I was denied SSDI disability benefits, what are my rights?This is a great question that most claimants do not think to ask. Up to 70% of claimants are denied at the initial disability application level, leaving many of them with the same questions: why was I denied disability benefits and what are my rights?
I am always amazed at the number of claimants who are denied and keep applying over and over again without understanding: 1) what does the Social Security Administration (SSA) need to find them disabled; 2) why they were denied; and 3) what are their rights to fight the disability denial. We will look at each of these questions individually.
How does the SSA find you disabled?
This is the MOST important question and probably the least understood. Many claimants apply multiple times and will never be considered disabled because they do not meet the criteria established by the SSA.
For instance, to qualify for Social Security Disability Insurance (SSDI) you must be determined disabled with a severe health condition that is expected to last for 12 continuous months and does not allow you to work at a substantial level. You must also have worked and paid into the SSA system and earned what the SSA calls work credits.
What if you have a short-term condition? What if you do not have enough work credits? What if your condition is not severe? What if you can still work part-time? What if you cannot do your current job but you can be retrain for new work?
These are all great questions, but if your conditions are not going to last 12 continuous months, you will be denied. If you have not worked and paid enough taxes, you will be denied. If your condition is not severe, you will be denied. If you can work at what the SSA considers a substantial level (making more than $1,000 per month in 2011), even if it is part-time, you will be denied. If you can retrain for any new work and work at a substantial level, you will be denied. So that leads us to our next two questions.
Understanding why you were denied and Fighting the SSDI Denial
First you have to know why you were denied and the reason should be clearly stated on your denial letter which the SSA sent to you. If you have questions about the reason you can contact the SSA at 1-800-772-1213.
Your rights after your denial will depend on why you were denied. For instance, if you do not have enough work credits for SSDI, unless you think the SSA made a calculation mistake, you do not have much of a reason to appeal.
If you are working and making too much money, you will always be denied because the very definition of disabled, according to the SSA, is that you would not be able to work. The assumption is if you can perform substantial gainful activity then you are not disabled. The SSA does not even pull your medical files and review your conditions if you are working too much.
So now we come to the denials that you may be able to challenge with some success: your condition is not severe, it is not expected to last 12 continuous months, or the SSA thinks you can do other work.
Each of these denials can be readily challenged with the right type of medical proof. Maybe the Social Security Administration was unable to locate enough medical evidence to support your claim of disability, maybe your medical records were not legible, maybe you simply need to go see the appropriate doctors. The bottom line- you need to get better medical information to prove that you cannot work.
If you have been denied and you want to challenge your denial, you will have 60 days from the date of the denial letter. You will need to file a Reconsideration, which is the first step in the disability appeal process in most states. A Request for Reconsideration can be completed by filling out form (SSA-561) and sending it to the SSA or contacting a disability lawyer for more information.