In this guide, we'll detail the frequent causes for denial of Social Security Administration (SSA) disability claims and provide guidance on how to increase your chances of receiving SSDI or SSI benefits if denied.
We will also discuss what steps you can take if your claim has been denied and how to increase your chances of getting approved for SSDI or SSI benefits.
Table of Contents:
- Understanding Denied Disability Claims
- Reasons for Denial of Disability Claims
- Appeal Process After Denial of Disability Claim
- Resources for Denied Disability Claimants
- Why do so many people get denied disability?
- What disqualifies a person from disability?
- What is the most commonly overlooked disability?
- Is it normal to be denied disability first time?
Understanding Denied Disability Claims
If your disability claim has been denied, you may be feeling overwhelmed by the process of appealing the decision. Examining the explanation for the denial of your claim is a necessary first step in understanding why it was not approved.
The letter from the Social Security Administration (SSA) that includes your denied disability status should detail which medical records were looked at and what criteria weren't satisfied for your claim to gain approval.
In some cases, additional evidence may need to be provided in order for an appeal to be successful.
When appealing a denied disability claim, it’s important to provide as much detail as possible about how your disabling condition affects your ability to work or perform daily activities.
Medical records from doctors who have treated you should also accompany any appeals filed with the Social Security Administration (SSA). This information helps demonstrate that all relevant facts related to a claimant’s medical condition were considered during initial review of their case.
Even if all the required paperwork is submitted with an appeal, there is no guarantee that a disability benefit will be granted after reconsideration or administrative hearing stages are completed.
The Social Security Administration (SSA) takes into account various factors such as taxes paid through payroll deductions while working and prior employment history to make their determination.
Give comprehensive particulars about how your medical conditions affect your capability to work or do daily tasks in order to boost the possibility of being approved.
Keep track of deadlines associated with filing appeals so you don't miss out on potential payments.
Reasons for Denial of Disability Claims
Denied benefits are a common occurrence, but the reasons for denial can vary. Grasping why your claim was rejected is essential to successfully contest a refused application.
Denial of disability claims typically transpires due to the absence of medical substantiation.
- To be eligible for SSDI or SSI, you must have an impairment that has lasted or is expected to last at least one year and affects your capacity to work.
Your doctor must provide sufficient medical records detailing your impairment and its impact on your ability to work. If there isn’t enough evidence in your medical records, then your claim may be denied due to insufficient documentation.
- Claims for disability can be refused if the petitioner does not satisfy standards set by the Social Security Administration, including work history under Social Security taxes and income levels needed to qualify for SSI. This includes having worked long enough and recently enough under Social Security taxes as well as meeting income requirements for SSI benefits.
If the criteria are not fulfilled, then a denial of your application may be issued by the SSA even if there is adequate medical evidence to demonstrate an inability to work due to an ailment or injury.
- Accurately and completely fill out all forms is critical for a swift and successful processing of your application.
Any inaccuracies or omissions may result in an immediate denial of benefits, so make sure to double-check everything before submitting it. Before submitting to the SSA, review your application thoroughly for accuracy.
- Applicants should make sure they include all necessary documents such as proof of identity, birth certificate copies or other official documents requested when filing their initial applications in order to avoid being denied due to something being left out accidentally during the submission process.
Taking time up front can save time later on if appeals need to be made due to improper denials.
Next, we will look at how you can navigate the appeals process after being denied benefits.
Appeal Process After Denial of Disability Claim
A claimant may challenge a denied disability claim by submitting an appeal. It's important to understand that filing an appeal does not guarantee success, but it does give you another opportunity to present your case and have it reconsidered by a higher authority.
This process involves submitting additional medical evidence and other documents related to your condition. The SSA will assess the data presented and decide if they should grant your request.
If the SSA denies your request for reconsideration, you can then proceed with filing an administrative law judge hearing request. After the SSA denies your request for reconsideration, you can then appeal to an administrative law judge who will hear both sides' arguments and consider your medical history and current condition in order to make a final determination of eligibility.
At the administrative law judge hearing, you may be interrogated concerning your medical background and current condition to decide if you meet all qualifications for getting disability benefits.
