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SSDI denial- SSA doctor and my doctor disagreed whether I was disabled

Why did I get an SSDI denial?

It’s not unusual for a Social Security Disability Insurance (SSDI) applicant to receive and SSDI denial. In fact, up to 70% of initial applications are denied by the SSA. What does surprise some SSDI applicants is to get a SSDI denial after their doctor said they are disabled. Recently on our disability forum we had a user ask, “How can I be denied SSDI if my doctor and my workers’ compensation doctor state I am disabled but the SSA doctors said I was not?”

Why were you sent to the Consultative Examiner?

First, it’s important to understand that the only reasons you will be sent to a “SSA doctor” or Consultative Examiner is if the SSA does not have enough information from your treating doctor to determine you are disabled, if they have not received medical information from your doctor or they needed more information from a specialist.

So if you were sent to the C.E. there is a good chance that your own medical records were insufficient for the SSA to make a disability determination.

What do I do after a SSDI denial?

Assuming you received an SSDI denial only because your medical records were insufficient to prove you were disabled, then it is time to gather more medical information. This may mean you need to go see the doctor again, with a clearer understanding of the type of information the SSA needs to make their disability determination, or you may need to see a specialist for your condition.

The key going forward is to do enough research that you understand what it means to be disabled by the SSA. Many disability applicants receive a SSDI denial simply because they do not know what type of medical documentation they need to send to the SSA to prove they are disabled.

If you have received an SSDI denial you have 60 days from the date of the SSDI denial letter to file a reconsideration. This is the first step in the SSA disability appeals process.

Was the SSDI denial a non-medical denial?

Because I don’t have more information about this particular disability applicant it’s tough to know if they may have been denied for nonmedical reasons. For instance, maybe when they applied for SSDI they were not working but by the time their application was reviewed they had returned to work at a level that was deemed “substantial.” In this case their SSDI application would be denied regardless of the severity of their health condition. Make sure you understand why you were denied BEFORE you complete the appeal.

SSA disregarded my doctor’s opinion and gave me an SSDI denial

Whether it was the judge or the SSA who disregarded your doctor’s opinion it’s time to find out why. For instance, were they a medical doctor? Did you have enough medical evidence? Let’s take a look at what information you need and who you need to see.

To gather disability information it is important to see a professional medical doctor. From this doctor you will gather medical evidence which can include doctor’s notes, laboratory findings, X-rays, MRI, physical therapy notes, blood tests, etc. Some doctors will not be considered profession medical doctors. Make sure you see one of the following:

• licensed medical or osteopathic doctors
• licensed or certified psychologists
• qualified speech-language pathologists only for purposes of establishing speech or language impairments
• licensed optometrists only for purposes of establishing visual disorders (except in the U.S. Virgin Islands where licensed optometrists are acceptable medical sources only for the measurement of visual acuity and visual fields)
• licensed podiatrists only for purposes of establishing impairments of the foot

If you fail to see the appropriate doctor their opinion may not be considered as important as another doctor’s opinion.
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