Top 5 Reasons Your Social Security Claim Was Denied

According to Social Security’s most recent statistics, over 66 % of claimants have to go to a hearing before an Administrative Law Judge regarding their social security disability application.  But why are so many cases denied?  Here is our list of the Top 5 Reasons your Social Security Claim was denied:

1.  Your Medical condition is not severe enough or has not last long enough.

Social Security reviews your medical records and compares your conditions against a set of laws, called the “listings,” which when met automatically qualify you for benefits.  If you do not meet the listing then your case is often denied.

 2. You have not been off work long enough or you are still working.  

Often times claimants are working full time or even part time.  Our experience has been that if a claimant is work, even minimally, that this can be a reason for a denial of your Social Security claim.  It casts doubt as to whether you are truly disabled.

Remember you can apply for SSDI or SSI immediately after you stop working. However, to be considered disabled, you must be expected to not able to work for at least one year.

3. You do not communicate with Social Security.

Social Security will send a variety of questionnaires to both you and family members or friends.  You may also receive letters asking you to contact them to answer additional questions about your work history, medical treatment and limitations.  Or they may send you to a consultative exam.  Often times claimants simply ignore the paperwork, or fail to keep Social Security advised of changes in their address and phone number.

4. Social Security does not have all of your medical records or treatment.

Related to #3, often times Social Security will deny claims because they do not have all of your medical records.  This could be a result of your doctor or the medical facility not responding to Social Security’s request for records.  It could also be that Social Security was not made aware of your recent doctor’s visit, test or hospitalization.

5.  Lack of treatment or not following the prescribed treatment.

Often times, social security denials are because the claimant has not been treating with his or her doctor so there is not enough evidence to support a favorable outcome.  Other times, claimants are not following the doctor’s recommend course of treatment and not trying to get better to re-enter the workforce.  Social Security may deny the claim because a claimant is not trying to help himself or herself.

 

If you have filed your Social Security Disability application and been denied, contact us now for a free initial consultation to see if your denial should be appealed.

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How long will it take before my Social Security claim is approved?

Clients often ask, “how long will it take for my social security claim to be approved?”   The time frame to obtain a favorable outcome differs from case to case.  However, the process is lengthy for most clients.

Some clients’ disability cases are approved at the initial application level.  This usually occurs within 3 to 4 months of filing.

Other have their case approved after filing a request for reconsideration.  This usually takes 2 to 3 months after filing the request for reconsideration.

However, over 66% of claimants must go to a hearing before an Administrative Law Judge (“ALJ”).   It usually takes 16 to 18 months from the filing of the request for hearing before a hearing is scheduled on a case.  But do not despair!  According to the Social Security’s Office’s most recent statistics, a little over half of those cases that go before the ALJ are approved.

As you can see, the time frame varies greatly from case to case and can take up to 24 months.

If you have filed your Social Security Disability application and been denied, contact us  now for a free initial consultation to see if your denial should be appealed.

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Social Security Application: The Process

Many potential clients are curious about the Social Security Disability application process.

Step 1  The Application

This first step is filing the application.  This can be done online through the Social Security Administrations website or by contacting your local Social Security Office.  Questions often arise as to whether to apply for SSDI, SSI or both.  This depends on a variety of factors.  It also depends on the benefits that you are eligible for under each program.

Step 2  Application Review

Next the application will be reviewed to see if the claimant is disabled.   Social Security has a strict definition of “disability.”  To learn more about when Social Security considers a claimant disabled, see our prior blog post.  If Social Security does not find that you are disabled, then your claim will be denied.  You have 60 days to file a Request for Reconsideration.

Step 2  Request for Reconsideration

During the Request for Reconsideration stage, Social Security will review your application again along with any new information that is provided including recent medical appointments.  You and/or your family members may receive forms to complete.  Finally, you may also be sent to an exam to have a doctor hired by Social Security examine you or perform tests.  If Social Security does not find that you are disable, then a second denial of your claim will be issued.  You have 60 days to file a Request for Hearing.

Step 3 Request for Hearing

After a Request for Hearing is filed, your claim will be assigned to an Administrative Law Judge (“ALJ”).   You and your attorney will attend the hearing, and you will testify.  After reviewing your medical records and hearing your testimony, the ALJ will issue a ruling in your case.  If the ALJ denies your claim, then under certain circumstances, you may be able to file an appeal within 60 days of the ruling, or sometimes you may be able to file a new application.

 

Although the Social Security Disability application process itself is not complicated, it is lengthy.  There are also many pitfalls that an unrepresented claimant is not aware of.  If you have filed your Social Security Disability application and been denied, contact us now for a free initial consultation to see if your denial should be appealed.

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SSDI vs. SSI: Which Type of Disability Benefit Should I Apply For

There are two main programs that provide assistance to people with disabilities – Social Security Disability Insurance (“SSDI”) and Supplemental Security Income (“SSI”).

Both of these programs are administered by the Social Security Administration. Both programs require a person to be disabled and to meet certain medical eligibility requirements.

However, Social Security Disability Insurance pays benefits to you and certain members of your family if you are “insured. ” This means that you have worked long enough and paid Social Security Taxes. Supplemental Security Income pays benefits strictly based on financial need either because you never worked, did not work long enough to earn sufficient credits, or your disability insurance credits expired.

What is SSDI?

An individual funds his or her social security disability insurance through payroll taxes earned while working. You generally remain insured for five (5) after leaving full time work. There are no income or asset requirements. Instead, you only needed to have earned enough credits while working to be eligible.

Individuals are eligible for Medicare two years after the date he or she is found to be disabled.

If awarded, there is a six month waiting period before SSDI benefits are paid.

What is SSI?

SSI is “means-tested.” This has nothing to do with your work history but instead looks at your financial need. You must meet SSI income requirements, typically have a very limited income and have few assets.

Many individuals who are eligible for SSI may also be eligible for Medicaid.

If awarded, there is no waiting period for SSI benefits. Your benefits begin the first of the month that you submitted your application.

 

Although not a comprehensive list, these are just a few of the similarities and differences between these two programs. If you have filed your Social Security Disability application, for either SSDI or SSI, and been denied, contact us now for a free initial consultation to see if your denial should be appealed.

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Worman Legal to attend Veteran Organizations Involved in Community Education Event

Worman Legal is pleased to announce that it will be a vendor again at the VOICE Expo 2017.  This event will take place Saturday, May 13, 2017 beginning at 11:00 am at the National Guard Armory, located at 3000 E. Division St.  There will be numerous activities for children, adults and the entire family.  Admission is free.

If you have questions about Veteran’s (VA) Disability benefits, Social Security Disability benefits, or just want to stop by and visit our both, make sure you attend this wonderful event.  The expo is sponsored by Veteran Organizations Involved in Community Education, whose mission is to be the premiere voice of Veterans events of Southwestern Indiana.

We are pleased to be part of this event and hope to you see there!

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