Securing either Social Security Disability or Supplemental Security Income benefits is not simple or straightforward. Even if you believe you are clearly disabled because you are suffering from a serious illness or injury, the process is complicated, intimidating, and discouraging. Don’t give up. Our representatives may be able to get you set on the path toward the better life that you deserve.
Getting approved for disability is not as simple as proving that you cannot work your current or past jobs. The challenging aspect of a Social Security claim is that you generally have to prove that you cannot work any job that is available nationwide. According to the Social Security Administration (SSA), 53 percent of disability claims are denied and nearly 80 percent of consequent appeals are also denied. At The Disability Help Group, we understand the specific reasons for initial application denials and can help you to avoid the common mistakes and pitfalls of the disability claims process.
If your application for Social Security benefits has been denied, DON’T GIVE UP!
Through the years, our disability advocates and their supporting resources have assisted Social Security disability claimants suffering from many severe ailments, including:
For more information on these medical conditions, visit our Common Diagnoses page.
Don’t spend another day worrying about how you will pay your medical bills and support your family. Don’t continue to think that you are not entitled to disability benefits because your application has been denied. Our disability advocates and the many experts that they work with are ready to help you now.
CALL us today at 1-800-800-2009 or fill out our contact form.
You want the upper-hand on your Social Security Disability claim – don’t you? Then request a FREE copy of our publication Secrets Social Security Won’t Tell You to learn valuable insider tips on how you can increase the chances of winning your claim. Click here for more information.
Severe or temporary low back pain may last a few days to a few weeks. Intense back pain usually results from trauma to the lower back or a disorder such as arthritis. Trauma to the back may stem from a sports injury, doing household chores or working in the garden, or a car accident.
American Academy of Neurological and Orthopaedic Surgeons
American Academy of Physical Medicine and Rehabilitation
Diabetes is a disease of disordered metabolism, usually due to a combination of hereditary and environmental causes, resulting in unusually high blood sugar levels, also known as hyperglycemia. Blood glucose levels are regulated by the hormone insulin made by the beta cells of the pancreas. The two most common forms of diabetes are due to either a reduced production of insulin (type 1), or weak response by the body to insulin (type 2 and gestational). Both types of diabetes lead to hyperglycemia, which mainly causes the acute signs of diabetes: excessive urine production, which consequently results in increased thirst and fluid intake, blurred vision, unexplained weight loss, lethargy, and changes in energy metabolism. If it is not controlled, diabetes and its treatments can cause many severe side effects such as, hypoglycemia, ketoacidosis, or nonketotic hyperosmolar coma.
Type 1 diabetes can only be treated with injected insulin. Most doctors will also strongly recommend dietary and other lifestyle adjustments as part of the treatment.
Type 2 is usually controlled with a combination of dietary treatment, tablets, and frequently, insulin supplementation. Insulin can also be delivered continuously by a specialized pump which provides insulin under the skin through a temporary catheter.
American Diabetes Association
Fibromyalgia is a syndrome that causes chronic fatigue, painful pressure points and generalized muscle pain. While the syndrome does not cause damage to joints or tissue it does cause significant pain. This can make living with fibromyalgia very difficult. Even though it is not truly a form of arthritis it is considered a rheumatic condition.The causes of fibromyalgia are not fully understood. Most agree that the theory of central sensitization comes closest to explaining the illness. This theory states that people who have fibromyalgia have a lower threshold for pain due to an increased sensitivity in the brain to pain signals. This causes the sufferer to experience an amplification of pain and other senses. Recent studies suggest that individuals may have a genetic predisposition for fibromyalgia. Though for some the onset of the disorder is slow, for most people the onset is sudden and triggered by an illness or trauma.
NIH – Fybromyalgia FAQs
Chronic Obstructive Pulmonary Disease (COPD) is a swelling of the lungs and airways. The most common forms of COPD are chronic bronchitis and emphysema.
American Lung Association
The most common heart disease is coronary artery disease, which occurs when the arteries that run to the heart become damaged or diseased. The damage occurs when plaques, or fatty deposits, buildup on the artery walls. These deposits narrow the arteries, causing your heart to receive less blood. Eventually complete blockage can occur, causing a heart attack. The causes of coronary artery disease relate to the reason plaques are building up on the walls of the arteries.
American Heart Association
Cancer is the ramped growth of abnormal, malignant cells in the body. There are hundreds of cancer types, many of which are deadly.
American Cancer Society
TBI, also known as acquired brain injury or head injury, is a result of sudden trauma that causes damage to the brain. Depending on the damage to the brain, symptoms can range from mild to severe.
National Institute of Neurological Disorders and Stroke
Hypertension is also knows as high blood pressure. It occurs when the force of blood against the artery walls is too strong. This can lead to damage in your arteries, heart and kidneys. Unfortunately, unless you have your blood pressure taken on a regular basis, you may have no idea that you have hypertension. Symptoms only occur when the pressure is extremely high. Generally there are no noticeable signs or symptoms of high blood pressure. Nearly 1/3 of the people suffering from hypertension do not know they have it. Getting your blood pressure checked on a regular basis is the often the only way to detect hypertension. Symptoms of high blood pressure do not occur until your blood pressure is very high.
