What to Do if You Are Denied Disability Benefits

Christian Worstell
In this article...
  • Learn how to appeal a denied disability claim, including reasons for denial and how to navigate the Social Security disability benefits system.
Man Filling Out A Form

In this guide, we'll detail the frequent causes for denial of Social Security Administration (SSA) disability claims and provide guidance on how to increase your chances of receiving SSDI or SSI benefits if denied.

We will also discuss what steps you can take if your claim has been denied and how to increase your chances of getting approved for SSDI or SSI benefits.

Table of Contents:

 

Understanding Denied Disability Claims

If your disability claim has been denied, you may be feeling overwhelmed by the process of appealing the decision. Examining the explanation for the denial of your claim is a necessary first step in understanding why it was not approved.

The letter from the Social Security Administration (SSA) that includes your denied disability status should detail which medical records were looked at and what criteria weren't satisfied for your claim to gain approval.

In some cases, additional evidence may need to be provided in order for an appeal to be successful. 

When appealing a denied disability claim, it’s important to provide as much detail as possible about how your disabling condition affects your ability to work or perform daily activities.

Medical records from doctors who have treated you should also accompany any appeals filed with the Social Security Administration (SSA). This information helps demonstrate that all relevant facts related to a claimant’s medical condition were considered during initial review of their case.

Even if all the required paperwork is submitted with an appeal, there is no guarantee that a disability benefit will be granted after reconsideration or administrative hearing stages are completed.

The Social Security Administration (SSA) takes into account various factors such as taxes paid through payroll deductions while working and prior employment history to make their determination.

Give comprehensive particulars about how your medical conditions affect your capability to work or do daily tasks in order to boost the possibility of being approved.

Keep track of deadlines associated with filing appeals so you don't miss out on potential payments.

Reasons for Denial of Disability Claims

Denied benefits are a common occurrence, but the reasons for denial can vary. Grasping why your claim was rejected is essential to successfully contest a refused application.

Denial of disability claims typically transpires due to the absence of medical substantiation.

  • To be eligible for SSDI or SSI, you must have an impairment that has lasted or is expected to last at least one year and affects your capacity to work.

    Your doctor must provide sufficient medical records detailing your impairment and its impact on your ability to work. If there isn’t enough evidence in your medical records, then your claim may be denied due to insufficient documentation.

  • Claims for disability can be refused if the petitioner does not satisfy standards set by the Social Security Administration, including work history under Social Security taxes and income levels needed to qualify for SSI. This includes having worked long enough and recently enough under Social Security taxes as well as meeting income requirements for SSI benefits.

    If the criteria are not fulfilled, then a denial of your application may be issued by the SSA even if there is adequate medical evidence to demonstrate an inability to work due to an ailment or injury.

  • Accurately and completely fill out all forms is critical for a swift and successful processing of your application.

    Any inaccuracies or omissions may result in an immediate denial of benefits, so make sure to double-check everything before submitting it. Before submitting to the SSA, review your application thoroughly for accuracy.

  • Applicants should make sure they include all necessary documents such as proof of identity, birth certificate copies or other official documents requested when filing their initial applications in order to avoid being denied due to something being left out accidentally during the submission process.

    Taking time up front can save time later on if appeals need to be made due to improper denials.

Next, we will look at how you can navigate the appeals process after being denied benefits.

Appeal Process After Denial of Disability Claim

A claimant may challenge a denied disability claim by submitting an appeal. It's important to understand that filing an appeal does not guarantee success, but it does give you another opportunity to present your case and have it reconsidered by a higher authority.

This process involves submitting additional medical evidence and other documents related to your condition. The SSA will assess the data presented and decide if they should grant your request.

If the SSA denies your request for reconsideration, you can then proceed with filing an administrative law judge hearing request. After the SSA denies your request for reconsideration, you can then appeal to an administrative law judge who will hear both sides' arguments and consider your medical history and current condition in order to make a final determination of eligibility.

At the administrative law judge hearing, you may be interrogated concerning your medical background and current condition to decide if you meet all qualifications for getting disability benefits.

