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Common Reasons Why Social Security Disability Claims Are Denied
Those who suffer from serious injuries, chronic illnesses, or other health conditions may be unable to support themselves financially, and they may apply for Social Security disability benefits to receive assistance with their ongoing needs. However, many Social Security disability claims are denied. By understanding some of the most common reasons for the denial of these claims, applicants can avoid issues that may affect their ability to receive benefits.
Denial of SSD Applications
A claim for Social Security disability benefits may be denied based on:
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The length of time a condition has lasted - To qualify for disability benefits, a health condition must last for at least one year. If an applicant has not been affected by a disability for at least 12 months, or if their condition is not expected to last for a total of 12 months or more, they will not be able to receive disability benefits.
How Is Hearing Loss Evaluated in Social Security Disability Cases?
Those who experience health issues that prevent them from being able to maintain gainful employment may be able to receive disability benefits through Social Security. There are multiple different types of health conditions that are recognized as disabilities by Social Security, but an applicant for disability benefits will need to meet specific requirements to demonstrate that they are disabled. People with hearing impairments will need to understand how these disabilities are addressed in the listing of impairments used by Social Security.
Hearing Loss Without Cochlear Implants
For those who have not had surgical implants to correct hearing loss, the determination of whether they are disabled will depend on the results of medical examinations and hearing tests. An otologic examination must be performed by a licensed physician, and it will look at a person’s medical history and the ways hearing loss has affected their life. A doctor will examine the person’s external ears, the eardrum, and the middle ear to look for abnormalities or issues that may affect the person’s hearing.
What Is the Difference Between SSDI and SSI Benefits?
People in the United States who are unable to work may be able to receive benefits through the federal government. Social Security offers disability benefits to those who experience physical or mental conditions that prevent them from earning enough income to support themselves, as long as a person’s condition has lasted or is expected to last for 12 months or more. There are two different types of Social Security disability benefits: Social Security Disability Insurance and Supplemental Security Income. Understanding the differences between these two programs will help a person with a disability understand the types of benefits they may be able to receive.
Qualifying for SSDI With Work Credits
Social Security Disability Insurance, or SSDI, provides benefits based on a person’s work history. To qualify for SSDI, a person must have earned sufficient work credits throughout their career. A person can earn up to four work credits per year, and these credits are based on the amount they earned in a particular year. For 2021, earnings of $1,470 will constitute one work credit, and a person will earn all four credits for the year once they make $5,880.
How Does Social Security Determine Whether a Person Is Disabled?
Those who suffer from health conditions that affect their ability to work may be able to receive disability benefits through Social Security. To qualify for Social Security disability, a person will need to demonstrate that they have a disabling condition that has affected their ability to earn enough income. When evaluating a disability claim, Social Security uses a specific process to determine whether an applicant’s condition is considered a disability. By understanding this process and working with an attorney to provide the proper evidence and documentation, a person can ensure that they will be able to receive the benefits they need.
The Five-Step Evaluation Process for Assessing Disability
After a person applies for Social Security disability benefits, their claim may be approved or denied. Following a denied claim, an applicant can appeal this decision, and an administrative hearing will be held in which their case will be reviewed by an administrative law judge (ALJ). The ALJ will use what is known as a “sequential evaluation” process to determine whether the person is disabled. This process includes five steps:
Can People With Mental Illnesses Receive Social Security Disability?
There are a variety of conditions that can affect a person’s ability to maintain employment and earn enough income to support themselves. Fortunately, Social Security disability benefits, including Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), are available for those who suffer from debilitating conditions.
In addition to serious physical conditions that limit the types of work-related activities a person can perform, there are multiple types of mental illnesses that may allow a person to qualify for disability benefits. However, proving that a person’s condition is severe enough to be considered a disability can often be a complex process, and those who are applying for Social Security disability benefits will want to work with an experienced attorney to ensure that they provide the correct information to demonstrate the need for financial assistance.
Common Injuries That Qualify for SSDI Payments
While any injury can be traumatic, it's hard to overstate the difficulties that follow from an injury that prevents you from performing the job you've done all your life. Fortunately, the federal government can help by providing monthly benefits through its Social Security Disability Insurance ('SSDI') and Supplemental Security Income ('SSI') programs. However, to qualify for these benefits, you must show that your inability to work results from a specific injury or illness.
At Coats & Todd, we want you to know how to identify if you qualify for SSDI and SSI benefits so that you can move forward without the added financial stress that follows from being unable to work. Our team is here to help you every step of the way.