American Heart Institute
Crohn’s disease is a disorder that affects the digestive tract. The digestive tract, also known as the gastrointestinal (GI) tract, can be affected at any point, from the mouth to the anus. However, it most commonly affects the lower part of the small intestine. The symptoms of Crohn’s disease are easily confused with other disorders of the GI. Because of this it is important that you carefully monitor any and all signs and symptoms and report them to your physician. Symptoms may come and go. People who suffer from crohn’s disease often experience symptom free days, even years. However, the disease is chronic and most people will relapse many times in their lives.
Asthma is a disease that affects your airways. Your airways are the tubes that transport air to and from your lungs. If you’re asthmatic, the walls of your airways can feel sore and become swollen making them ultra sensitive and reactive to things that you are allergic to or find irritating. As a result, your airways become constricted and your lungs receive less air. This can cause breathing problems, especially during the early morning hours and at night, wheezing, coughing, and tightness in the chest. The majority of people with asthma will experience wheezing attacks separated by periods where they will be symptom-free. A number of asthma patients are affected by long-term shortness of breath and go through bouts of increased shortness of breath. For others however, the principal symptom may be a cough. Asthma attacks may last a few minutes or span out to a number of days. Attacks may be life-threatening if the airways become severely constricted.
American Academy of Allergy, Asthma & Immunology
Schizophrenia is classified as a mental disorder that makes it difficult to distinguish between reality and imagined experiences, have logical thoughts and typical emotional reactions, and behave normally in social situations.
National Instute of Mental Health
Bipolar disorder results from disturbances in the areas of the brain that regulate a person’s mood and is characterized by intervals of exhilaration (referred to as mania) alternating with intervals of depression. The fluctuation between mania and depression can be sudden. During manic periods, a person suffering from bipolar disorder may act on sudden urges, have lots of energy and a larger-than-life attitude. The depressed period causes the person to feel extremely anxious, not worthy, and have suicidal thoughts.
National Institute of Mental Health
Attention Deficit Hyperactive Disorder (ADHD) is a problem with distraction, hyperactivity, impulsivity, or a combination. For a child to be diagnosed as ADHD, their behavioral problems must be out of the normal range for the child’s age and development. ADHD affects school performance and interpersonal relationships.
National Institute of Neurological Disorders and Stroke
Human Immunodeficiency Virus (HIV) is a disease that slowly destroys a person’s immune system. Consequently making it difficult for the body to fight infections. Given that infections can occur throughout the body, HIV can manifest itself through a number of illnesses.
Acquired Immune Deficiency Syndrome (AIDS) is the last and most serious stage of the HIV disease. During this phase of the disease, the person’s immune system is severely damaged.
NIH – AIDS Info
A spinal cord injury occurs when a trauma affects the spinal cord. This can happen when the vertebrae that surround the spinal cord break, shatter or dislocate. The violent movement of the vertebrae can force a piece of the vertebrae, disc material or ligament to tear into the spinal cord tissue.
During most spinal traumas the spinal cord itself does not sever completely. Instead, the axons, nerve cells that carry signals from the brain to the body, are crushed or destroyed. The extent of the damage depends on how many of these axons are destroyed.
Mayo Clinic – Spinal Cord Injuries
Joint swelling is the accumulation of fluid in the soft tissue surrounding the joint. Joint swelling may be a byproduct of Osteoarthritis, trauma, Gout, rheumatoid arthritis, Ankylosing Spondylitis, Enteropathic Arthropathy, infection, Ludwig’s Angina, Psoriatic Arthritis, Reiter’s Syndrome, Lupus, or Hemarthrosis.
American College of Rheumatology
RSD is also referred to as Complex Regional Pain Syndrome, is a rare nerve disorder. Although doctors are unsure of the root cause, people diagnosed with RSD feel intense pain, typically in the arms, hands, legs or feet after experiencing an injury to a nerve. The skin surrounding the affected area may be extremely sensitive and may burn, and dramatically change in temperature and color. Unfortunately, there is no known cure.
Multiple Sclerosis (MS) is an auto-immune disease that affects the brain and spinal cord (also know as the central nervous system). People who suffer from MS experience difficulty controlling small movements.
National MS Society
NIH – Multiple Schlerosis FAQs
64,685 Americans are receiving Social Security benefits as of May of 2015. Do you need to be one of them? Having trouble getting your claim approved? You’re not alone.
Depending on what type of benefits you are applying for, the reasons to be denied are seemingly endless. Don’t hesitate to get assistance from The Disability Help Group for the following claims types (along with veterans disability).
In order to qualify for SSDI, you must have built up enough “work credits” and also meet the SSA’s definition of disability. According to the Social Security Administration,
Your eligibility for SSDI benefits also may depend on your age, work history, medical history, and even the type of disability that you are dealing with.
