A mistake many injured or sick Americans make is assuming SSD (Social Security disability) claims will get approved. In fact, they often get denied; this frequently happens for various reasons. This post will examine why SSD claims get rejected, what affected parties can do to appeal them, and how an SSD lawyer can assist them.
Reasons why SSD claims get denied
There are many reasons why SSD claims are rejected. While some people aren’t eligible to receive disability benefits, many make mistakes during the application process. Understanding why claims get denied—and avoiding common mistakes—will help you maximize your chances of success. Below are the leading reasons behind disability claims denial.
You don’t meet basic requirements
Before you file for SSD benefits, it’s important to know you meet the basic criteria for consideration. Social Security Administration (SSA) provides financial support to individuals who have a qualifying disability, meeting all the following conditions:
- You have a medically determinable physical or mental impairment that’s expected to result in death or lasts for a continuous period of at least 12months;
- You can’t work and engage in substantial gainful activity because of your medical condition;
- You can’t do work you did previously or adjust to other jobs because of your medical condition.
You must meet this strict definition of disability to qualify for benefits. You may also be eligible for Social Security disability benefits under some special situations, including:
- You’re blind or have low vision
- You’re the worker’s widow or widower
- You became disabled after you served in the armed forces
You don’t own enough work credits
You must have worked long enough — and recently enough — under Social Security to qualify for disability benefits. As per law, you must earn at least 40 Social Security credits to qualify for the benefits, 20 of which were earned in the last 10 years ending with the year your disability begins. In 2022, you must earn $6,040 to get the maximum four credits for the year.
You don’t submit the right documentation
To receive consideration for disability benefits, you must submit a completed application to the SSA. If your application is incomplete in any respect—whether you left out medical documents or you forgot to sign at the end—this may cause them to issue a denial. Medical documents should include diagnoses, medical tests and results, treatment history, surgery evidence, and other relevant medical details to demonstrate not just that you have a problem, but also that you have been getting regular medical treatment for it.
You’re earning too much
SSD benefits are for people unable to work. If you continue to work and earn too much money, this will make you ineligible for benefits. You must earn no more than the regulated wage amount when receiving these benefits.
You fail to attend a consultative examination
While your disability application is pending, the SSA may ask you to attend a consultative examination (CE). This is an examination performed by a doctor who works for the SSA. If you fail to attend a CE as required, you may have to face claim denial.
How to appeal a rejected claim
In case your SSD claim is denied, you have the legal right to appeal the decision if you disagree. Here’s the four-level process to follow while making the appeal:
- Reconsideration: The SSA ensures a complete review of the claim by someone who did not take part in the first determination. They will look at all the evidence used in the first determination, plus any new evidence you submit for your case.
- Hearing: This is a proceeding with an administrative law judge (ALJ) from the SSA who didn’t take part in the first determination or reconsideration. The ALJ will look at all of the evidence in your case.
- Review by the Appeals Council: If you disagree with your hearing decision, you may ask the Appeals Council to review it. If the Appeals Council grants your request for review, it will either issue a new decision or return your case to an administrative law judge for further action.
- Federal court review: You can file a civil suit in federal district court. This is a complicated process, and you’ll want to seek help from qualified legal counsel. However, you must consider the timeframe as the most important part of an appeal. Generally, you have 60 days from the date you receive the notice of decision to appeal.
An SSD lawyer can help appeal rejected claims
Whether you’re thinking about filing for benefits or you’ve received a denial letter from the SSA, it’s best to seek help from an SSD lawyer who can guide you through the next steps. If you’re looking to file your SSD claim application for the first time, an experienced SSD attorney can help you fill out the application,, calculate work credits, and provide the SSA with all the evidence and medical documents needed to support your claim.
If the SSA denied your first application, the process of filing for appeal can be frustrating and confusing. Knowing why you were denied is imperative in order to move on with the process. An SSD lawyer can assist in finding the missing gaps, collecting all the required documents, and building a strong case, thereby increasing your chances of success.
Working with a Social Security disability lawyer makes you nearly three times as likely to win benefits than going it alone. Our network of disability advocates work on a contingency basis, so you pay nothing for legal assistance if you don’t win benefits. And if you win, then you’ll only pay a small, one-time fee.
Ready to see if you may qualify? Complete your free online SSD benefits evaluation now!