In some cases, claimants may also choose to pursue further appeals through federal court proceedings after being denied at both the reconsideration level and during their hearing before an administrative law judge.
This option is often used when there are disagreements over legal issues or interpretation of facts surrounding a particular case that cannot be resolved by either party alone or through mediation between them.
It is important to note that each step in appealing a denied disability claim requires specific forms as well as supporting documentation such as doctor’s notes or test results proving impairment due to illness or injury.
It is wise for claimants seeking approval of their claims to use every resource available including professional advice from lawyers specializing in social security disability cases if needed while navigating these complex processes.
Resources for Denied Disability Claimants
For those whose disability claims have been denied, there are many resources available to assist them with the appeals process, such as free legal advice from organizations like NDRN and a helpline provided by Social Security Administration.
NDRN, a legal aid, offers no-cost guidance and backing for appeals to those whose disability claim has been denied.
The Social Security Administration also offers a toll-free helpline for those needing information about their disability claims. The ABA Pro Bono Program furnishes access to lawyers with knowledge in disability law who provide their services without charge.
Various online outlets are available to provide assistance and direction for people whose requests have been refused. The Social Security Denial Guide is an online resource developed by NDRN that helps individuals understand why their application was rejected and how they can appeal it successfully.
BenefitsCheckUp® is a website that furnishes comprehensive data about government benefit programs, including the eligibility criteria and process for obtaining Social Security Disability Insurance (SSDI).
Veterans may be able to access additional aid through the Veterans Affairs (VA) offices or local VA medical centers, which often provide specialized services for those with disabilities including vocational rehabilitation and financial counseling.
These facilities often offer specialized services for veterans with disabilities including vocational rehabilitation services and financial counseling.
Medicaid offers coverage for people who meet certain income guidelines; however this program does not cover all types of disabilities so it’s important to research your state’s specific rules before applying for coverage under this program.
Why do so many people get denied disability?
Many people are denied SSDI due to insufficient medical evidence or a lack of documentation. Sometimes, the individual may not have had enough data to demonstrate their impairment and how it limits their occupation. Other times, the application was incomplete or incorrect in some way.
What disqualifies a person from disability?
To qualify for disability benefits, the SSA requires an individual to have a physical or mental impairment that has lasted or is expected to last at least one year and be unable to engage in any substantial gainful activity despite adjusting job duties.
The impairment must be so severe that it prevents the individual from engaging in any kind of work and they cannot modify their job to fit within their restrictions. Finally, medical evidence such as doctor’s notes and lab tests are required in order for an individual's claim for disability benefits to be approved.
What is the most commonly overlooked disability?
The most commonly overlooked disability is a hidden one - invisible disabilities. These are physical, mental or emotional impairments that may not be immediately obvious to others but can have significant impacts on day-to-day life. Examples may include physical, psychological or emotional issues such as aches, exhaustion, gloom and apprehension. People with invisible disabilities often find it difficult to get the assistance they require due to their symptoms being misunderstood or overlooked.
Is it normal to be denied disability first time?
No, it is not normal to be denied disability benefits the first time. In fact, the majority of applicants are approved on their initial application. Though the majority of applicants are accepted on their first attempt, some may be refused due to missing documents or inadequate medical proof. If a claim is denied, it is beneficial to appeal and supply additional evidence for increased chances of approval.
Navigating the disability claim rejection can be tough, but help is available.
If you have been denied disability benefits, it is important to understand the reasons why and explore your options for appealing the decision. With knowledge of the appeals process and access to helpful resources, you may be able to successfully overturn your denial and receive much-needed financial assistance from Social Security Disability Insurance (SSDI).
When your disability check isn't enough to live on, you may have additional options at your disposal. For example, you may qualify for extra help in specific areas such as health care costs, food, and housing. Different federal, state, and local programs may be available.How do you respond to a disability denial? ›
If your Voluntary Plan (VP) denies you benefits and you disagree, you have the right to appeal the decision and have a hearing before an impartial Administrative Law Judge. To file an appeal, send us a detailed letter stating why you think you are eligible. Be sure to include your: Full printed name.What happens if you get denied twice for disability? ›
There is further action you can take even after your application has effectively been denied twice. After denial upon reconsideration appeal, you can file a second appeal. The second appeal is a request for a disability hearing in front of an administrative law judge, or ALJ.Why does disability keep denying me? ›
Here are some common leading reasons claims are often denied: Lack of medical evidence. Prior denials. Too much earnings.How do you survive financially while waiting for disability? ›
- Apply for TANF. While waiting for disability checks to arrive, applying for Temporary Assistance for Needy Families (TANF) is an excellent way to generate cash. ...
