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Social Security Disability Insurance (SSDI) provides financial assistance for Americans who cannot work because of physical or mental disability or blindness, but most first-time applications for SSDI benefits are denied. If you’re a denied applicant, you may appeal the denial and ask for a reconsideration by the Social Security Administration (SSA). If you’re still denied, you may request a hearing before an administrative law judge. You’re more likely to prevail at the hearing stage if you’re represented by an SSDI attorney from Dulaney, Lauer & Thomas.
When You Can’t Work Because of a Disability
The SSA uses your medical records to determine your residual functional capacity (RFC) to perform or not to perform various types of jobs. SSDI applications are generally accepted when the SSA determines that RFC restrictions prevent the applicant from working at a previous job or in any other position. Restrictions that typically result in acceptance include the following.
Inability to Meet the Demands of Competitive Employment
If your medical restrictions prevent you from showing up at work regularly or make it impossible for you to focus on your occupational tasks, no employer is likely to hire you. In such a case, your SSDI claim could be accepted.
Non-Exertional Limitations
Almost every job requires the employee to perform simple activities like holding a pen, using a keyboard, sitting in a chair, or communicating with others. If your RFC restrictions prevent you from carrying out such basic tasks, you might be eligible for SSDI.
Inability to Perform Sedentary Tasks
Even a job at which you sit most of the day generally requires you to spend some time standing and to lift light objects of ten pounds or less. If you cannot stand or lift any weight at all, you could be found eligible for benefits.
Medical-Vocational Grid
The SSA uses a medical-vocational grid to determine the degree of your disability. For any applicant over 50, not only RFC restrictions but also age will determine whether an applicant is considered disabled for SSDI purposes.
Reasons for Disability Denials, Even When You Can't Work
Your SSDI application might be denied for one or more of the following reasons.
Non-Medical Reasons
Because SSDI is funded by Social Security FICA tax, your eligibility for benefits depends on how much you’ve paid into Social Security. In most cases, you’re required to have worked and contributed taxes for at least five of the ten years before you apply. You must be 18 to receive SSDI benefits.
Medical Reasons
Only if your RFC shows that you’re unable to do any job are you likely to be awarded SSDI. Failing to follow your doctor’s advice and treatment plan in regard to your disability can make you ineligible for benefits.
Duplicate Application
Instead of requesting a reconsideration or a hearing to appeal a denied application, you filed a second application for SSDI.
Failure to Provide Information
You could be denied benefits if you failed to submit information requested by the SSA during the review of your application.
Too Much Income
By working while your application was under review, you earned too much income to qualify for SSDI benefits.
Ability to Work at Different Job
If the SSA determines that you’re able to work at a job less demanding than your previous one, you won’t receive benefits. The ability to do a “light-duty” job is the most common reason for SSDI denials.
Denial Letter
Your denial letter from the SSA should explain the specific reasons for your denial. You may also request your disability file, which will include the technical rationale used by the SSA to deny your claim. This information can help you and your attorney prepare for a hearing to appeal the SSA’s decision.
Reasons for Not Working That the SSA Will Not Consider
The SSA’s determination of your ability to work is a theoretical one that is not influenced by practical issues or temporal or geographical circumstances. Factors such as those listed below will not be taken into consideration:
- Your desire to do or not to do a certain job
- Lack of required vocational licensing or certification
- Lack of technological ability
- The need to relocate for a job
- Your inability to pass a physical exam
- A reduction in salary
- Lack of access to childcare
- A long commute
- The lack of a vehicle or driver’s license
- The presence or absence of current job vacancies
What to Do After a Denial
If you receive an SSDI denial letter from the SSA, your case is not necessarily closed. If you’re truly disabled and in need of SSDI, there are steps you can take to pursue your claim.
- Request a reconsideration and ask the SSA to review your file.
- Request a hearing before an administrative law judge. At the hearing, you may present evidence and witness testimony to prove your disability.
- Submit further medical evidence of your disability and make sure your doctor has filled out the RFC form for you.
- Improve your chance of acceptance by consulting an SSDI attorney from Dulaney, Lauer & Thomas for help with the appeals process and representation at your hearing.