Most importantly, getting approved for SSDI relies on the information presented in your application. Make sure your application is as complete as possible and includes clear details of how your impairment affects your life. Provide any/all documentation to support what you state.
Medicare is a health insurance program, usually (but not always) for the 65 and older group. It is paid for by taxes, along with monthly premiums deducted from their disability checks. The main benefits to having Medicare include basic medical insurance, hospital insurance, prescription drug coverage, and Medicare Advantage plans. If you have been receiving disability benefits for at least two years, you might automatically qualify for Medicare.
SSI is calculated simply by comparing one’s income with their necessary expenses. The program was created with the intentions of lightening the burden of health expenses for disabled people that have a low or nonexistent income. You application must be submitted in person, however, some interviews can be done over the phone. In certain cases, children may also qualify.
Of course, in a Supplemental Security Income claim, you or your child’s impairments, income, and health expenses must be proven to the SSA.
If you need to apply for SSI, we want you to know that it is your right to have assistance in doing so. The Disability Help Group is happy to do this for you, and can inform you of other rights you have when it comes to SSI (such as your right to appeal an unfavorable decision). Equally important, you also have certain responsibilities as a recipient of SSI benefits, such as reporting any change in your income or disability.
Medicaid is a health insurance program for lower incomes. The program provides health coverage to almost 9 million people that are not elderly but are disabled. The majority of states provide Medicaid to people that have already been approved for SSI, but this is not guaranteed as the rules vary per state.
Your first step toward a successful disability claim is to perfect the contents of your initial application. This is where you will provide details about your disability and how it relates to your daily life. You will need to include details about all of your medical treatment, in addition to your work history. It’s best to submit any supporting documents that are available.
Your application is given to the Disability Determination Services (DDS). They will look further into your records and decide on your residual functional capacity (RFC). This is a professional opinion on your capabilities, and your approval/denial is widely based on it.
If your initial application is denied (which is often the case), the process to appeal that decision can begin. You only have 60 days to appeal, and if it’s not done on time, you must start the process all over from the beginning. To appeal, you can start with a request for reconsideration. DDS receives your claim again and reviews it once more, this time by a different examiner. If the claim is denied again, don’t give up! This happens almost 80% of the time.
Several states have decided to get rid of the reconsideration level and now go straight to the hearing level.
This stage has the longest wait time, however, often has a better result. Be patient, because this level can sometimes take even more than a year or two to get past. New evidence, if there is any, can be submitted to an Administrative Law Judge (ALJ) that reviews your claim. Medical evidence is especially valuable. If you have an attorney, he or she may join and assist you. The hearing is private, but is recorded in case you need to refer back to it later. The judge will provide a written decision after the hearing.
If the judge has provided you with an unfavorable decision (a denial), the next step is to turn to the Appeals Council. This must be done within 60 days of your most recent denial. Otherwise, your appeal might be completely dismissed. The Appeals Council reviews your claim and will either reverse or agree with the judge’s decision. They may decide to return your case to the judge to have it reconsidered by him/her. Like the hearing, this stage in the process could require a wait anywhere between 6 months to 3 years.
If the Appeals Court confirmed the ALJ’s decision, you may decide to take your claim to Federal Court. Like other appeals, you have 60 days to do so. Simply put, a lawsuit is filed against the Social Security Administration (SSA) for mishandling your claim.
Once you have decided to take your case to Federal Court, the official complaint and summons must be mailed via registered or certified mail to the SSA’s Office of General Counsel that oversees your area. In court, both you and the SSA will have lawyers present. There is a fee for filing this civil action, and it is not a good idea to make this decision without consulting the advice of an attorney first.
This is the most serious stage in the appeals process, and most claims do not require such actions.
More often than not, a disability claim will be denied on the first attempt. In fact, it happens to almost 3 out of 4 applicants. Having your Social Security disability claim can be discouraging, but we urge you to persevere. The journey to success when it comes to disability is not an easy one, but with the right knowledge, resources, and assistance, there is hope.
Below, you can learn about a few of the common reasons that disability claims are denied (assuming that you provide them access to all of your medical records and information).
It is only fair that your part is done to improve your health, and if the SSA does not find proof that you have gone to the doctor or followed his prescriptions, they may decide to deny your claim.
Generally, you might still be allowed to work with limits if you are receiving Social Security benefits. However, your income cannot surpass what the SSA considers “substantial gainful activity” (SGA). As of 2015, the limit is $1,090, but the figure is subject to change each year.
The SSA might deny a claim if they feel that your condition will not last 12 months (or become fatal).
Your impairment must cause you to have extreme limitations in order to qualify for SSI or SSDI.
If the SSA and/or DDS (Disability Determination Services) is unable to reach you, they may decide to deny the claim.
Unfortunately, the SSA does not approve claims that are based on drug, alcohol, or other addictions. They may decide otherwise if they think your disability would continue without the addiction.
There are several other reasons why a denial happens that are not mentioned here. Whatever the case may be, we encourage you to stay positive. Feel free to rely on The Disability Help Group for support and advice.