In Its Final Weeks, the Trump Administration Makes It Harder Than Ever for Disabled Americans to Get and Keep Their Social Security Disability Benefits
With only a few weeks left, the Trump Administration has upended a number of rules to make it harder to receive (and even keep) Social Security disability benefits. The White House announced a number of sweeping changes to reduce the number of people on Social Security and to save about $2.5 billion a year.
Some of the biggest new changes to Social Security are:
- Stricter requirements for back impairments: One of the most prevalent disabilities we see are disabling back impairments, particularly those involving the lower ('lumbar') spine. But under new rules effective starting April 21, 2021, the government will no longer grant benefits to people who are unable to walk effectively due to low back impairments. Now, you have to prove you have to use some prosthetic device that prohibits you from using either arm. So a one-handed walker or cane apparently isn't enough. What's more, the rules say that all of the necessary medical findings have to be documented within a 4-month time period-despite a court of appeals ruling that rejected that position! See Radford v. Colvin, 734 F.3d 288 (4th Cir. 2013). Although the Administration used to abide by that appeals court ruling, they've changed their mind. Understandably, several people have objected to these changes. However, the Administration responded that, 'even if in some cases (although not all) the revised rule results in more [denials], we still have a statutory obligation to ensure the listings are up to date... ' Despite the White House's focus on achieving 'progress,' we suspect this will have a devastating effect on millions of Americans for decades to come.
Fibromyalgia & Social Security Disability Filings
Fibromyalgia is a fairly common incurable health condition that is still being researched by medical sciences. What causes fibromyalgia is not completely understood, but it is believed to be rooted in complications of an overactive nervous system, an overabundant amount of blood vessels near the skin, and possibly immune system deficiencies. A study in 2013 shed some light on the theory of nerve and blood vessel complications, but more work needs to be done.
What is understood is that the symptoms of fibromyalgia can be persistent and troubling, most often manifesting as chronic pain that cannot be remedied with painkillers and full-body fatigue that does not go away after a good night's sleep. It is also common for fibromyalgia patients to experience hypersensitivity to touch, numbness in extremities, and joint stiffness.
For many fibromyalgia patients, the symptoms are so consistent and problematic that continuing to work is difficult or seemingly impossible. If you have found yourself in the same situation, then you should know that you might qualify for Social Security Disability Insurance benefits because of your fibromyalgia diagnosis. Every case is different, though, so getting benefits is not guaranteed.
Working and Disability
Can you work and collect disability? That's a question we often get, and the answer isn't as easy as you might think. This topic gets complicated quickly and it's impossible to provide a comprehensive answer in a single blog post. However, this should help to provide a basic overview of how working can affect your disability application.
It's not about 'work'; it's about 'substantial gainful activity.'
To keep this as simple as possible, the government will not award disability benefits to those who are gainfully working. In fact, that's the very first question Social Security asks itself when it receives a disability application. Except instead of referring to 'work,' it refers to 'substantial gainful activity,' or SGA. This SGA concept is so significant, in fact, that Congress specifically defined disability as the 'inability to engage in any substantial gainful activity. . . .'
So what is SGA? Social Security defines SGA as any work that both 1) entails significant physical or mental activities and 2) is done for pay or profit. In fact, SSA has specific monthly dollar amounts for blind and non-blind individuals for each year, and earnings that exceed those levels are generally found to be SGA. For 2020, the monthly threshold is $2,110 for the blind and $1260/month for non-blind individuals. So if you earn more than that amount on a monthly basis, you are very likely performing SGA and cannot be found disabled. But the converse is not necessarily true--even if you make less than the SGA threshold, that does not rule out the possibility of SGA; it just raises a presumption that your work isn't SGA.
SSDI and SSI, What’s the Difference?
A lot of people get confused about the difference between SSI and SSDI, and some of our clients have spent years applying for disability without any grasp of the two programs. If you're wondering about the difference, then this is for you.
Let's start with how the programs are similar. SSDI and SSI both provide monthly benefits for those who are disabled, and the standards for what is a 'disability' are virtually identical. Both apply a five-step analysis that grants disability if you are not working, so long as you have a severe impairment that either:
a) meets/equals the medical criteria the government set in its Listing of Impairments, or else:
b) prevents you from performing your past work and any other work in the economy.
And both programs are subject to the lengthy appeal process (initial determination, followed by a reconsideration determination, then a hearing, and finally Appeals Council review). So, if you apply for SSI and SSDI, chances are good that both applications will be jointly decided by the same Stage agency and the same judge.
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