Why was I denied disability benefits by the Social Security Administration?Up to 70% of claimants are denied at the initial disability application level, leaving many of them with the same question: Why was I denied disability benefits?
The answer can be complicated and it will depend on whether or not you have applied for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).
Denied for Social Security Disability Insurance Benefits
Working too much
You can be denied SSDI benefits if you are performing substantial gainful activity (SGA) or working at a level the Social Security Administration considers substantial. Claimants who are working and making too much money ($1640 for blind claimants and $1000 for non-blind claimants) will be denied SSDI benefits, regardless of the severity of their mental or physical health condition.
Keep in mind, work does not have to be for pay or profit and can include other substantial activities such as attending school, self-employment (even if you are not making money) and illegal activities.
Most claimants are denied because the SSA has determined that their condition is not severe enough to keep them from working at a substantial level.
Does this mean you are not sick? No, it could mean the Social Security Administration was unable to locate enough medical evidence to support your claim of disability, you did not see the appropriate doctors or your medical sources failed to send all of your medical records.
Many claimants are sick and very disabled and simply do not have the medical evidence to support their claim. Hire a disability lawyer who will send your primary doctor a residual functional capacity or RFC form to complete. RFC forms clearly document the types of tasks that you can and cannot perform given your current medical conditions.
The Mental or Physical Health condition is considered a Short-term condition
Many SSDI claimants are very sick right now, but their condition may not be expected to last for 12 continuous months. The SSA does not provide short-term or temporary disability benefits. If your condition is not expected to last for 12 continuous months, you will be denied SSDI benefits.
Lacking sufficient work credits to qualify for SSDI
Social Security Disability Insurance (SSDI) is only awarded to claimants who are considered disabled and who have worked long enough and paid enough employment taxes to be considered "insured". To determine if you are insured you can contact the SSA at 1-800-772-1213 or you can preview your most recent SSA statement of earnings.
Denied for Supplemental Security Income (SSI)
As mentioned above, the reasons that you may be denied SSDI benefits may be different than why you might be denied for SSI. SSI benefits, for example, have an additional non-medical criteria which requires claimants to have VERY limited income and resources. All the reasons you could be denied SSI benefits is listed below.
Non-medical criteria will differ for both the Supplemental Security Income (SSI) and the Social Security Disability Insurance (SSDI) program. The SSI program requires you to meet certain income and resource limits, in addition to meeting the disability criteria. If you do not meet the income and resource criteria you will be denied SSI benefits, regardless of whether you meet the other medical criteria (aged, blind or disabled).
In 2011, claimants may have $2000.00 in resources (i.e. cars, stocks, land, boats, and 401K balances) and married couples may have $3,000 in resources.
The SSA will determine you are disabled using the same criteria they use for Social Security Disability Insurance. You must have a severe mental or physical health condition which is so serious that it does not allow you to perform substantial work for at least 12 continuous months or is expected to result in your death.
Mental or Physical Health condition is considered a Short-term condition
As mentioned above, if your condition is not expected to last for at least 12 continuous months you will be denied SSI benefits, regardless of the severity of your current health condition.
Performing Substantial Gainful Activity
If you are working and making too much money, the SSA will deny Supplemental Security Income benefits. As mentioned above, work does not have to be full-time and you do not have to be realizing a profit.
The Social Security Administration will send you an acceptance or denial letter approximately 90 to 120 days after you have applied for either SSI or SSDI benefits. If you are accepted, the SSA will list your estimated payment date and the date your SSI or SSDI benefits will begin.
If you are denied SSI or SSDI benefits you have the right to appeal the denial within 60 days from the date of your SSD denial letter. To file an appeal you can either follow the instructions on the denial letter or you can contact a Social Security Disability lawyer.