My Social Security Disability Claim Has Been Denied

Filing a Social Security Disability Claim is not a casual walk in the park. It is an uphill battle. However, if you have filed for SSDI/SSI and received a letter from Social Security with “CLAIM DENIED” stamped across the top, your fight is not lost. Instead, it is just beginning. In most states, between 67% to 71% of initial claims are denied.

When a disabled claimant receives their denial letter, most are shocked. You submitted numerous medical records diagnosing your disability, so what more is needed to be awarded disability benefits? These are the same “head-scratching” thoughts that keep lawyers awake at night. Most attorneys see a large percentage of their “initial applications” denied, and although the denial letter gives a reason, attorneys rarely agree with what is in the letter.

What makes matters worse is that you are still suffering from a painful and impacting condition. On the advice of friends, family members, and even your doctors, it was suggested that you stop working and file for a Social Security Disability Insurance claim. Those suggestions were reasonable. In fact, it was your understanding that all those taxes taken from your paychecks over the years were intended to cover events exactly like what has happened to you— — — an unexpected disability has occurred. Although the letter contained a nicely worded explanation of why SSA denied your application, the explanation does not answer this question; “What do I do now?

First, do not give up. Also, we strongly suggest that you do not immediately file another application. There are better options. Being disappointed is a normal reaction, but do not stop trying to get your claim approved. Understand that if your SSDI/SSI claim was denied, you only have 60 days to file an appeal. At Dan Wimmer Law, if your disability claim is denied, we can assist you with the next step to obtain the benefits you deserve.

Second, statistics published by the Government Accounting Office indicate that claimants with representation, like an attorney, were more likely to be granted disability benefits. Some published articles imply that the chances of being approved for benefits when represented by an attorney are three times greater than that of claimants pursuing Social Security benefits without an attorney. There are many reasons why this is true, and much depends on why your claim was denied.

What is true is that there is more to the process than being diagnosed with a disability by your doctor. Here is the critical point: Many people work full-time jobs even though their doctors have medically diagnosed them with a disability. For example, a person could be diagnosed with carpal tunnel or arthritis and might still be able to work. However, having a diagnosed disability is the first step, although it does not prove that you are unable to work. The real test is that you or your attorney must prove that the disability prevents you from working. Under SSA rules, it is your burden to demonstrate that you are disabled and unable to work, and we can assist you if you are facing this dilemma.

Third, it is not unusual for a claimant’s medical records to often omit some critical information that could prove that your disability prevents you from working if it was stated differently. On the other hand, many people suffering from an excruciatingly painful injury or disability do not know how to explain their symptoms meaningfully and accurately during a doctor’s visit. Claimants face the same difficulties when cross-examined during an ALJ hearing. Accordingly, the pain and impact of a disabling injury do not always become part of the medical records. We provide our clients with a training session on properly discussing their pain, symptoms, and activity limitations. Learning how to discuss these important personal issues with SSA personnel, your doctors, or consultative exam doctors will enhance your chances of proving your disability and its impact on your activities.

Social Security Disability attorneys spend time helping their clients learn the best ways and methods of explaining every symptom, pain, and effect to doctors. Also, a Disability Attorney would have provided you with Social Security’s “Medical Source Statement” to give to your doctor. Doctors can use this form to provide an opinion regarding the nature and severity of your limitations. This form is helpful because it assists SSA in evaluating your disability and often narrows down the specific medical issues affecting you. This is necessary because most medical records involving SSDI cases can be 500-1,000 pages. Small details can easily get lost because of the volume of paperwork involving SSDI cases.

Social Security Disability lawyers will look through each page of every claim file, including each Social Security form, all medical records, and every other document, to identify any weaknesses or strengths with evidence. Even with initial applications, a disability attorney will try to strengthen an application from the beginning and will certainly attempt to do so when the case is on appeal. Also, when a claim has been denied, disability attorneys will supplement the case file with any new or additional evidence before filing an appeal. By carefully analyzing a claim file when considering an appeal, many disability attorneys will write a prehearing brief or memorandum to explain the connection between your condition and the medical records.

This is generally true because a Social Security disability lawyer would typically only present claims that show the claimant’s burden of proof has been met with objective medical records. This information should support the claimant’s inability to work. Frequently, unrepresented claimants place more attention on their diagnosed disability and less attention on what limitations their disability causes. Being unable to work is the legal issue that must be shown before Social Security Disability Insurance benefits will be awarded.

Fourth, according to recent publications, properly supported and documented appeals that address the “Five-Step Sequential Evaluation Process” at the ALJ hearing level have over a 50% chance of being granted. Our firm knows how to address each of the five steps.

Fifth, we also provide legal, pragmatic, and strategic recommendations with our free Social Security claim evaluation. During this evaluation process, we will carefully review why your claim was denied and look for methods to improve your chances of getting approved. When a Social Security Disability Insurance benefits claim has been denied, our approach is to present a stronger case. We do this by reviewing and examining the file from its beginning to its current status. We want to get a denied Social Security disability claim decision reversed at one of the administrative appeal levels.

Generally, we prefer to represent claimants before their initial application is filed. This way, we know in advance the strength of the evidence being submitted. Compiling a claim file with numerous personal statements from the claimant’s family and friends does not strengthen the claim. When we are involved from the beginning, we have an opportunity to compare your evidence with Social Security’s “Blue Book” listing of impairments and the specifications needed for each condition to qualify for disability benefits. With this information, a claimant and their legal representatives can develop a strategy and present a strong claim.

Many Social Security claims are denied because of inadequate or insufficient medical records. Doctors often fail to submit relevant, objective, and complete medical records, and many do not submit those records within the SSA’s allotted time. Under SSA’s rules, untimely responses are deemed incomplete, rendering a claim to be denied. Claimants who are represented have a better chance of avoiding problems like this.

There are also many other reasons a disability claim could be denied—for example, incomplete paperwork, missing forms, conflicting work statements, or inconsistent medical records. Sometimes, medical records include conflicting conclusions or misstatements. On the other hand, an appropriately crafted reconsideration request or a prehearing brief to the Administrative Law Judge can assist in directing the judge’s attention to a diagnosis. This is accomplished by presenting a roadmap to medical evidence that connects the claimant’s condition to their inability to work. This is what good lawyering is about.

A disability claim is sometimes denied for non-medical reasons, such as insufficient work credits or with SSI claims when the claimant earns too much income. A Social Security Disability Attorney will work with you and offer assistance about how to present a successful disability claim application. This could also include a different approach when appealing a denied claim by submitting relevant non-medical evidence, such as letters from employers, friends, and church members who are familiar with the limitations caused by your condition.

About 70% of the disability claims are denied based on medical purposes. In such cases, SSA/DDS is saying that even if your disability or condition is listed in SSA’s Blue Book of Impairments, they do not believe your condition is so severe as to prevent you from working. As your teammates, we will know the quality of your medical evidence BEFORE filing an “initial application” or an appeal. This puts us in the best position to argue that SSA has misunderstood your condition and its effect on your daily activities.

We want to win your appeal, and we believe that our best opportunity is when we know everything about you and why your disability claim was denied beyond just reading a denial letter.