Why was I Denied Disability Benefits?
Thousands of people with disabilities are waiting months to get through a Social Security appeal of their denied disability case. If you are one of them or are in disbelief that you were denied in the first place, you may think that the Social Security Administration (SSA) disability approval system is unfair. It is not the intent of SSA to be unfair. However, close to two-thirds of initial disability applications are denied. Why?
SSA must be absolutely certain that a medical condition has impaired a person’s functionality to such an extent that they are unable to work at any job. The Social Security disability insurance (SSDI) program is a financial safety net available to workers who have paid into Social Security long enough and recently enough. Should they find themselves unable to continue working because of a severe medical condition, they are entitled to benefits. However, SSA follows very strict rules to prove that entitlement.
Key Parts of a Disability Application
Your initial disability application is comprised of a packet of forms and reports that tells SSA how your medical condition has made it impossible for you to physically work to earn no more than $1,000 a month, or “substantial gainful activity.” This is an SSA term and is a measure of a person’s work ability to earn income.
The key parts of an application packet are the:
- Disability Technical Application – Information about you, your family, your jobs and earnings to determine entitlement to Social Security disability benefits
- Adult Disability Report (ADR) – very specific information detailing your medical condition, medications and treatments; work history and the physical demands of past work; and your work skills and education
- Function Report – information on how your medical impairment impacts activities associated with daily living such as preparing meals, paying bills or interacting socially with others
The Evaluation Process – Medical
Once your application is sent to Social Security, disability examiners at your state’s Disability Determination Services (DDS) office begin a very strict step-by-step evaluation process to determine if your medical condition meets, or is equal to, it’s qualifying list of impairments. They may send you additional questionnaires specifically about your medical impairment. These supplemental forms ask the same questions in a different way. They may also require that you undergo a consultative examination (CE) with an SSA-contracted medical professional to further evaluate your medical history and condition.
The Evaluation Process – Functionality
DDS must understand just how capable you are at doing work, so they evaluate how your condition impacts what you do throughout your day. They will identify what things you can still do in spite of your physical or mental impairment. This is your “residual capacity.” If they think you cannot return to your past work, they will factor in your age, education and capabilities to decide if you can train for different work.
A Road Map Decision
SSA’s disability examiners must decide, without a doubt, that your medical condition is expected to keep you from working at any job for a year or longer, or may result in death. They follow a very black-and-white, letter-of –the-law, road map of rules to make that determination. If there is any room for doubt, DDS will deny your application at this point in the process. It usually takes three to four months for DDS to make a decision on an initial disability case.
The Judge has the Power
However, if your claim is denied, you can get approved through the Appeals process. In fact, approval rates improve greatly by the time a case reaches the hearing level of an appeal when the final decision is made by an Administrative Law Judge (ALJ). The judge is not strictly held to the bureaucratic process at DDS and has the ultimate power to decide a case. Also, more time has passed and more medical evidence has been added to support your case. The ALJ does a new review and meets with you face-to-face to ask questions. The judge can make a far more subjective decision about your condition and capacity to work.
Build a Disability Case that Wins with Freedom Disability
Think of the disability approval process as if it were a tower of building blocks. There are so many factors that can shake the tower. Your medical records may not be complete enough. The answers to questions about your daily activities may not be convincing enough. Working with an expert Freedom Disability Advocate will help you avoid making these mistakes from the start. One thing is definite about the process – it is long, complicated and very difficult to get through on your own.
If you are one of the thousands of people with disabilities who have been initially denied disability benefits, you can succeed. But you must follow the necessary steps to get approved. If you started the process with Freedom Disability, or need help appealing your case, our Freedom Disability Advocates are the experts you need to help you build a strong disability case that wins.
