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SSI and SSDI - Medical Disability Denials

Many claimants are denied Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). In fact, it is estimated that up to 70% of claimants are denied at the application level. This seems like a staggering number of denials but many claimants are denied because they fail to meet the most basic requirements for SSI or SSDI.

If your application has been reviewed and you have met the non-medical requirements for SSI or SSDI it will be sent to the appropriate Disability Determination Services Office for review. At this point the DDS will request your medical records and begin to evaluate the severity of your condition.

Why was my SSDI or SSI claim denied if I cannot work?

There are several reasons your SSI or SSDI application may be denied by the Disability Determination Services Office: the condition is not expected to last for 12 continuous months or the SSA determines you are not disabled and although you may not be able to continue to work your previous job, the Social Security Administration has decided you can retrain for new work.

Unlike most non-medical denials, a medical denial can be challenged. If you are denied for one of the medical reasons outlined above you can file a reconsideration (the first level of appeals in the SSA disability process in most states).

The reconsideration must be filed within 60 days from the date of the SSA disability denial letter. You can either file the letter yourself or you can contact a disability lawyer who can complete the reconsideration paperwork for you.

Why were you denied SSI or SSDI ?

There are many times when this may have already been determined at the local SSA office prior to your application being sent to the DDS (for instance if the applicant filed for disability because they were pregnant) but, under some conditions, the SSA may not know whether or not your condition is expected to last for 12 continuous months until they review your medical records.

Luckily, many disability applicants will be able to either consult with a disability lawyer or get better medical care and medical evidence to challenge the SSA decision that their condition is not severe enough to last for 12 continuous months.

The most common reason that disability applicants are denied SSI or SSDI benefits is because the SSA claims they are not disabled, and they either can continue to work their current job at a substantial level or they can retrain for new work.

If you have waited weeks for your disability decision and the SSA denied you benefits you may be very discouraged. The good news is that if the SSA claims you are not disabled this can be challenged within 60 days from the date of the disability denial letter.

Many claimants who are denied SSI or SSDI the first time they apply may be able to win benefits through the SSA disability appeals process. The first step is to talk to a disability lawyer and make sure you understand why you were denied. Some disability claimants can also fight the denial on their own, but this is only recommended if you have the time to review your medical files and find out what other types of medical evidence you will need to prove that you cannot work.
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