Welcome to Disability Benefits Help, an organization committed to helping claimants across the United States receive approval for disability benefits.
Since applying for Social Security disability benefits can be a difficult process, a disability attorney or advocate may increase your chances of being awarded benefits by helping accurately and favorably complete the complex paperwork, ensuring that all deadlines are met, and providing you with representation at a hearing. After submitting our web form, you will receive a 100% FREE evaluation of your disability claim. Disability attorneys and advocates receive compensation if you are awarded back benefits. We have no affiliation with the Social Security Administration, the agency at which you can apply for Social Security disability at no cost.
About 65% of all Social Security disability benefits claims are denied at the initial application stage. Suffering an injury or being diagnosed with a disability can be a very stressful and frightening time.
More than likely you will be worried about how you will support yourself and your family, especially if the disability prevents you from carrying out your job.
Applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits can alleviate some of these worries. Unfortunately, there is a significant chance that your application will be denied, even if you rightfully qualify for disability benefits.
Getting an Unfavorable Decision
If your initial disability application was denied, you are not alone.
Approximately 65-70% of all initial applicants are denied disability benefits.
Though this may seem like a large amount, claims are denied for all different reasons. After you are denied, you will have the option to appeal your decision and improve your claim.
If you have applied for Social Security Disability benefits and are faced with an unfavorable decision, do not panic. If you are denied Social Security disability, you can fight the decision.
The SSDI and SSI application process includes an involved reconsideration and appeals process, so with the help of a Social Security Disability lawyer or advocate, there is a good chance that you will eventually be awarded the benefits that you rightfully deserve.
SSDI Denial Reasons
There are several reasons why someone might be denied SSDI benefits. Below are some of the most common reasons for denial.
Lack of Sufficient Work Credits
SSDI requires that you have earned enough work credits, which are based on your age and the number of years you’ve worked.
If you haven’t worked long enough or recently enough, you may not qualify for benefits. Generally, you need 40 work credits, with at least 20 earned in the last 10 years ending with the year you become disabled. Younger applicants have lower work credit requirements.
Earning Too Much Income
If you are earning more than the Substantial Gainful Activity (SGA) limit, which is $1,550 per month for non-blind individuals and $2,590 for blind individuals in 2024, you may not be considered disabled by the SSA. Earning above these thresholds indicates that you can engage in meaningful work despite your disability.
Condition Doesn’t Meet SSA’s Blue Book Listings
The SSA uses a guide known as the Blue Book to list conditions that automatically qualify as disabilities if specific criteria are met. If your condition does not meet or equal a listing, you may need to provide additional evidence showing how your condition impacts your ability to work
Condition Not Severe Enough
The SSA requires that your disability be severe enough to significantly limit your ability to perform basic work activities. If your condition does not meet this criteria, your application may be denied.
Lack of Medical Evidence
Insufficient medical documentation can lead to a denial. You must provide detailed and up-to-date medical records that demonstrate the severity of your condition and its impact on your ability to work.
Violation of Income Limitation
You cannot have SSI income that is more than $2,000 per year. This includes wages and the income generated from self-employment.
The $2,000 limit also applies to assets, such as stocks, government bonds, and a life insurance policy. Even if you do not generate more than $2,000 income from a rental property, the real estate value of the property cannot exceed $2,000.
Lack of Proper Documentation
As one of the more obvious reasons to deny SSI, failing to submit the proper documents to the SSA leads to the denial of your claim.
If you did not receive the correct paperwork, the SSA still denies your claim for inadequate documentation. The SSA has established strict deadlines for submitting documents.
If you missed a filing deadline, you can expect the SSA to deny your SSI claim. The SSA has a list of documents you need in your application in the SSA's Blue Book for that condition.
Not a United States Citizen
Here we have a less obvious reason for having an SSI claim come back denied by the SSA. The rules for establishing citizenship are complex, with eight different categories defining a non-citizen. Any non-citizen that files a claim for SSI benefits will receive a denial letter from the SSA.
Failure to Return a Phone Call
Disability case workers from the SSA often follow up on applications to get more information out of applicants.
They are not as interested in your income as they are interested in the type of work you have done. You get one phone call from a disability caseworker and if you miss it, you have a limited amount of time to return the call, or else you receive a denied claim letter from the SSA.
If you believe the SSA denied your SSI unjustly, you should speak with a Social Security disability attorney or advocate to determine the best course of action.
What To Do If Your Disability Claim is Denied?
Now that you’ve determined why your initial application was denied, it’s time to file a request for an appeal from the SSA. The first stage of the appeals process is called the reconsideration stage and its complete review of your disability claim by someone at the SSA who was not part of your initial denial position.
After your initial disability claim is denied, you usually have up to 60 days to file an appeal for reconsideration. It is recommended that you file your claim for reconsideration as soon as possible.
If your disability claim is denied, you will be able to file your appeals claim online. You are allowed to provide more medical information and evidence to back up your claim that you are unable to work because of your disability.
That person performing your disability reconsideration will look at any evidence used to make the original decision and all the new evidence provided to determine whether your disability claim is approved or denied.
To make sure you submit the strongest appeal you possibly can, check out our article discussing the signs your disability claim will be approved for some helpful tips and information.
Filing an Appeal
By understanding the reconsideration and appeals procedures that are built into the disability application process, and perhaps with the help of a qualified Social Security Disability attorney or disability advocate, you may still have an excellent chance of receiving disability benefits.
Although there is no way to be certain whether you will be awarded SSDI or SSI benefits upon appeal, you can drastically increase your chances by understanding the reasons for denial and then properly addressing them in your appeal.
