At Saffren and Weinberg, Marc Alan Weinberg, Attorney and Kenneth Scott Saffren, Attorney are partners. The firm’s tagline is “The People’s Voice In Court.” They make themselves available via phone at (215) 576-0100 or by email on the Saffren and Weinberg website. Saffren and Weinberg provides a no-charge, complimentary case review and answers questions for prospective clients.
What to Do When Your SSDI Claim Is Denied
You’ve taken the time to carefully complete your Social Security Disability claim (or SSDI benefits claim), and now you’ve received the notification that your claim has been denied. The good news is that you aren’t alone, and an initial denial is typically part of the process. Disability denials are very common and should be what you might expect after filing. The statistics show that 65% of initial claims are denied. Additionally, the first step of the appeal process, called a reconsideration, are denied at an even higher rate of up to 85%.
Just because your disability claim is denied doesn’t mean this is the end of the road and that you do not qualify for disability. Most claimants are forced to go through the social security disability appeal process due to the initial claim being denied because there wasn’t enough medical evidence to prove their disability. You shouldn’t be discouraged or give up at this point. Now is actually the time to quickly step into action. If your claim has been denied, follow these very important steps and make sure you take these steps in a timely manner.
- Figure out why your case was denied.
- Consider hiring a disability attorney to help you appeal the denial.
- Contact the Social Security office (or your social security disability attorney) and request an appeal.
Denial Notice
The denial notice sent from the Social Security Administration office contains the following:
- A brief description of your medical condition
- A list of any impairments that were considered toward the disability
- Any medical and other records that were reviewed
- An explanation for the denial of disability benefits
The explanation of the denial is a very important part of the notice, and you should pay special attention to it as it will help you understand what you will need to consider if you file an appeal. For example, the explanation might state you are disabled from your most previous job, but you aren’t disabled from all jobs. Your denial notice might include a detailed explanation of the considerations of your medical issues and what your residual functional capacity (RFC) is. If there isn’t information on why your claim was denied, you have the right to request to review your file from the Social Security office.
Once you’ve received the denial and understand why you were denied, you will want to quickly step into action. Do not give up at this point. Once your claim has been denied, you can officially appeal the denial. The sooner you file an appeal, the sooner your hearing with Social Security will be scheduled, and your chances of winning the claim will be improved.
Always Appeal
If your claim has been denied, you should request an appeal immediately, definitely within the 60-day deadline. Don’t wait to file the appeal, even if you have to do this part without an attorney. At this point, you just want to have the appeal officially on record as soon as possible, and you can pull your case together afterward. This is the point in the process where many claimants may make a mistake of not filing the appeal in a timely manner, giving up on the process, or filing a brand new claim. If your appeal is not filed on time, you may lose the right to appeal and will have to start the whole process over.
The chances of winning your claim and being awarded SSDI benefits are much higher during the appeals process, so remember not to file a new claim instead of appeals, and don’t miss the appeal filing deadline of 60 days. Your lawyer can help you determine your social security disability claim status and will help you through the whole process.
Reasons for a Denial
There are several common reasons for denials of Social Security disability claims. Knowing what the common denial reasons are might help you and your attorney understand how to present your case in your initial claim or appeal.
1. Your income is too high
When applying for disability benefits, Social Security will review your income to verify if your income is above the limit that is considered “substantial gainful activity” (SGA), which means your income is too high to be considered disabled. This doesn’t mean you can’t work while applying for or once you are approved for disability; however, you should familiarize yourself with the rules in this area if you are still working or plan to continue working.
2. SSA cannot locate you
The Social Security Administration office must be able to contact you to determine your eligibility for disability benefits. If they are not able to communicate with you when they have questions on your application, you may be denied benefits. If you are working with an attorney, you will want to ensure your attorney stays in contact and communicates regularly with the Social Security Administration office. If you move or change phone numbers during the application process, make sure you update your information with the Social Security Administration office.
3. You don’t supply the requested information
Proving your disability requires the Social Security office to access and review your medical records. If you do not release your records to Social Security, your claim will more than likely be denied.
There will be instances where Social Security may request that you obtain one or more consultative examinations (CE) at their expense. If you refuse to go to the consultation, your claim could be denied due to inadequate medical documentation. There are some circumstances, such as travel concerns, that explain why you can’t attend a CE; however, any potential reasons need to be cleared through the Social Security Administration office.
4. Your disability isn’t severe enough or won’t last long enough
In order to qualify for disability benefits, the Social Security Administration office must have proof your disability will last at least 12 months or could result in your death.
5. You fail to follow prescribed therapy
If your physician prescribes therapy and you do not follow the therapy, your disability claim could be denied unless there is a valid reason you are not going to your therapy appointments.
6. Your disability is based on alcoholism or drug addiction
Social Security may deny disability benefits to a claimant whose drug addiction or alcoholism contributed to the disability.
7. You have been convicted of a crime
There are certain provisions related to the conviction of a crime that may exclude you from being eligible for Social Security.
8. Your claim is fraudulent
If you falsify information in your disability application, Social Security can deny your benefits or terminate them immediately if you had already started receiving payments.
For more information
If your Social Security Disability claim has been denied or if you are working through the Social Security Disability appeals process, make sure you consult with a qualified social security disability attorney. Working with the right attorney can ensure your claim or appeal is handled appropriately and timely.
For the best in social security disability lawyers, call (215) 576-0100 for Saffren and Weinberg. Our experienced attorneys are ready to help you with your case.
