While the Social Security disability determination process may seem arbitrary, there are actual several common factors that can cause an applicant to be rejected. Here, Jeffrey Scholnick explains these factors and how they can negatively impact your chances for receiving disability benefits.
Your Type and Length of Disability Did Not Meet SSA Requirements (According to their Strict Interpretation of their Rules)
The Social Security Administration has specific requirements that your disability must meet in order to qualify. Your disability must last at least 12 months, or until your death—cases of blindness are excluded from this time requirement. Your disability must also be severe enough to warrant disability benefits. A Listing of Impairments will be used to compare your disability to SSA-approved impairments, which would require benefits to be provided. The SSA has created a list of disabilities that, due to their inherent severity, are fast-tracked for approval, found here. Disabilities not included on the list may still qualify, but every case is unique, and may not incur benefits in the same way. The real problem is that the examiners at SSA do not feel that they have the authority to find you disabled unless your medical condition meets exactly the wording in a Listing of Impairments. You may have a number of medical conditions that, together, prevent you from working. But, if you do not meet each of requirements of a specific Listing, you will be denied at the first two levels of review. Fortunately, an Administrative Law Judge can look at the “totality of the circumstances” and find you disabled and entitled to benefits
To increase your chances of approval, ensure you have provided the SSA all relevant documentation regarding your disability and any medical treatment you have sought and that you have an Attorney as an Advocate to show the SSA reviewers and a Judge that your Impairment is severe enough to meet the Listings.
Your Level of Income Was Too High
The SSA has established a level of “substantial gainful activity” (SGA) which allows them to determine whether an applicant qualifies for benefits. If an applicant makes over the determined SGA amount, they will likely be denied benefits. In 2017, an applicant may earn $1,170 a month before being deemed too high an earner for benefits—those who are blind are able to earn up to $1,950 per month.
If applying for SSI, which is exclusively for low-income applicants, the SGA limit still stands, but applicants will also be denied if all unearned and earned income (benefits and income) equal or are greater to $1,500 per month. Those who make over $740 a month will have their benefits terminated. While we encourage everyone to try to work and it is beneficial to earn your own income, you need to know the effect of these earnings on your potential claim.
A History of Fraudulent, Criminal or Addictive Behavior
If you were injured in the process of committing a crime and are charged for the crime, you will not be able to receive disability benefits. Furthermore, if your disability is due to alcohol or drug use, the SSA will likely reject your application; however, an applicant who is a drug or alcohol user can still receive benefits, provided their habits do not contribute to their disability. Finally, committing benefits fraud is an obvious detractor from your chances of receiving benefits.
Failure to Follow Prescribed Therapy or Treatment
Failing to follow a doctor’s prescribed therapy, when you have the means to do so, can prevent you from receiving disability benefits. However, the SSA has established a set of acceptable reasons why an applicant may choose to forgo treatment. These include religious and financial grounds, as well as the ability to refuse treatment another doctor disagrees with. For those who are mentally ill, or who would be severely emotionally or psychologically impacted by treatment (for example, a phobia of surgery), benefits may still be available even if they do not comply with recommended treatment protocols.
Receive the Benefits You Need
A serious disability can make working extremely difficult, or even impossible, leaving you worried about your future. At Scholnick Law, we believe those who are disabled deserve to receive benefits to help them through this difficult period in their lives. Our dedicated and experienced firm is waiting to help you take the steps toward receiving benefits, or petitioning a rejected application. For more information, or to schedule a free consultation, contact us today.