- The Supplemental Nutrition Assistance Program (SNAP) ...
- Other Sources. ...
- Charities. ...
- Health Insurance.
To acquire the full amount, you need to maximize your working life and begin collecting your check until age 70. Another way to maximize your check is by asking for a raise every two or three years. Moving companies throughout your career is another way to prove your worth, and generate more money.What is the most approved disability? ›
What Is the Most Approved Disability? Arthritis and other musculoskeletal system disabilities make up the most commonly approved conditions for social security disability benefits. This is because arthritis is so common. In the United States, over 58 million people suffer from arthritis.What are the 5 steps of disability determination? ›
- Step 1: Financial Eligibility. ...
- Step 2: Severe Impairment. ...
- Step 3: Impairment Criteria. ...
- Step 4: Previous Employment. ...
- Step 5: Work Capacity.
Disability Law: Do I Have to Disclose My Disability to an Employer? The short answer is no. You are not legally required to mention your disability while you're being considered for a job. You do not need to disclose your disability on your resume, cover letter, or other application materials, or during your interview.Is it better to appeal or reapply for disability? ›
It is almost always better to appeal your disability decision rather than send in a new application. Appeals are easier for you and often result in a faster decision from the Social Security Administration than a brand new application will. Following are a few more benefits to appealing a denial: Increased acceptance.
According to information provided by the Social Security Administration (SSA), 53% of Social Security Disability applicants receive a denial of benefits based on their first application. Based on this information, that means that 47% are approved for benefits the first time they apply.What are the odds of getting approved for disability the second time? ›
On average, the chance of approval at the Reconsideration level is only 13 percent. This means that only in 13 percent of the cases that are originally denied, DDS reverses the denial into an approval. The rest are denied a second time.What is the hardest state to get disability? ›
- Utah — 47% approval rate.
- Connecticut — 47% approval rate.
- Colorado — 47% approval rate.
- Rhode Island — 47% approval rate.
- Virginia — 48% approval rate.
- Minnesota — 49% approval rate.
- Illinois — 49% approval rate.
- Washington — 49% approval rate.
Lack of technical compliance. Failing to provide required health information to the Social Security Administration, or failing to follow a doctor's prescribed treatment program, may lead to disqualification for SSDI. Disability sustained by substance abuse.At what age is it easiest to get disability? ›
The older you are, the easier it can be to get disability benefits under Social Security disability rules after age 55. But it may still require diligent professional assistance.How much money can I have in the bank if I'm on disability? ›
SSA limits the value of resources you own to no more than $2,000. The resource limit for a couple is only slightly more at $3,000. Resources are any assets that can be converted into cash, including bank accounts.How much monthly income would you have available if disabled? ›
SSDI payments range on average between $800 and $1,800 per month.Can you collect Social Security while waiting for disability? ›
Receiving Reduced Retirement Benefits While Waiting For Your Disability Decision. Because of your age, you are eligible for Social Security retirement benefits while we process your application for disability.What is the secret bonus for Social Security? ›
What Is the Social Security Bonus? There is no specific “bonus” retirees can collect from the Social Security Administration. For example, you're not eligible to get a $5,000 bonus check on top of your regular benefits just because you worked in a specific career. Social Security doesn't randomly award money to people.Who gets the $1657 from Social Security? ›
To receive SSI, one must meet two eligibility requirements. One must either be over the age of sixty-five, blind and/or disabled. Additionally, they must have a limited income and resources as the program is need-based and aims to assist beneficiaries to cover basic costs for food and shelter.
