Top Four Reasons You Won’t Get Social Security Disability Payments

The Social Security Administration (SSA) provides two programs to individuals who suffer from medical impairments that prohibit them from working for a living. Depending on your circumstances, you could qualify for Social Security Disability Insurance (SSDI) benefits or Supplemental Security Income (SSI). No matter which program you apply for, the application process often feels intimidating, if not impossible. This feeling exists because the application process is challenging. In fact, the majority of initial claims are denied.

Receiving notification that examiners have denied your claim for disability benefits is a crushing blow if you are in a desperate financial situation. Here you are with a serious illness or injury, and the federal government has the gall to deny you access to a fund you’ve already paint into? How can they get away with doing that? As it turns out, there are several reasons why investigators could choose to reject your application, and most of them are your entire fault. Our Philadelphia disability lawyers detail the problem areas they see most commonly and how to correct them – if that’s possible.

Social Security Disability benefits help millions of people. However, obtaining them is often frustrating and rarely easy. At Young, Marr, Mallis & Associates, our team of experienced attorneys and staff are dedicated to helping people get the benefits they deserve. To schedule a free appointment in Pennsylvania, call (215) 515-2954. If you live in New Jersey, contact our law offices at (609) 557-3081.

A High Percentage of Initial Social Security Disability Applications Are Denied

According to the Social Security Administration’s statistics, approximately 65% of disability applications are denied. While every case is unique, there are some common reasons why claims are denied. In some cases, a claimant might be able to address the problem. With the help of Pennsylvania disability lawyers, some of these issues could be avoided or appealed.

Ineligible Medical Impairment or Insufficient Medical Documentation

Doctors must expect an injury or illness to reduce your functional capacity significantly for at least 12 months for you to be eligible for disability benefits through the federal government. In many instances, injuries sustained through accidents are not serious enough to render you incapable of working for this length of time, which means you cannot get disability pay.

However, if you are suffering from a condition that limits your ability to work, medical records relating to your illness or injury are critical to obtain approval of your application. In many instances, your doctor’s treatment records are incomplete or you do not have a doctor currently providing care. If you refuse to cooperate with an independent medical examination as requested by Social Security Disability, your application will likely be denied.

When preparing your disability application, it is crucial to provide enough supporting medical evidence to sway the SSA’s decision in your favor. The SSA publishes a listing of eligible impairments that case specialists use to determine if an applicant has a qualifying medical condition. This publication, known as the “Blue Book,” is also available for treating physicians. Your doctor should provide medical evidence to demonstrate you meet the required criteria of a listed impairment. If your documentation does not show you suffer from a listed condition, your claim will likely be denied. Our Pennsylvania disability lawyers will make certain your medical history is as detailed as possible when compiling materials.

Failure to Follow Through with Prescribed Treatment

Following your doctor’s orders to achieve a maximum medical improvement is a must for the government to consider you disabled under the law. If you simply refuse to go through with therapy, take prescribed medication, or other doctor-recommended procedure, you can’t recover money for your health problems. Note that doctors must expect the prescribed treatment to restore your ability to perform substantial gainful activities – meaning your ability to work. There are exceptions made if you have significant mental disabilities, have a severe fear of surgery, or are financially incapable of paying for treatment. Our Bucks County disability attorneys can assist in exploring all available options before submitting your paperwork to the SSA.

Earning too Much Money or Having Too Many Assets

Income and resources could be a reason why your claim was denied. However, it does depend on the benefits program. SSDI is designed for disabled workers who have paid into the Social Security Fund through their payroll or self-employment taxes. Therefore, the SSA does not look at an applicant’s resources or assets. That does not mean that income does not factor into the SSA’s decision.

Having an income that exceeds the Social Security Administration’s threshold for disability benefits will disqualify you from eligibility. The ceiling for finances is not a high one, with those earning more than $1,310 per month (as of 2021) being ineligible. It is important to note that only working income counts towards this amount, not money obtained through investments. If you can continue working in spite of your physical condition, you should do so. Having a job that pays below the monthly SSDI income limit in Pennsylvania or NJ won’t disqualify you in the eyes of disability examiners.

SSI is a program intended for individuals with limited income and resources who have not paid into the Social Security Fund. The income threshold for SSI applicants is lower. If you earn more than $794 as an individual or $1.191 as a couple, you will not be eligible for SSI. Furthermore, the SSA will look at your resources and assets. For example, if your spouse owns substantial assets, you will probably not qualify for SSI. Resources and income included anything that could be used for food or shelter – even in-kind income. Fortunately, not all types of income and assets are counted. For example, your home is exempt. Additionally, certain unearned income is not counted, including tax refunds, Supplemental Nutrition Assistance Program (SNAP), and other welfare programs. Our knowledgeable Allentown disability attorneys will thoroughly review your income and assets to ensure they are being counted accurately.

You Have the Training of Experience to Work Another Job

The SSA will not only look at your medical records, it will also evaluate your work history. Before you are eligible for disability benefits, you will have to show that your experience and training are not applicable for other employment options.

For instance, suppose a construction worker falls from scaffolding and damages their spine. The accident paralyzes the worker from their waist down. Clearly, their condition prohibits working in the construction industry again. However, if the injured worker had previous experience working at a call center, the SSA could determine that they are capable of earning a living and deny disability benefits.

Appealing a Denied Social Security Disability Benefits Claim

As stated above, approximately 65% of initial disability claims are denied. If this happens, you have sixty days to file an appeal. There are four levels of appeal available. You contact our experienced West Chester disability lawyers if you need to appeal a denied claim.

Reconsideration

You can request that another case specialist reviews your initial application. This procedure allows a fresh set of eyes to review your medical documentation. More importantly, you are permitted to present additional evidence. If your medical documentation was insufficient the first time, now you have the opportunity to provide more supporting evidence.

Hearing Before an Administrative Law Judge

If you are unsatisfied with the decision after your claim has been reconsidered, you could request a hearing before an administrative law judge (ALJ). In addition to providing additional evidence, a hearing provides you the opportunity to clarify the documentation you supplied and offer expert medical testimony. The ALJ will ask you specific questions regarding your claim and condition. At this point, you do not want to exaggerate. Your goal is to connect the dots that might have been missed during the reconsideration phase.

Social Security Appeals Council

If you are still unsatisfied with the administrative law judge’s decision, you could request an appeal before the Social Security Appeals Council. At this point, the Council could determine in your favor, rule against you, or send your case back to the ALJ with additional instructions.

Federal Court Claim

If your denial still stands after the Social Security Appeals Council’s decision, your options are limited to filing a civil lawsuit in federal court. At this point, the chances of your claim being approved are very slim. If you want to pursue a federal claim, you need knowledgeable legal representation.

If Your Social Security Benefits Have Been Denied, Contact Our Pennsylvania Disability Lawyers for a Free Consultation

If you, or someone in your family, are suffering from a long-term injury or illness, we can help recover deserved disability benefits to ease any financial pains associated with the condition. Contact our Bensalem disability attorneys today for a free consultation. As always, if we cannot recover benefits on you or your loved one’s behalf, there’s no charge for our services. You can reach Young, Marr, Mallis & Associates in Pennsylvania at (215) 515-2954 and New Jersey at (609) 557-3081.