What Is a Social Security Disability Denial Based On?

by Feb 23, 2018Disability Benefits

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The Social Security Administration (SSA) denies applications for disability benefits due to two main reasons:

  • The applicant did not meet the medical standards for benefits, or
  • The applicant did not meet the income, asset, or work history requirements of the program to which they applied.

A disability attorney from the Disability Advantage Group, can help you understand what your Social Security Disability denial was based on. If you received a denial letter, call 865-566-0800 today to discuss your appeal options during a free consultation.

What Is a Medical Denial?

A medical denial occurs when the SSA does not believe your medical condition qualifies for disability benefits. Specific reasons for medical denials include the following.

Insufficient Evidence

The person who reviews your claim for the SSA does not have the privilege of seeing you on a daily basis and observing how your condition affects your ability to work and carry out daily living activities.

Therefore, you must provide compelling evidence that proves the extent of your disability. Specifically, you must show that, due to your condition, you cannot work and earn a living.

A strong packet of evidence generally includes some or all of the following:

  • Medical diagnoses;
  • Doctor’s letters;
  • Lab test results;
  • Statements from co-workersor supervisors;
  • Personal daily journals; and
  • Testimony from friends, relatives, or

If your condition is in the SSA’s Blue Book, the listing spells out the specific requirements you must meet to receive benefits. You should make sure you have the right kind of evidence and enough of it to prove you meet every one of those criteria.

One of our attorneys can help you gather the evidence you need for a winning claim.

Your Condition Is Not Expected to Last

To qualify for disability, you must have a medical condition expected to last for at least one year or result in death. Accordingly, your evidence must make it clear and unequivocal your doctor does not expect you to recover enough to work for at least 12 months.

If your doctor expects you to return to work on a part-time basis before a year is up, even that might be enough to disqualify you for disability benefits.

The important thing to remember about disability is that it is an all-or-nothing proposition. In the eyes of the SSA, you are either totally disabled or not disabled. You must be totally disabled before the organization will approve your application for benefits.

Your Condition Is Due to Drug or Alcohol Abuse

Scientific research has turned up extensive proof that addiction is a disease. Nonetheless, the SSA does not grant disability benefits if drug or alcohol addiction is what prevents you from working. Moreover, if you have a medical condition that would improve to the point where you could return to work if you stopped using drugs or alcohol, the SSA will deny your disability claim.

However, the SSA does grant benefits to applicants who have qualifying disabilities for which drug or alcohol use was a contributing factor in developing the condition. For instance, if you have a seizure disorder brought on by drug use or cirrhosis of the liver due to alcoholism, you may still qualify for disability. If you are currently seeking treatment in a rehab program, you may also qualify for benefits.

What If My Denial Involved My Income or Work History?

Both major disability programs, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), have certain financial requirements you must meet for approval.

Approval for SSDI requires you to have worked a certain number of years and paid payroll taxes. You must also earn less than a specific monthly income. To receive SSI, your income and total assets must both fall below certain levels, as this program is a welfare benefit for the needy.

We can review your work history and finances and determine which disability program you qualify for.

How Can I Talk to a Disability Lawyer for Free?

The disability attorneys at the Disability Advantage Group, want to help you put together a winning application and get approved for the benefits you deserve. Call us at 865-566-0800 to set up a free consultation.