If a person becomes ill, injured, or otherwise disabled, they may find it necessary to apply for their Social Security Disability Insurance or SSDI. During our employment, we are required to pay into the Social Security programs. This is how we are assured financial stability when we become too old, or too sick to work. Paying into the program is mandatory. If the employee is no longer able to work due to illness or injury, an individual will file a claim with SSDI requesting that their benefits begin. If the illness or injury is determined to be within the guidelines of the program, they will begin receiving a check each month from SSDI.
Unfortunately, not everyone who applies for their benefits is approved. They may be under the impression that if their doctor says they should not work, or they feel they can no longer maintain their employment that they will simply tell the Social Security Administration and they will be approved. The fact is, those two factors are not enough to ensure approval. Thousands of people file for their disability insurance every year. Sixty-five percent of applicants are denied on their first filing. That seems like a very high percentage, but many times the reason for the denial is inaccurate or missing information. In the appeal process, denial percentage is improved a bit. However, if the case is heard by a judge in the appeal process, denial percentages are reduced to 34%. Consult a Social Security Disability attorney in Los Angeles for more information and assistance.
Sometimes, the applicant does qualify for the SSDI program, but they are still denied. In most cases, the application was rejected due to errors. Once the errors are corrected and the application is accepted, they may be approved. It is important that you follow the procedure exactly and correctly. Below are a few common reasons why an applicant is denied:
You make too much money
This is a tough one. People have to have a source of income to live. SSDI is not a fast process. There is a waiting period of five months from the time you are approved. SSA checks are sent for the previous month. This means it will be six months until you get your first payment at best. However, if you can work and make enough money to live on while you are waiting, it disqualifies you from being able to take advantage of your SSDI. The Social Security Administration allows you to work and make a modest income while you wait, but if you make more than $1130.00 per month, they consider your pay as substantial gainful activity and you are disqualified from the program. Even if you are approved, your SSDI payment would be lowered if you earned more than $1500.00 in a month. At $1500.00 you would receive no payment at all.
Your recovery time is less than a year
The Social Security Administration only considers you disabled if your illness is expected to last more than 12 months, or will result in your death. If you are unable to work because you have broken bones, you may be denied because bones will heal in most cases in less than a year. However, each case is looked at individually. So, if you and your doctor think the injury is going to severely limit your abilities and those limitations will last longer than 12 months, be sure to detail that in your application.
You are not cooperating
The process is long and tiring. You are already injured and the stress of working through government red tape is not fun. Unfortunately, if you want to draw your SSDI, they must be able to find you, reach you for information, and you must follow their rules. You are required to release your medical records to the SSA. If the records are incomplete or simply not detailed enough, they will send you to one of their doctors who will examine you and report back to them. This is not a personal attack, they simply have rules to follow. By being easy to contact and being cooperative, your case will progress faster and you are less likely to be denied.
You are not following the doctor’s orders
If you are prescribed certain therapy, medications, or surgeries by your doctor, and you fail to follow them, your disability could be denied. However, there are some reasons that SSA will accept as a valid reason not to follow the doctor’s orders. This includes severe fear of a surgery that is documented by a doctor, mental illness that prevents you from completing the tasks, and that you physically cannot do the therapy without assistance. There are other reasons that are acceptable which you can read about here.
The following list includes other factors that may keep you from drawing your disability. As these factors are seldom generic, it is wise to contact an attorney for help if any of these apply to you and you feel you need to file for Social Security Disability.
- You have a drug and/or alcohol problem
SSA must determine your disability would be resolved or improved enough for you to work, if you stopped taking drugs and alcohol.
- You have committed a felony and you are incarcerated
(Note: in some cases, this is reconsidered if you are in a treatment program while in jail)
- You became disabled while committing the felony, or you became disabled while in prison for the crime.
It is a common misconception that SSA simply denies everyone the first time they file. As discussed, the denial rate is higher on the first application due to errors and issues in the application process. Those who are careful to follow the steps outlined and those who utilize the assistance of a qualified attorney find the process works much more smoothly and the risk of a rejected application is greatly reduced.
Author information: For more than 20 years, Social Security lawyer Tony Adderley has been working with clients across Southern California, including Los Angeles. He can help you with every aspect of the process, from guiding you through the application process, to helping you appeal or re-apply after a denial, representing you in court proceedings or administrative hearings and beyond. He will fight aggressively to help you get the funds that you are entitled to receive!