The Social Security Administration (SSA) offers two programs that provide financial support for individuals who suffer from disabling medical conditions and cannot work: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). The benefits are extremely advantageous, as the amount you may receive will go a long way towards helping with monthly bills. However, the key is qualifying for SSDI/SSI under strict SSA rules. SSA statistics show that just 22 percent of applicants are approved at the initial claims level, and denials average around 63 percent.
Fortunately, you do have recourse if SSA rejects your initial claim or denies benefits at later stages of the process. You increase your chances of getting approval when you work with a South Carolina Social Security disability lawyer who can assist with your four options.
Common Reasons for SSDI/SSI Denials: Before getting to what you can do when SSA rejects your application, it is important to know why it may have happened. In general, there are strict rules to qualify for benefits under the (SSDI) and (SSI) programs. As such, SSA may deny because:
- You did not provide sufficient medical records and other information regarding your disability;
- You failed to follow up on SSA’s request for additional details regarding your disabling medical condition;
- You did not follow your doctor’s orders regarding treatment;
- You skipped appointments with your treating physician;
- You did not accumulate sufficient work credits by paying into Social Security through your payroll taxes, if you are applying for SSDI; or,
- Your assets and/or income levels are too high for purposes of SSI, which is a needs-based program.
Your Options After SSA Denies Your Claim: There are four levels of appeal for Social Security disability programs:
- File for Reconsideration: SSA will include a document that describes the reasons they denied your initial application, and this will be useful in asking for a second look. Through reconsideration, you are requesting for SSA to review everything you previously submitted. It is possible that the claims examiner missed a crucial detail. You have 60 days after receipt of the denial to file for reconsideration.
- Request a Disability Hearing: If you do not gain approval after reconsidering, you can ask for a hearing before an administrative law judge (ALJ). This proceeding is similar to a trial in the sense that you can present evidence and testimony from medical witnesses to support your claim. At the conclusion of the hearing, the ALJ will decide whether SSA’s decision to deny was supported by the evidence or should be overturned.
- Go Before the Appeals Council: You can request additional review if you do not find success at the hearing level. The Appeals Council may:
- Deny your request on the grounds that the ALJ made a proper decision;
- Refer your case back to the ALJ with instructions; or,
- Make its own determination.
- Appeal to Federal District Court: If you do not get approval for SSDI/SSI benefits through the above options, you may need to take your claim to court for a determination on whether you qualify for benefits.
Call Now to Speak to a South Carolina Social Security Disability Attorney
This overview should convince you to not give up if your initial application for SSDI/SSI benefits was denied by SSA. Errors or omissions may have doomed your claim the first time around, so it is important to get things right through these appeals options. To learn how we can help with your application or at later stages of the claims process, please contact Powers Law, LLC right away. We can set up a consultation for you to discuss your circumstances with a knowledgeable Social Security disability lawyer.