Why do the people who need help not get it, but those who don’t need it get it so easily?
Every day on our disability forum there are questions from claimants who are severely disabled, who cannot work but who continue to get denied Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) while other claimants who may seem less sick fly right through the system without a hiccup. This observation often leads to the question, “Why does it seem like the disability process is so unfair?”
On past forums we have addressed why claimants often get denied: they do not have enough work credits for SSDI, their resource and income levels are too high for SSI (Supplemental Security Income) , their condition is not expected to last for 12 continuous months, or the SSA determines they can work.
These are all common denial; denials that are generally easy to understand. This blog will discuss something that is not often addressed- the inequity that really does exist in the SSA disability determination process.
What is the greatest impediment to getting SSDI or SSI (Supplemental Security Income) benefits?
One of the main reasons that many claimants are denied SSI (Supplemental Security Income) or SSDI benefits is because they do not have adequate medical records to prove that they are disabled and unable to work. Getting great medical care costs money. Even if you have great insurance you will need the funds to pay large deductibles and co-payments. The costs to see a doctor or to get necessary surgery can be so high for claimants without medical insurance that it is cost prohibitive.
Without addressing the inequalities of the medical system or whether or not Obama Care is the solution it is necessary to state the harsh reality of winning SSDI or SSI: it will almost be impossible to win if you have not seen a doctor, you do not have a diagnosis and you do not have sufficient medical proof that you cannot work.
Why do some claimants get SSI or SSDI disability so easily?
So, let’s address the question from the forum, “Why do some claimants who do not seem disabled get benefits while those who are severely disabled cannot?” Unless there is fraud (claimants claiming they are disabled and “fooling” the system) the main reason I believe that many claimants get SSI (Supplemental Security Income) or SSDI so easily is because they understand the disability process and they have gone to the right doctors.
Other claimants who do not have insurance or who do not understand the system may never get approved. Consider the homeless claimant who has a severe, mental health disorder. What is the chance that they will be able to get a proper diagnosis, take the proper medication and get good counseling? What is the chance that they are going to be able to accumulate enough medical proof to prove to the SSA that they cannot work? This person may be the person in the need of the most help, but they find they are unable to get it.
Yes, the system is not fair. Most people readily agree on this point. If you are severely disabled and you cannot work, you will have to figure out how the system works and make sure you get the medical information you need to win SSI or SSDI benefits. If you don’t you could be like millions of other claimants who are never approved.
- SSDI and SSI: How many times can I apply for benefits? (disabilitybenefitshome.com)
- SSI and SSDI – Nonmedical Disability Denials (disabilitybenefitshome.com)
- SSI and SSDI – Medical Disability Denials (disabilitybenefitshome.com)