Denied SSDI Benefits? Learn How to Still Qualify [Edited]

You’ve recently filed for Social Security Disability Income benefits because you have a disabling condition, but the Social Security Administration denied your claim.

Does this initial rejection mean that you cannot qualify for benefits? No, but it does mean that you need to re-examine your claim and file for an appeal.

There are several factors that can cause the SSA to deny your initial application, and it is important to know which one was responsible for the denial of your claim so that you can address it during the appeal. When the SSA examines an application for disability, the things that they usually check for include:

• Is the applicant gainfully employed?
• Could the applicant find new work based on their skills and work history?
• Does the applicant's disability meet or exceed the severity of a condition on the disabling conditions list?
• Does the nature of the disability prevent the applicant from working a job similar to their old one?
• Is the disabling condition expected to last at least one year or result in death?
• Has the applicant contributed enough to Social Security in recent years to be considered insured under the Act?
• Does the applicant have any outstanding warrants for their arrest?

The answer to any one of the above questions could be a reason for the SSA to deny your application for disability benefits. Normally, the SSA will tell you the reason why they specifically denied your claim. For many, the rejection letter marks the end of their attempt to claim their rightful disability benefits. However, getting a rejection letter does not necessarily mean you will never be able to claim benefits.  

Why it's Important to File an Appeal Quickly

Even if your initial disability claim is rejected by the SSA, you can still file for an appeal. The standard for filing an appeal for SSDI benefits on the SSA website is that your appeal must be made "in writing within 60 days from the date you receive our letter." So, if you wish to appeal the SSA's decision to reject your disability claim, time is of the essence.

If the 60-day time limit lapses, you will have to file a new disability claim from the beginning, and my even lose access to some of the SSDI pay you would otherwise have been eligible for. Why? Because, the SSA will only pay benefits that you were eligible for up to a year before the initial disability application, and your eligibility begins 5 months after the onset of your disabling condition.

So, if you were eligible for benefits starting in April 2012, and filed for benefits at that time, and received your rejection letter in February 2013, but didn't file your appeal until June 2013, your appeal would be thrown out, and you would be instructed to file a new claim. If your new claim was approved, you would only receive benefits from June 2012 onward, as that would be one year before the claim was filed, even though you actually filed in April 2012 originally. If you were to file your appeal in March, just one month after being rejected, you would be paid all benefits to which you were entitled.

Appealing the SSA's Decision

As mentioned before, the SSA will typically tell you why your initial claim was denied in their rejection letter. If you wish to appeal their decision, you will need to address the cause of the rejection.

For example, if the SSA makes the determination that you are not disabled because of your educational history giving you the ability to work in a different field, you need to establish why your disability would prevent you from pursuing a career in that line of work or demonstrate that the change in occupation would not be feasible for you (such as there being no employment opportunities for the new job that the SSA claims you could be eligible for, or your disability would actually still prevent you from doing the work).

If the SSA denied your claim because they felt that there was insufficient medical evidence to prove your disability, then you will need to collect more information about your disability and how it impacts your ability to find gainful employment. Remember, the more thorough your documentation of your disability, the better. If the SSA does not have access to all of the information that they need, they may have no other choice than to reject your claim.

Once you've made the decision to appeal the rejection of your SSDI benefits, you will have four methods of appeal:

• Reconsideration- The first step in the appeals process. Here, an SSA official who was not part of the initial decision reviews your application and the initial decision, including both the original evidence and any new evidence you can introduce. If your claim was rejected erroneously, or because there was insufficient evidence of disability during the initial claim, you can be approved through this process, especially if you have new evidence to prove your disability. 
• Hearing- The second step of the appeals process after the reconsideration is the hearing. Here, an Administrative Law Judge reviews the case, questioning you and any witnesses you can provide about your condition. This means that you will have to be available to answer questions directly. You, or your representative, can also pose questions to the experts involved in your disability case. Attendance is usually recommended, as it is your chance to explain your case. It is possible to be exempted from attending, but you must write to the court ahead of time that you will not be present and why. Sometimes, instead of physically going to court, it is possible to attend via teleconference.
• Review by the Appeals Council- If the results of the hearing are not in your favor, you can take your case to the Social Security Appeals Council. The Appeals Council will review your case and the reason(s) you disagree with the decision of the judge denying your disability claim. The Council will look to see if the decision of the judge is supported by substantial evidence. They will also look to see if the judge followed the law, regulations and rulings in arriving at his/her decision about your disability. The Appeals Council can agree with the judge and uphold the denial of your disability claim, they can reverse the decision of the judge and award you your disability or they can remand your case back to the judge for a new hearing to address any errors made in the decision.  Once the Appeals Council has made a decision you will receive a notice in the mail explaining what their decision is and your rights to appeal.     
• Federal Court- The final, and most drastic step in pursuing your SSDI benefits is to file a lawsuit and take your case to federal court. If you are convinced that you are being unfairly denied benefits for a legitimate disabling condition, then you may wish to pursue this course of action if all else should fail. Before taking the SSA to court, be sure to compile all pertinent documents to your case. You will want to review your case with a disability expert before beginning litigation in order to ensure that your case is as strong as possible.

One of the important things to remember when filing an appeal for your rejection is that your situation conforms to all of the requirements for Social Security Disability Income. If you are not sure if you qualify for SSDI benefits, or need assistance from a team of dedicated Social Security advocates, contact us right away for help. Time is of the essence when filing SSDI appeals, so don't miss your chance to claim all of the benefits you are entitled to. A rejection from the SSA does not mean you aren't disabled, it only means that you need to re-examine your case, preferably with some help.