You must have worked and paid Social Security taxes in five of the last 10 years. If you also get a pension from a job where you didn't pay Social Security taxes (e.g., a civil service or teacher's pension), your Social Security benefit might be reduced.What gives 100% disability? ›
A 100% VA Disability Rating can be given for a single severe condition or for a group of conditions whose ratings can be combined using VA Math to equal 100%. A 100% VA Disability Rating is commonly given to veterans who have two or more limbs paralyzed or amputated, or for active diseases, like tuberculosis or cancer.What is the number 1 disability in the world? ›
Arthritis and Other Musculoskeletal Disorders. According to the Mayo Clinic, arthritis is inflammation and tenderness in one or more joints. Symptoms include stiffness, pain, swelling, and a lower range of motion. The CDC reports that arthritis is the most common cause of disability for U.S. adults.What is considered to be a permanent disability? ›
Permanent disability (PD) is any lasting disability from your work injury or illness that affects your ability to earn a living. If your injury or illness results in PD you are entitled to PD benefits, even if you are able to go back to work.What not to say in a disability interview? ›
- No one will hire me; I can't find work. ...
- I am not under medical treatment for my disability. ...
- I have a history of drug abuse or criminal activity. ...
- I do household chores and go for walks. ...
- My pain is severe and unbearable. ...
- Legal Guidance When SSDI Benefits Are Denied.
Like stated above, a fully favorable decision essentially means the judge agreed with the disability onset date that is laid out in the application by the individual – the alleged onset date. The judge has the authority to agree or disagree with the alleged onset date.What if I can't physically do my job anymore? ›
You may qualify for Social Security disability if you can't work any full-time job on a regular basis. If you don't have a medical condition that qualifies you for immediate approval of disability benefits (called a "listing"), you'll need to prove that you can't work anymore.Is anxiety considered a disability? ›
Yes, the Social Security Administration (SSA) considers anxiety as a disability. However, people with anxiety may find it challenging to prove that their condition qualifies them for monthly disability benefits.What is a common question about disability? ›
What problems do people with disabilities face in your country? Do you think it would be harder to live with a physical disability or an intellectual disability? Do you always try to help people who are disabled? Do you tend to think that disabled people always need your help?How do you answer Question 6 on a function report? ›
Question 6 of the SSD Function Report can be tricky. It asks you to describe what you do from the time you wake up until you go to bed at night. Most people with disabilities have “good days” and “bad days”. Make sure you clearly identify and describe what you do on a good day and on a bad day.
The answer to the question, “How many times can you get denied for disability?” is there is not a limit established by the SSA for the number of times an applicant can submit a disability claim.Can you reapply for SSDI after being denied? ›
Answer: Yes, you can reapply for disability benefits from Social Security by filing a new claim. You can also request that your original claim be reopened when you file the new claim.Is reconsideration good for disability? ›
You are much more likely to be approved for benefits if you keep fighting through the appeals process than if you keep filing new applications with the same information. If nothing has changed in your application, there's a strong chance the decision will stay the same, too.What disabilities are hard to prove? ›
Mental disorders such as depression, anxiety and post-traumatic stress disorder are qualifying disabilities that are difficult to prove. Having a long history of medical treatments and contact with a mental health practitioner can improve your case.Do SSDI denials come faster than approvals? ›
SSDI denials do not come faster than approvals. In most cases, SSDI denials do not come faster than SSDI approvals. When you apply for Social Security Disability Insurance (SSDI) benefits, your application goes through a specific process.What does denied disability mean? ›
Insufficient Medical Evidence
A common reason SSDI claims are denied is that the SSA disagrees that an applicant meets its disability criteria. This is usually because the application lacks adequate medical evidence supporting the person's claim they are disabled and unable to work.
