Unlike most Workers’ Compensation systems where many, if not most, claims are processed and approved routinely, applications for Social Security Disability (SSD, SSDI or DI) are often denied. In fact, approximately 65% of those who file an initial application for disability benefits will have to appeal the Social Security Administration’s initial denial. The reasons for Social Security denials are numerous and a denial does not mean that your condition isn’t serious. Rather, your denial could be due to insufficient evidence or other technical grounds. Working with an experienced Rogers disability attorney can help you appeal the unfavorable initial determination by presenting your medical evidence in a straight-forward and understandable manner.
Why Was My SSD Claim for a Serious Medical Impairment Denied?
To understand the exact reason for your denial, you should review the Social Security denial letter that was sent by the Social Security Administration (SSA). Unfortunately these letters can often contain a great deal of technical terms and legal jargon. An experienced Fayetteville AR disability lawyer can explain the exact reasoning behind your denial and present the options that are likely to correct you unfavorable disability benefits determination.
While every benefits decision is the product of the unique factors and circumstances that are present, there are two basic reasons: failure to satisfy non-medical program requirements & failure to satisfy medical requirements. However, before we delve into some of the medical and non-medical reasons for your denial, there are two other important facts contained in your letter. First is the date of the letter. The date is in the upper right hand corner of your denial letter and signifies the beginning of your 60-day window to appeal. Second, the letter will explain how to appeal the decision made by the SSA.
Understanding Non-Medical Program Denials
Non-medical denials, or technical denials, are not concerned with your medical condition but rather your ability to satisfy the rules of the SSD program. There are many ways one may fail to satisfy the technical requirements of the SSD program, they can include:
- The impaired individual has not worked for a sufficient number of years and therefore has insufficient work credits.
- The applicant is still working.
- The applicant’s substantial gainful activity is too great.
- The last work performed occurred too recently
- There are jobs of sufficient number available in your region that you can perform despite your impairment.
It is clear that there are a broad array of technical reasons for your claim’s denial. The good news is that working with an experienced attorney who is familiar with the SSA’s rules and regulations can correct many of these technical problems.
What are Medical Reasons for a Denial?
At Step 2 of the SSA’s 5-Step Sequential evaluation process for adults, the agency will first inquire into your medical condition. At step 2 the inquiry is focused on whether your medical condition can be considered to be severe as per SSA definitions. In short, a condition is considered to be severe if it results in significant limitations in the things that you are able to do. A non-severe impairment is one that causes no, or a slight, limitation in the things that you are able to do.
If the SSA determines that your condition is not severe, you will not be able to obtain disability benefits through Social Security. The reasons for the SSA’s determination can include a lack of longitudinal medical evidence, presentation of only a diagnosis of a listed condition without more evidence, or a perceived failure to follow treatment instructions. Other misunderstands that lead to a denial can include when the individual making the claim determination considers the impairment or injury to be controlled by medication or therapy when it is not. An experienced Social Security attorney can also assist you in marshaling evidence and presenting it in a manner that tracks the Social Security Administration’s decision–making process.
What Do I Do After Receiving a SSD Denial Letter?
As previously discussed, first make note of your appeal deadline date. Then read the letter to understand your reason for denial. Key phrases that may explain why your claim was denied include:
- Non-severe impairment
- May perform past relevant work
- May perform other work
- Does not meet or medically equal an impairment
Once you understand the exact reason for your denial you can file for the first level of appeal which is known as Reconsideration. Approval of Reconsideration requests is extremely uncommon, so it is likely that you may need to request a disability hearing before an administrative law judge. When you work with Ken Kieklak you can rest assured that a thorough investigation will occur and a strategic approach will be developed. We can handle each and every step of your SSD appeal. To schedule your free and confidential SSD appeal consultation, contact us online or at (479) 316-0438.
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