In some cases, claimants may also choose to pursue further appeals through federal court proceedings after being denied at both the reconsideration level and during their hearing before an administrative law judge.

This option is often used when there are disagreements over legal issues or interpretation of facts surrounding a particular case that cannot be resolved by either party alone or through mediation between them.

It is important to note that each step in appealing a denied disability claim requires specific forms as well as supporting documentation such as doctor’s notes or test results proving impairment due to illness or injury.

It is wise for claimants seeking approval of their claims to use every resource available including professional advice from lawyers specializing in social security disability cases if needed while navigating these complex processes.

Resources for Denied Disability Claimants

For those whose disability claims have been denied, there are many resources available to assist them with the appeals process, such as free legal advice from organizations like NDRN and a helpline provided by Social Security Administration.

NDRN, a legal aid, offers no-cost guidance and backing for appeals to those whose disability claim has been denied.

The Social Security Administration also offers a toll-free helpline for those needing information about their disability claims. The ABA Pro Bono Program furnishes access to lawyers with knowledge in disability law who provide their services without charge.

Various online outlets are available to provide assistance and direction for people whose requests have been refused. The Social Security Denial Guide is an online resource developed by NDRN that helps individuals understand why their application was rejected and how they can appeal it successfully.

BenefitsCheckUp® is a website that furnishes comprehensive data about government benefit programs, including the eligibility criteria and process for obtaining Social Security Disability Insurance (SSDI).

Veterans may be able to access additional aid through the Veterans Affairs (VA) offices or local VA medical centers, which often provide specialized services for those with disabilities including vocational rehabilitation and financial counseling.

These facilities often offer specialized services for veterans with disabilities including vocational rehabilitation services and financial counseling.

Medicaid offers coverage for people who meet certain income guidelines; however this program does not cover all types of disabilities so it’s important to research your state’s specific rules before applying for coverage under this program.

FAQs

Why do so many people get denied disability?

Many people are denied SSDI due to insufficient medical evidence or a lack of documentation. Sometimes, the individual may not have had enough data to demonstrate their impairment and how it limits their occupation. Other times, the application was incomplete or incorrect in some way. 

What disqualifies a person from disability?

To qualify for disability benefits, the SSA requires an individual to have a physical or mental impairment that has lasted or is expected to last at least one year and be unable to engage in any substantial gainful activity despite adjusting job duties.

The impairment must be so severe that it prevents the individual from engaging in any kind of work and they cannot modify their job to fit within their restrictions. Finally, medical evidence such as doctor’s notes and lab tests are required in order for an individual's claim for disability benefits to be approved.

What is the most commonly overlooked disability?

The most commonly overlooked disability is a hidden one - invisible disabilities. These are physical, mental or emotional impairments that may not be immediately obvious to others but can have significant impacts on day-to-day life. Examples may include physical, psychological or emotional issues such as aches, exhaustion, gloom and apprehension. People with invisible disabilities often find it difficult to get the assistance they require due to their symptoms being misunderstood or overlooked. 

Is it normal to be denied disability first time?

No, it is not normal to be denied disability benefits the first time. In fact, the majority of applicants are approved on their initial application. Though the majority of applicants are accepted on their first attempt, some may be refused due to missing documents or inadequate medical proof. If a claim is denied, it is beneficial to appeal and supply additional evidence for increased chances of approval.

Conclusion

Navigating the disability claim rejection can be tough, but help is available.

If you have been denied disability benefits, it is important to understand the reasons why and explore your options for appealing the decision. With knowledge of the appeals process and access to helpful resources, you may be able to successfully overturn your denial and receive much-needed financial assistance from Social Security Disability Insurance (SSDI).

Christian Worstell
About the Author

Christian Worstell is a senior Medicare and health insurance writer with HelpAdivsor.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

While at HelpAdvisor, Christian has written hundreds of articles that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. You can find Christian’s most recent articles in our blog.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@MyHelpAdvisor.com.

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