Maybe I better stop while I am ahead. I do get a SSI, it gets me by. When I slipped and broke my back on Ford Motor Company property, I was out of work for 2 yrs. After I return, the labor relations told me I would be fired if I sued the company. I worked 34 1/2 yrs and had to retire early because my back got worse and the pain was unbearable. Through the trauma, I’ve had many surgeries since. I retired in 01-01-1097. It is too late for me to be helped. Maybe others can be helped if they were threaten as I was. Thank you for this program, I just wish I knew about it back when I was forced to retire early because of my back problems. There is no hope of me recieving anymore other than what I already have so please help those that may have been succumbed under pressure or fear we would lose our retirement if we filed for disability.
Typo on the year I broke my back at the Saline Ford Motor company in Saline Michigan. It was in 1990 when I fell and in 1997 when I retired. Being forced to work on a lesser job, being labled as a workmans comp employee and were shunned where before this accident, I held a very respectful position within the company. The ice being on a sidewalk which led to the entranced to the shop was an error of the company not ordering the people in charged of outside salting of the walks. Other’s slipped but I slipped and fell. The sidewalks were salted and cleared of that ice after I fell and broke my back. I was rushed to the hospital and my elbow was sitched up. I was 55 back when I retired and now I just turn 69. Like I mention in my first comment, when you council people, be sure to ask if they had been told if they file for disability, they could lose their job. It happens.
I am on SSD and SSI already but 637.00 a month is bareley a month’s worth for me to go on. now I have an 8 month old and I know nothing or if there IS any help with raising my income…can anyone answer fr me? PLEASE
i just went to my hearing my lawyer told me that social security said i could still work 2 hours a day i cannot barely type this i have incrediable pain and agony eveyday. i have hardwear in my neck but if the ssa said i was somewhat disabled does that help my case …as desperate as they come thanks
Rebecca,
Your lawyer should be able to explain to you what this determination from the judge could mean in terms of the final decision. There’s no way for us to guess what it may mean for you. From what you say SSA may have decided that you have some functional capacity to work. Should your case be denied you still have another opportunity to appeal.
I was denied SSDI because my primary doctor says I am not disabled. I have Ehlers-Danlos, osteopenia, vertigo, Raynaud’s, parasthesias and hearing difficulty, just to name a few. I’ve been told by other lawyers I won’t get SSDI because of my doctor and no one will take my case. Also since I have no income and no insurance, can’t get another doctor to help. Any ideas?
Col,
One of the determining factors to be found disabled is the patient’s level of functionality and the patient’s age. Though you have quite a range of conditions, if the doctor felt that you have enough ability to do a level of work, and you are able to learn new skills, those findings would make it difficult to prove your case. You definitely need a strong medical history and the support from your doctor. Perhaps you should consider finding other medical professionals to review your symptoms. Please read our article “The Government Can Help You Find a Doctor.”
Should I still recieve SSIbenifits all though I was cut off at 18 yrs old
Mark, here’s a link to the SSA Web site that explains rules for children disabled before age 22 and more info from SSA on what happens when children reach 18 years of age.
I was denied ssdi and have copd and well within the qualifying perameters. But was told i needed 6 more points and would have to go back to work for another 1and 1/2 years to quailify. Plus the man who did my phone interview told me i had too much stuff. Like a 96 ford i owned and the dodge truck i previouly ran my business out of. And the was told after I worked for another 1.5 years to sell all my stuff, seperate from my wife (because she makes too much money) and leave my home and sleep on a friens couch for a while. And the re-apply. So “make myself homeless”. And illegals in this country get all the entitlements they apply for. Can you please answer this for me. Im 56 years old i was a contractor and cant work like that any more I have 1 teenager and 1 adult working but still at home. Where do I go from here
Charles,
The Social Security federal programs have very specific eligibility rules for getting benefits. The work history criteria is the way Social Security determines if a person is insured for benefits and they base it on a work-credit grid based on age. If you fall short there’s nothing you can do to change that rule. If you were insured, you’d still have to prove that your condition is so severe it is preventing you from doing any kind of work. The Supplemental Security Income program is based on need and a qualifying severe condition that still must meet SSA’s definition of disability. From what you say, your income and resources are above the threshold for getting an SSI monthly payment. Taking drastic steps to get a monthly SSI check, which still may not be enough to meet your needs, seems extreme. You’re lucky your wife and children have jobs. Perhaps there are local social services available to help you in some way, or something you can do that is not too strenuous to help you earn the credits you need for SSDI. So sorry about your circumstances. At least you have paid into Social Security and could get early retirement benefits (the same benefit as SSDI) when you reach 62 years of age.