If you have been denied because your medical history is unsubstantial or incomplete, working closely with medical professionals to ensure that you have submitted the appropriate medical documentation and Residual Functional Capacity (RFC) form may have an extremely positive impact on your case.
Hiring a qualified Social Security Disability attorney or advocate to help you fully understand and prepare for your appeal, as well as to ensure all appropriate paperwork is in order, can greatly increase your claim’s chances of success.
In many cases, disability lawyers and advocates will not only have a vast knowledge of the Social Security application process, but may also have specific insights into the specific requirements for approval at your regional Social Security office.
Hearing in Front of an Administrative Law Judge
Up until now, every interaction with the SSA took place via email, snail-mail, and over the phone. The second step of the appeal process puts you in front of an Administrative Law Judge (ALJ).
A few weeks before your ALJ hearing, the SSA sends you a letter confirming the date, time, and location of your hearing. If you fail to appear at the hearing, the ALJ will dismiss your claim.
Working with a Social Security disability attorney can help you prepare for the ALJ hearing. You should know most of the questions the ALJ asks, as well as how to deliver your side of the story in the most convincing way possible.
During the ALJ hearing, the judge will ask you to explain the reasons why you can no longer work. You have to demonstrate why the medical condition that you suffer from limits your ability to complete ordinary job functions. Your lawyer will ask medical experts to testify on your behalf as well.
How Many Times Can You Get Denied For Disability?
You can get denied up to five times for disability. After your initial claim for disability gets denied there are another four stages of the appeals process. As discussed above, the first stage of the appeals process is the reconsideration stage, followed by a hearing with an administrative law judge (ALJ).
If your claim is denied at that stage, you can request a review by the appeals council. If your claim is still denied, the last part of the appeals process is a federal court review.
While you can get denied up to five times for a single disability claim, there are no limits for how many times that you can send in an application.
As your claim gets denied, it becomes harder and harder to get approved for disability benefits. Because of that it is recommended to gather and provide as much medical paperwork and evidence of your disability as possible with your initial claim to prove that your disability will make it impossible for you to work full time.
Denied SSI, But Approved For SSDI, And Vice Versa
The Social Security benefits process can be complex, especially when it comes to understanding why you might be denied for one program but approved for another. Below are the reasons you may be denied benefits for one program, but approved for the other.
Denied SSDI, But Approved for SSI
SSDI eligibility primarily depends on your work history and the number of work credits you have accumulated over your career.
The SSA requires you to have paid sufficient payroll taxes, essentially treating them as insurance premiums for SSDI.
You also need sufficient work credits to qualify for SSDI, which is based on age. If your disability occurred after you stopped accumulating these work credits, you might be denied SSDI but still qualify for SSI.
SSI, on the other hand, is a need-based program that doesn't require a specific work history. Instead, it focuses on your current income and resources.
If your income and assets fall below the set limits, you may qualify for SSI even if you don't have enough work credits for SSDI. Therefore, it is possible to be denied SSDI due to insufficient work credits while being approved for SSI because of financial need.
Denied SSI, But Approved for SSDI
On the other hand, you can be denied SSI but approved for SSDI. SSI has strict income and resource limits, and exceeding these limits can lead to a denial, regardless of the severity of your disability.
However, SSDI does not have such income restrictions. Instead, it focuses on your work history and medical condition. If you have enough work credits and a qualifying disability that prevents you from working, you can be approved for SSDI even if your income disqualifies you from receiving SSI.
Your work history and income levels play crucial roles in determining eligibility for SSDI and SSI. If you have an extensive work history and a severe disability, but your income is too high, you might be approved for SSDI but denied SSI. If you lack the necessary work credits but have limited income and resources, you could be denied SSDI but approved for SSI.
How To Avoid A Denied Disability Claim
Each claim for disability benefits brings different issues to the table, but there are a few common reasons why claims get denied by the SSA.
Meet the SSA's Criteria: Ensure your condition meets the SSA's definition of disability, which requires that your condition is severe enough to prevent you from working for at least 12 months or is expected to result in death.
Provide Detailed Medical Records: Collect all relevant medical records, including test results, treatment notes, and letters from healthcare providers that demonstrate the severity of your condition.
Complete All Sections: Ensure every section of the application is filled out accurately and completely. Be specific about how your disability affects your ability to perform daily activities and work-related tasks. Include information about your physical, mental, and sensory limitations.
Hire a Disability Lawyer: A disability lawyer can guide you through the application process, help gather evidence, and represent you in appeals if necessary. Their expertise can increase your chances of approval.
Know Work Credit and Income Limits: Ensure you have enough work credits for SSDI or meet the income limits for SSI. Keep records of your employment history and earnings to demonstrate your eligibility
By taking these steps, you can strengthen your application and improve your chances of receiving the disability benefits you need. For additional guidance, consider consulting resources from the SSA or seeking advice from a legal professional specializing in disability claims.
Connect With A Disability Attorney Today
Getting connected with a disability lawyer today can significantly increase your chances of getting approved for Social Security Disability benefits.
A disability lawyer can help you with the initial application process by ensuring that all required documentation and medical evidence is submitted accurately and on time.
They can also assist with developing a strong case that meets the SSA's criteria for disability.If your claim is denied, a lawyer will be crucial in navigating the appeals process, representing you at hearings, and maximizing your chances of success.
Additionally, a disability lawyer can help you understand your potential benefits, which could be up to $3,882 per month.
They will evaluate your case to determine how much you can potentially earn in disability income, providing you with the financial support you need. By having a disability lawyer by your side, you are more likely to secure the benefits you deserve.
