Applying for Social Security Disability benefits is no walk in the park. Did you know that from 2001 to 2010, 53% of initial Social Security Disability claims were denied?
But why is the Social Security Administration (SSA) denying more than half of disability applicants? The reasons can vary based on the claimant’s income, past work experience, therapy and more. To avoid a denied disability claim, try to keep in mind these 6 reasons why people get denied for disability benefits.
The Social Security Administration has a strict definition of disability that takes into consideration the ability to earn an income and the duration of the disability. They define disability as “the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”
In order to evaluate your disability against their own definition, they follow a 5-step question process when reviewing your application, detailed on their official website: http://www.ssa.gov/dibplan/dqualify5.htm. To make sure that you are actually eligible for disability, read through the 5-step process to see if you qualify.
Both Social Security Disability Programs have a limit on how much monthly income you make in order to be approved. They call it Substantial Gainful Activity (SGA) . If you are making more than a certain amount of money per month, you are not considered “disabled” because you are engaging in SGA. For example, in 2012, if you were making more than $1,010 a month, your application would be denied. The SGA limit is adjusted every year.
The SSA sends your claim to the Disability Determination Services (DDS), an agency that evaluates disability claims. The DDS takes your information and contacts your medical providers and past employers to verify that your disability claims are accurate. If there are not enough medical records that reference your disabling condition, your application might be denied. The DDS may also find that the medical records they receive are not relevant to your condition and that you are able to engage in SGA.
In order to avoid this, you should seek medical attention early on in your disability so that your condition can be documented. You should also gather your own medical records and obtain relevant documents from your health care providers yourself, so that you may turn in these documents to the SSA directly. This may maximize the amount of medical information that can be used when evaluating your claim.
Make sure to review the SSA’s application check list to ensure you aren’t missing any documents: http://www.ssa.gov/hlp/radr/10/ovw001-checklist.htm.
In the SSA’s definition of disability, your disabling condition has to last longer than 12 months. Social Security Disability Benefits do not cover any short term disabilities—i.e. a condition lasting less than 12 months. The SSA assumes that other benefit programs—like Worker’s Compensation—will cover a claimant during that time.
If you believe that your disability is and can be considered long term, it is important to retrieve necessary medical documents that can prove it. Contact your doctor and ask for a note that records his medical opinion on your condition.
The DDS looks at your work history for the past 15 years to see if you can perform any other previous job with your current disability. Even if you were at the same job for ten years when you got your disability, a less-demanding job that you had a few years before that would be taken into consideration. This criterion goes back to the SSA’s definition of disability and your ability to participate in substantial gainful activity.
In order to avoid this type of application denial, it is important for you to list your own job descriptions detailing the previous jobs you held and the activities that were involved, as your performed them. By providing them your own account of the work you performed, the DDS will be able to have a more accurate evaluation of the jobs you’ve held in the past and your ability to perform them in your current disabled state.
There are many reasons why applications are denied disability, so it is important to keep in mind all the details and pit falls of the application process. One missing document could cost you your benefits. Try your best to stay informed and give as much information as possible, and your application may be on its way to a successful review.