i m bi polar i was denied twice they said i could not do what i once did but could do other things
PLEASE Help? I have Agoraphobia, Clinical depression, P.T.S.D., Panic and Anxiety Disorder, and Social Anxiety. I have been denied by the Appeals Council to even Review the Decision of my case. How can I work if I cannot leave my Home? The only time I leave is for my Psych. Appointments, And that is pure hell. What do I do? I’m 42 and worked all of my Life until I got sick. I’m so confused. Why can’t you get help if you need it?
i was recently denied for disability. i have chronic HBV. i get really tired after only a few hours of working and have to sit or rest. i also have other issues going on. i was denied and told that i could still do other work. so i am in the process of reconsideration. who is gonna hire someone that cant work like they use to do. who is gonna take a risk like that.
I have applied and been denied twice by the SSA. I am in the process of appealing the 2nd decision and have been granted a hearing. I must tell the judge the name of the representative or advocate I have engaged to help me by February 3. 2012. He will then schedule a hearing. Please advise me as to the best way to proceed. I have contacted many groups such as yours and have not received much help; it seems either since I have been denied twice, my case is too difficult or because I am already 61 years old. I am very anxious about appearing without at least speaking to someone about what I can expect to experience. Please either e-mail me or call me on my cell: 571-271-9525. I have not even been able to get a complete copy of my file, so am not sure what documentation was received by SSA from the large number of doctors I have seen and still continue to see. No one has discussed my medical conditions with me either on the phone or in person. No doctor has seen me…no one has seen me for that matter. I have extensive evidence form 5,6,7,8, years ago that indicate my issues were serious. I no longer have as much evidence in contact with doctors, but am still taking much medication, so my drug history continuously supports the presence of my disabling conditions. Please advise me as to what to do.
Hi Elizabeth,
Thank you for reaching out to us. It sounds like we might be able to assist you with your appeals hearing. One of our Eligibility Consultants will be in touch with you shortly.
well ive been trying to get my disability for 2 years now been denied twice by social security so now my lawyer told me im on the backside of it now im going to a hearing now i got parmele they help you win its all they deal with so i asked my lawyer am i gonna win he told me yeah so i hope so was a truck driver for 23 years im 44 years old and had a bad accident in a big truck in 2007 messed my back up and neck now and i got sleep apena real bad and after had my accident found out im a diabetic so im praying every day this happens for me dont know what else i can do fall a sleep at any time.
what do you guys think.
My son was diagnosed with Autism at age 3. He was on SSI until I got married in January 2011. Since then they completely took my sons benefits and insurance away because my husband makes too much money. The appeal period already passed but he really needs his benefits. What should I do? Do I have a chance of appealing and getting his benefits back?