Whether you are disabled by a single impairment or a combination of serious medical conditions, approval for disability benefits is the same. Likewise, the dollar amount of your monthly benefit payment remains the same no matter how many disabling conditions may qualify you for SSDI and/or SSI.What is the step 3 of SSDI reconsideration? ›
Step 3: A medical screen to allow applicants who are the most severely disabled. Medical evidence on an applicant's impairment is assessed under step 3 using codified clinical criteria called the Listing of Impairments, which includes over 100 impairments.What does pending processing mean for disability? ›
If you have a Pending status for any weeks on your UI OnlineSM Claim History, we may need to determine your eligibility or verify your identify. If we need to verify your identity, you'll receive a notice to provide additional documentation. For more information, visit Respond to Your Request for Identity Verification.What state pays the most disability? ›
|Rank||State||Average SSI benefit|
|1||District of Columbia||$606.08|
Massachusetts – This state topped their list with the second-best livability score and fourth-best health care score. Though 10th on the list for walkability and public transit, 98.3% of residents with a disability have health insurance.Why do I keep getting denied disability? ›
Here are some common leading reasons claims are often denied: Lack of medical evidence. Prior denials. Too much earnings.What is the easiest disability to get SSI for? ›
Arthritis and other musculoskeletal system disabilities make up the most commonly approved conditions for social security disability benefits. This is because arthritis is so common.How do I get SSI after being denied? ›
Go to www.ssa.gov/benefits/disability/appeal.htmlwww.ssa.gov/apply/appeal-application-decision/request-review-hearing-decision to complete an online request for Appeals Council review. You (or your representative) must ask for an Appeals Council review within 60 days after you get the hearing decision.What is the 55 rule for disability? ›
Once you turn 55, you are typically "protected" and will no longer have to attend an exam to prove that your condition has not changed unless there is reason to suspect fraud. This is sometimes called the 55-year rule.Can you be denied disability because of your age? ›
In fact, age may be the reason a disability claim is approved or denied. The Social Security Administration utilizes "Medical-Vocational Guidelines"—also called "the grids"—to determine how someone's age factors into their disability.What is the 55 rule for SSDI? ›
If you are age 55 or older and have become disabled, your chance of being awarded Social Security disability benefits is higher than someone below age 55. If you are over 55 and can no longer do sedentary work, you must be able to transition to "skilled" labor to be considered not disabled.What is unnecessary disability? ›
This definition includes loss of full capacity to an employee's dependent, because a dependent's medical problems can affect an employee's productivity as well.How much disability is enough? ›
Your disability benefit should be about 60% of your gross pay, which usually equals your take-home paycheck. For that level of coverage, you can expect to pay between 1% and 3% of your annual salary in premiums, though the actual amount will vary based on how much coverage you buy.What is the average amount a person gets on disability? ›
Living and surviving on only SSDI is possible. However, making ends meet with disability benefits alone can be a challenge. It's important to know how to make the most of your benefits and consider other income or benefit sources. Budgeting and minimizing your monthly costs can make it easier to live on SSDI alone.What is the most commonly overlooked disability? ›
- Psychiatric Disabilities—Examples include major depression, bipolar disorder, schizophrenia and anxiety disorders, post-traumatic stress disorder, etc.
- Traumatic Brain Injury.
- Chronic Fatigue Syndrome.
- Cystic Fibrosis.
Arthritis and other musculoskeletal disabilities are the most commonly approved conditions for disability benefits. If you are unable to walk due to arthritis, or unable to perform dexterous movements like typing or writing, you will qualify.How hard is it to get 100% disability? ›
As you might expect, it is difficult to obtain a 100% VA disability rating with just one service-connected disability. Most veterans who receive a 100% rating have two or more disabling conditions. Often, these conditions have a secondary service connection.What does 80% disability get you? ›
What Benefits Can I Expect Based on My Rating? According to the VA's 2022 disability compensation rates, if you have an 80% rating you will receive $1,778.43 per month if you have no dependents. However, with a 100% disability rating that number can increase to $3,332.06 per month.How much will disability checks be in 2023? ›
The monthly maximum SSI Federal Payments amounts for 2023: $914 for an eligible individual. $1,371 for an eligible individual with an eligible spouse. $458 for an essential person.Can you get disability for anxiety? ›
Yes, the Social Security Administration (SSA) considers anxiety as a disability. However, people with anxiety may find it challenging to prove that their condition qualifies them for monthly disability benefits.How much money can you have in the bank on Social Security disability? ›
The SSDI program does not limit how much money you can have in the bank because there are no resource limits as you find with SSI.Which state has the best disability benefits? ›
Massachusetts – This state topped their list with the second-best livability score and fourth-best health care score. Though 10th on the list for walkability and public transit, 98.3% of residents with a disability have health insurance.