When illness or injury result in disability, those affected face serious financial and life-quality challenges. Loss of income, medical expenses, lack of mobility, and emotional and psychological trauma create stress and anxiety. For those affected, a denial of a disability claim can be devastating.
The Truth About Social Security Disability Insurance Claims
Written into law in 1956, Social Security Disability Insurance (SSDI) was intended to provide income for workers who suffered an injury or illness that prevented them from working. In 1974 the Supplemental Security Income (SSI) program was added to the federal government’s efforts to assist the disabled. Depending on circumstances, a recipient may be awarded both types of disability in accordance with the program guidelines.
A worker and family members can receive SSDI benefits if the worker paid Social Security Tax and worked a sufficient number of years. SSI, on the other hand, is need-based. The benefits are paid according to the recipient’s income and financial need.
Despite these seemingly simple guidelines, filing for Social Security Disability Fredericksburg VA is more likely to result in denial than approval of the claim. The truth is that less than 30 percent of SSDI claims are approved outright. The vast majority is denied for technical and medical reasons. Many claims remain pending or under review for months or years.
Reasons for Claim Denial
Incorrect claim submissions result in delayed benefits or denial. It is important to understand other issues associated with disability claims. According to the Social Security Administration (SSA), the five main reasons SSDI claims are denied include:
- Medical Evidence – Filing a claim requires documentation from a treating physician. Social Security may request follow-up evaluations with medical professionals, but they will not send a claimant to a primary doctor to determine if there is a disability. The claimant’s treating physician must provide the medical records to substantiate the claim.
- Prior Claim Denial – In many cases where a claim was filed previously and denied, it will be denied again if the claimant has not gone through the initial claim appeal process.
- Income Over the Limits – The rule is that a claimant cannot collect disability if they earn over a set limit. In 2018 the income limit is $1,180 a month. Even working part-time affects a claim if the income exceeds the monthly limit.
- Claimant Avoided Medical Treatment – A claimant who fails to follow through on treatment prescribed by their physician is a red flag to claims examiners and will almost automatically result in claim denial.
- Non-cooperation – Requests for documentation and verification can be frustrating but failing to cooperate with the Social Security Administration is one of the top five reasons for SSDI claim denial.
Avoid Claim Denial
For those who are struggling with a disability, the intricacies of the claim process can be overwhelming. Some claimants seek assistance from an attorney in filing a claim. While an attorney is not required, even the Social Security Administration advises that in some cases an SSDI attorney may be able to assist claimants in compliance with filing requirements. In all cases, complete documentation, cooperation and meeting the income guidelines are key to satisfactory claim resolution.