WE MUST PROTEST WASHINGTON AND DEMAND DUE PROCESS TIMELY FAIR HEARINGS BY ADMINISTRATIVE LAW JUSTICES BE ADEQUATELY FUNDED. CONGRESS MUST ESTABLISH A STATUTE OR CONSTITUITIONAL AMMENDMENT REQUIRING A SPECIFIC MAXIMUM TIME PERIOD ALLOWED FOR SCHEDULING ADMINISTRATIVE HEARINGS IN ALL STATES OF THE USA. ANY PROPERLY FILED CASE NOT SCHEDULED FOR ALJ WITHIN SIX MONTHS SHALL BY DEFAULT BE DEEMED DECIDED IN FAVOR OF THE APPLICANT OR APPLICANTS HEIRS. ANY STATE EXCEEDING THE ALLOWED WAITING PERIOD SHALL BE NOTIFIED BY CONGRESS OF AN ACT OF INSURRECTION AGAINST THE US FEDERAL CONSTITUTION AND THOSE STATES SHALL BE SUMMONED TO VOTE FOR SUCCESSION FROM THE USA AND ALL STATES WILL BE ALLOWED TO VOTE TO RATIFY THE DECISON TO SUCCEED FROM THE UNION. ALL STATES WILL BE REQUIRED TO VOTE IN A POPULUS STYLE ELECTION BY MAJORITY TO RATIFY THE DECISON TO SUCCEED FROM THE UNION. IF THE US FEDERAL GOVERNMENT VOTES TO VETO OR BLOCK SUCCESSION OF A STATE THAT HAS BEEN CONSISTENTLY VIOLATING THE CIVIL RIGHTS AND DUE PROCESS THEN THE FEDERAL GOVERNMENT WILL BE DULY LIABLE FOR ALL PUNITIVE DAMAGES AND COMPENSATORY TREBLE DAMAGES TO THOSE DISABLED CITIZENS THAT HAVE BEEN INTENTIONALLY DENIED OR IPSO FACTO DENIED TIMELY DUE PROCESS. IF THE FEDERAL GOVERNMENT DOES NOT PAY THESE DAMAGES THEN A STATE OF EMERGENCY SHALL BE DECLARED BY EITHER CONGRESS OR BY EXECUTIVE ORDER OF THE PRESIDENT AND A CONSTITUTIONAL CONVENTION SHALL BE CONVENED WITH REPRESENTATIVES OF ALL OF THESE UNITED STATES. AT THE CONSTITUTIONAL CONVENTION THESE MATTERS HEREFORE MENTIONED AND ANY NEW PERTINENT MATTERS OF CONSTITUTIONAL DEBATE WILL BE ON THE TABLE FOR DISCUSSION AND RATIFICATION INCLUDING BUT NOT LIMITED TO THE PROPOSITION OF NEW AMMENDMENTS OR REALIZATION OF AN ENTIRELY NEW CONSTITUITION IF THESE FOREMENTONED GRIEVENCES ARE REDRESSED WITH NO SATISIFACTORY RESOLVE BY CONGRESS, THE EXECUTIVE OFFICE OR SUPREME COURT THEN WE THE PEOPLE AS CITIZENS EMPOWERED BY OUR RIGHTS AND DUTY TO UPHOLD AND DEFEND THE CONSTITUTION WITH OUR LIVES SHALL BE OBLIGATED TO PROTEST AND/OR OVERTHROW THE TYRANNICAL GOVERNMENT WITH DILIGENCE & DUE FORCE AND VIOLENCE IF NECESSARY. OUR INALIENABLE RIGHTS SHALL NOT BE SUBJEGATED BY ANY RULING OR REIGNING TYRANTS BE THEM OVERSEAS OR ASHORE.
Wow, I didnt realize that there is more people going through this. I have been in doctors care from a car accident since May 2008. I have about 2 to 4 appointments a month. My co-pays probably add up to a number that i dont want to know. After in May 2011 I suffered a heart attack at 34 years old. I now have a stent in my right coronary artery and have to take a few prescription medications for my heart and blood health. I have been off the plavix for a few days now because I cant afford to get it. Even the generic. I havnet had my blood pressure meds either for about a week because i have no income!!!!!! ITS RIDICULOUS! The ghetto people down the street dont even speak english and have a brand new mercedes benz parked out front and like 5 kids.They even own the house and i am renting. I have been behind the mother in line at the market while she counts out her wic and other free benefits they get. I have never heard her speak a word of english either. I just dont understand why I have about 4 years of being considered disabled by doctors and ssdi was denied twice to me already. Now i am waiting for a hearing date. ANd I do have an attorney on this helping out, but its stuck here. The attorney told me that they cant do anything more expect wait. I spent a good 15 years of continuous employment and I was born and raised here in our AMERICA! I tried for food stamps and gi and unemployment and supplemental. They said no!!!!!! Because Im considered employed still on disability leave…..WHAT THE>>>>!! 2 years max is what you get from work comp and 1 year of state disability benefits here in California. I obviously ran those out. And now the “Man” considers me denied, like lets give him another heart attack and some depression to go with it! How about some anxiety, no income, and take away his manhood! All because I got hurt! It wasnt my fault, I didnt plan this crap. I would have been well off in the company i worked for if none of this happened. Too bad im not illegal, cause i just might get some help. Thank you and good luck to the honest applicants that arent ruining the reputation of the folks that really are in dire need!
