McDonough, Stockbridge, Peachtree City, Jackson, Barnesville, and Griffin. We serve clients all over the state as one of Georgia’s most respected law firms.