Published on: November 17, 2023
The Supplemental Security Income and Social Security Disability Insurance programs provide monthly payments when you cannot work due to a disability. A complex and challenging application review process makes it difficult to get approved for disability the first time. Fewer than one-third of the applications for disability benefits are approved after the initial review process.
People with otherwise valid claims for disability benefits may have their applications denied because of mistakes made during the initial determination process. According to data compiled by the Social Security Administration, more than 60% of people whose claims were denied win approval by appealing the initial determination.
This blog post explains the requirements to qualify for SSI and SSDI disability benefits. It also provides tips to avoid the common mistakes that cause claims to be rejected.
Social Security Disability Programs
SSI and SSDI pay disability benefits to people who meet medical and non-medical eligibility requirements. SSI is a needs-based program, so the non-medical eligibility requirements are that applicants must have limited income and resources. If the financial criteria are met, the application process continues to determine if there is a qualifying disability.
The SSDI program is for people who have worked long enough and paid Social Security taxes on their income. Social Security first reviews applications to determine if there is a qualifying work history. If there is, then the review process turns to the medical requirements.
The disability determination process decides whether you have a qualifying disability. Federal regulations define a disability as a medically determinable physical or mental impairment that prevents you from engaging in substantial gainful activity and is expected to last for at least 12 months or result in death. You must be unable to work at jobs that your employment history shows you did in the past or be able to do other types of work available in the national economy.
Common Reasons Why People Don’t Get Disability The First Time
Each application is different, but some of the most common reasons why you may not get benefits for a disability the first time include the following:
- Applying for disability benefits while you’re working: The definition of
- Errors made on the application: Leaving out important information and providing erroneous information can cause delays or result in a denial of benefits.
- Lack of medical evidence supporting the claim: The burden is on an applicant to prove the existence of a qualifying disability. Medical records, including treatment notes from your doctors, lab reports, diagnostic imaging, and other forms of proof, must be submitted to prove that you have a condition that prevents you from working. Disability advocates at Disability Experts of Florida work with your healthcare providers to ensure that complete and current medical evidence accompanies an application for SSI and SSDI.
- Ignoring the importance of other forms of evidence: Medical records are critical to success, but focusing entirely on medical evidence may ignore other forms of valuable evidence. For example, statements from employers, co-workers, friends, family, and yourself may be helpful to prove how your medical condition affects your ability to perform work-related activities, such as lifting, walking, climbing stairs, or understanding and following instructions.
- Failing to take prescribed medication or follow a treatment plan: The severity of a medical condition can be questioned when you do not take medications or follow the treatment plan prescribed by your doctor. Missing appointments with healthcare providers is another mistake that could prevent you from getting disability benefits. Ensure that you follow the doctor’s orders and that your medical records show a continuous course of treatment without any gaps.
- Failing to respond to requests from Social Security: Ignoring requests for additional information, correction of erroneous information, or other communications from the Social Security Administration will cause delays or a denial of your claim for benefits. If you receive a request from Social Security or the Disability Determination Services, respond to it immediately.
- Missing appointment for a consultative exam: Social Security may ask for a consultative exam by a physician to assist in evaluating your claim for disability benefits. If you do not attend the examination, your claim for benefits can be denied.
The application process to get approved for disability benefits is complicated and confusing, so getting help from an experienced disability advocate can be essential to avoiding common mistakes that lead to denied claims.
Rely On The Experts For Assistance
Get assistance applying for disability benefits from the disability advocates at Disability Experts of Florida. They know the law, regulations, and procedures to ensure that your application for SSI and SSDI has the best chance to get approved the first time. If you applied on your own and received a denial notice, a disability advocate can explain how to challenge it through the appeal process. Learn more by contacting Disability Experts of Florida today for a free consultation.