I was diagnosed HIV positive in 1998. I have worked since then continually. I was laid of due to “restructuring” from a job I had for 10 years in 2010. As I could no longer afford the expensive medicines without medical insurance I quit taking them for a time. I worked from 2011 to February 2012 at another job which didn’t have insurance. I became very ill in February and had to leave work one evening because I couldn’t breathe and had no energy. My friend insisted that I go to doctor the next day. I was immediately admitted to hospital and was in for just over a month. I now have full blown AIDS and was diagnosed with PCP Pneumonia. The doctors were not optimistic that I would survive at all. I think they were really amazed that I did pull through. I have a history of bi-polar disorder as well. I was advised to apply for Social Security as soon as I was well enough in the hospital. They seemed certain that I would be approved. I also lost about 55 pounds and looked like a living skeleton. I have made follow up visits to the doctor at least once a month since being released. My bloodwork has improved, but I still not up where you would want them to be. I am easily upset by things more now than ever before. I was denied on my initial application for disability because they said I could do other work. I honestly don’t see how I could face the pressure and stress of work any time soon. I have contacted an attorney to represent me in the appeal process. I have never been one to take advantage of the system. I never even collected unemployment between jobs. I am hoping that I am approved at the reconsideration level, but from what I read that is not often the case. I also read of the incredibly long wait for a hearing on the second appeal. Everything I read about qualify medical conditions said I should be eligible for benefits. I just don’t understand why I wasn’t approved. Good luck to all of you in need. I hope the system works for you.
I to be going thru this since 2006 been denied appelaed it went in front of judge they told me if i havent tried to commit sucide been in mental house i have no chance,i have bben to mental theryepy been on 900 mgr lithium 3 times a day 3oo mlgr tripletol 3 times aday lorazapam celexia paxil depakote zoloft ativan i can keep going now i am on halopraids and zoloft baiscally for a kicker to keep me level headed appealing my secong time around had nervouse breakdown the other night every bone inmy body hurts every minuteof the day cant walk long sit or stand back is bad have arthritis growing around spine all this is documented so i have a lawyer now just waitng on date to get in see judge and see what the excusee is now i have worked for over a yr due to alllll this
I was denied disability for the 4th time….Im 27 and have been suffering from hidradenitis suppurativa for 6 years along with fibromyalgia,chronic migraines/cluster headaches, degenerative disease of the spine, possible lupus (tested positive for it), menieres disease chronic stomach pains and other conditions as well. The smell and consistantly bursting and draining of lesions under my arms,groin and breast has been painful and embarrassing. Its so bad that I often need assistance bathing and getting dressed…Its sad cause they have been giving me the run around and im in the doctors office weekly getting incisioned n drained that I cant do anything else but they still think i can work. I have exhausted all medications for the skin disease cause they dont help and my dermatologist have suggested the last resort of this terrible disease…Skin graphing! No! I see no point cause it doesn’t cure the diesease and most patients if not all have to end up going back over and over and my surgeon also refused to do it because of the great risks and long recovery time. I have a daughter that I cannot afford not to be there for. -sighs- I just dont understand…I was told my age is the reason I was denied but that should have been thrown out the door with my medical evidence and everyday suffering of this disabling things, I wish they could be in my body for a day.
Amanda,
If you have been denied, I recommend contacting Freedom Disability. We can appeal your claim for you. I urge you to call us at 866-761-5942 and speak with one of our Eligibility Consultants. We may be able to assist you. Good luck.