Top 5 Reasons Why Social Security Disability Insurance Benefit Applications are Rejected

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During the process of applying for Social Security Disability Insurance (“SSDI”), people tend to think of all of the reasons why they should be awarded benefits.  Perhaps you cannot work as a result of your injuries, or you were diagnosed with an illness that has rendered you unable to enjoy life as you did before becoming ill.  However, it may be helpful to consider why you may end up being denied benefits, which could end up happening for a myriad of reasons.  Overall, anticipating the potential weaknesses in your case may actually help you avoid denial since you will be prepared ahead of time to address the situation should it arise.  Accordingly, the following are the top 5 scenarios that give rise to a denial of SSDI benefits:

  1. Your income exceeds the SSA’s limits.  For people who have worked for the requisite period of time necessary to apply for benefits, they could end up being denied based upon their income.  In other words, despite claiming to be disabled, you may currently be earning above the monetary amount that is considered by the Social Security Administration as a “substantial gainful activity”, or SGA.  This means that you make too much money to qualify as disabled for purposes of obtaining benefits.   For more information on SGA, it is advised that you visit the SSA’s substantial gainful activity page.
  2. Your disability will not last long enough to qualify for SSDI.  To qualify for SSDI, your disability must be severe enough, meaning that it must last for a year or more.  For example, if you broke your leg and cannot work for a certain period of time, the SSA will likely deny your application under the assumption that your injuries will heal within a year or less.
  3. The SSA cannot reach you.   Believe it or not, SSA benefits are regularly denied to people due to the fact that they cannot be located or reached.  If you decide to move and have an SSDI application on file with the SSA, be sure to apprise them of your new address.  Also, return the SSA’s phone calls should they leave you a message.  These simple steps will maximize your chances of obtaining the benefits you deserve.
  4. You are uncooperative.  If you fail to provide the SSA with medical records or other crucial information, your application will be denied.  Moreover, the SSA will require you to be examined by of its doctors, and even on more than one occasion.  If the SSA requests that you meet with one of its examining physicians, always be compliant.  If not, your SSDI application will likely be denied.
  5. You fail to follow your doctor’s treatment plan.  In the event that you regularly miss your doctor appointments or do not take your doctor’s advice seriously, you may be denied SSDI benefits.  While there are certain valid exceptions to this rule, it is always recommended that you follow your treatment plan accordingly to avoid facing a denial of SSDI.

If you require assistance in applying for SSDI benefits or appealing a denial decision by the SSA, contact the Sanger Law Office at 785-979-4353.  We will take the time necessary to evaluate your case and advise you of all of your legal options.  We look forward to providing you with excellent legal representation.

 

Working & Collecting Social Security Disability Insurance Benefits

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Generally speaking, if you are working at the level of engaging in a “substantial gainful activity”, or SGA, you will likely be unable to receive Social Security Disability Insurance benefits (SSDI).  Hence, a person who is making more than a certain amount per month is considered to be engaging in SGA.  Specifically, SGA means is that in 2013, if you are earning more than $1,040 or $1,740 if you are blind, you will not be eligible to collect SSDI. 

It is important to understand that there are exceptions to the SGA.  For people who wish to return to work after being rendered disabled, the SSA offers a “trial work program”, or TWP.  Otherwise stated, the TWA allows a person to work without automatically losing their benefits.   To illustrate, a person who receives SSDI benefits may “test the waters” to see whether they can work and may do so for a nine month period, regardless of whether their earnings exceed the SSA’s allowable SGA amounts or not.  In 2013, a person who is working pursuant to the SSA’s TWP must earn more than $750 in one month for it to be considered a “trial month” under the program.  If you are a sole proprietor, you must work 80 hours or more in any one month for it be qualify under the TWP.

Once your nine-month trial period has ended, you may still receive SSDI benefits even if your income falls below the SGA’s allowable amounts.   Referred to as the “extended period of eligibility”, this lasts for 36 months after your completion of work during the nine-month TWP period.  Keep in mind that if your earnings exceed $1,040 in a given month, you cannot collect SSDI during this time.

If your earnings are substantial, resulting in the termination of your benefits, you may have them reinstated within a five-year period should you be unable to work due to your disability.  This is commonly known as “expedited reinstatement”.  During these five years, you will not be required to reapply for SSDI benefits.

If you lose your job during the TWP, your SSDI benefits will not be affected however, if this occurs during the 36-month extended period of eligibility, you will need to contact the SSA to reinstate your benefits.

For more information on your ability to work while collected SSDI benefits, contact the Sanger Law Office at 785-979-4353.  We will take the time necessary to evaluate your case and advise you of all of your legal options.  We look forward to providing you with excellent legal representation.

The Top Ways in Which Your SSDI Benefits May be Terminated

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In most cases, people who are approved for Social Security Disability Insurance (SSDI) receive benefit checks for many years to come.  However, there are certain things that may cause a person’s benefits to be terminated.  In the event that you are applying for benefits or currently receive them, it is important to understand the ways in which you could lose your benefits so as to prevent this from happening to you.  The top reasons why most people’s benefits suddenly stop are as follows:

  1. Your symptoms dramatically improve.  If the symptoms that rendered you disabled substantially improve, your SSDI benefits may be terminated.  Periodically, the Social Security Administration (SSA) reviews the current status of its benefit recipients’ cases to determine whether they are still disabled to the point where ongoing benefits are necessary.  Known as “continuing benefits reviews”, these are considerably less strict then the SSA’s initial SSDI application review however, they nonetheless may end up terminating your benefits.  The good news is that most SSDI beneficiaries continue to receive benefits following this review.
  2. 2.      You returned to work.  If you go back to work while still collecting benefits, the SSA will review whether you are engaging in a “substantial gainful activity.” Also known as SGA, if someone is currently earning more than $1,040 (for blind people the amount is slightly higher at $1,740), you could be denied ongoing benefits.  There are a number of exceptions to this rule, including the SSA’s “trial work program”, which allows a person to work without automatically losing their benefits.  Otherwise stated, the SSA offers the person a trial period by which they can return to work, continue to collect SSDI, and determine whether they are capable of handling their job on a long term basis.  
  3. 3.      You reach retirement age.  No person can receive both SSDI and retirement benefits at the same time.  Hence, when you reach retirement age, your SSDI benefits will end.  Visit the SSA’s retirement age calculator for more information. 
  4. 4.      You have been imprisoned or institutionalized. While this depends upon the circumstances, if you are convicted of a crime or institutionalized for a certain period of time, your benefits will temporarily cease.  However, certain crimes may be egregious enough that the SSA will permanently terminate one’s SSDI benefits. 

If you require assistance in applying for SSDI benefits or appealing a termination decision by the SSA, contact the Sanger Law Office at 785-979-4353.  We will take the time necessary to evaluate your case and advise you of all of your legal options.  We look forward to providing you with excellent legal representation.

 

The Five Levels of SSDI Application Denial Appeals

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If your Social Security Disability Insurance benefit (SSDI) application is denied, there are a number of instructions that you will need to follow which are included in your notice of denial letter.  As the Social Security Administration’s (SSA) letter indicates, the first step you can take once your application is denied is to file a Request for Reconsideration.  Should this request fail, there are additional measures you can pursue in order to challenge the SSA’s denial decision.  These measures are as follows:

  1. Request for Reconsideration of Initial Claim.  As mentioned above, this is the first step that an applicant can take to challenge a denial of his or her SSDI application.  A reconsideration request is actually a complete review of one’s case, which is completed by a medical consultant and SSA claims examiner. Keep in mind that this process is completed at the Disability Determination Services (DDS) level by parties who were not involved in the review of your initial claim.  Overall, about 5% of applications are approved by the DDS when reconsidering claims.
  2. Request for Reconsideration of Ongoing Benefits.   In the event that your application is approved, the SSA periodically reviews current cases in what is known as a continuing disability review (CDR).  A SSDI recipient’s benefits may be terminated should their condition substantially approve or if they fail to cooperate with the SSA during its CDR process.
  3. Administrative Law Judge (ALJ).  Should your Request for Reconsideration be denied and you wish to pursue your case further, you must request a hearing by an ALJ within 60 days after you receive your notice of denial letter.  An ALJ is a lawyer who works for the SSA’s Office of Hearings and Appeals.  On average, about 67% of appeals are approved after being reviewed by an ALJ.
  4. SSA Appeals Council.  Should your case be denied by an ALJ during your administrative hearing, the SSA’s Appeals Council may review your case however, said decision is subject to their discretion.  The Appeals Council typically examines whether a case was denied in error by the ALJ.  Unfortunately, only about 5% of cases are approved by the Appeals Council should they choose to examine your case.
  5. Federal Court Review.   If your case is denied by the Appeals Council, your final option is to file a claim with the federal district court in your jurisdiction.  District court judges review benefit denial cases for legal errors, but may also rule on factual questions as well.   Unfortunately, only 1% of cases prevail at this level.

If you require assistance in applying for SSDI benefits or appealing a denial decision by the SSA, contact the Sanger Law Office at 785-979-4353.  We will take the time necessary to evaluate your case and advise you of all of your legal options.  Don’t wait until it is too late to obtain the benefits you deserve.