There are many stipulations to receiving Social Security Disability Insurance benefits. Due to the complexities of getting a claim approved, most people are unprepared to handle the claims process without legal support. Up to 70 percent of SSDI claims are denied on a first attempt—leaving claimants confused, stressed, and unable to afford the care they need.
Most people only think of why they deserve benefits, rather than what they can do to avoid having their disability claim denied. Keep in mind that only you know the reality of your situation—if your paperwork doesn’t demonstrate your eligibility effectively (or it misrepresents you on paper), then you’re likely to get your claim denied. Having an attorney handle your SSDI benefits appeal will increase the odds of receiving full benefits more quickly because we know what your case requires and how we can best present your needs.
Here are just a few ways that a deserving claimant can still have their case denied.
Number One: You Earn Too Much.
There is a limit to how much income you can earn while filing for a disability claim. Simply put, if you exceed that limit, you are not eligible for benefits because you earn too much to be considered disabled. This limit is $1,170 per month for non-blind applicants in 2017. Blind applicants may make up to $1,950 per month to still be eligible.
Number Two: The Disability Is Not Expected to Last Long Enough
The Social Security Administration’s (SSA) criteria for qualifying for disability benefits states that your disability must be expected to last 12 months or longer, or must be expected to result in death. In addition, SSDI benefits are designed for people with full disabilities—meaning those that are considered “partially disabled” will be denied. There are no temporary benefits under the program either.
In addition, your impairment must make working at your job impossible—not just more difficult. If it’s determined that you are eligible to work in a current or past line of work, you’ll qualify for other benefits, but not SSDI. The only exception to this rule is if your impairment meets the SSD listing requirements.
Example: potentially fatal conditions meet the listing requirements. Proof of lung cancer, for instance, does not require any proof that it will inhibit your ability to work—you will automatically qualify. Your lawyer can help you determine if your condition meets the listing requirements.
Blind applicants have their own requirements, and each case is evaluated individually.
Number Three: The SSA Cannot Find You
Make sure you give the Social Security Administration correct contact information for you and your representative (i.e your SSD attorney). If the agency cannot reach you for the answers to critical questions, your claim could be denied.
That’s another advantage to having an attorney handle your claim: you’ll always have a professional on top of your case’s needs. No need for you to wait for phone calls or have paperwork at the ready—your lawyer will handle that for you.
Number Four: Refusal to Cooperate
Your disability claim hinges on your medical records and their availability to the SSA. If you do not make those records available, your claim could be denied. Also, the SSA may request that you be seen by an SSA doctor at their expense. If you refuse to see their doctor, or if you insist that the SSA make a determination based upon your existing records, your disability claim could be denied.
Keep in mind that the SSA has specific requirements for how data is catalogues in your records, and that your primary doctor may not have met those requirements when documenting your condition.
Number Five: Failing to Follow Prescribed Therapy
If you fail to adhere to a physician’s prescribed treatment when you have the ability to do so, you may be denied disability benefits. There are exceptions that are excused by the SSA, so talk to your disability attorney about how these may apply to your situation.
Number Six: The Disability Is Based Upon Alcohol or Drug Addiction
If alcoholism or drug addiction are contributing factors to your disability, the SSA may deny you benefits. There is a common misconception that disability benefits are not allowed to those who are addicted to drugs or alcohol, which is not 100 percent true. There is also a common misconception that a drug or alcohol addiction is an automatic qualification for disability benefits—this is also not entirely true.
What a case like this hinges on is whether the alcohol/drugs was a “contributing factor” to the impairment (either by causing it or making it worse). For example, if an applicant has lung cancer, their drinking habits are unlikely to be a major factor in their case. However, if the SSA determines that your condition would be improved by not using drugs or alcohol, they’ll use that fact as grounds for denial.
Understanding the weaknesses of your case is vital for success. If you drink or use drugs, your case isn’t hopeless—but it requires you to be extra attentive to the facts of your claim.
Number Seven: You Have Been Convicted of a Crime
Certain crimes and conditions of imprisonment can prevent you from receiving disability benefits if:
- Your impairment was created or worsened by committing a felony
- Your impairment was created or worsened by your time in prison
Otherwise, the law (in theory) does not consider your criminal history when it comes to SSDI benefits. That said, the court (or the SSA doctor) may determine that your disabilities were caused by your crime or subsequent imprisonment. If that’s the case, you’ll need to develop a case that proves otherwise.
Number Eight: Fraudulent Claims
If you receive Social Security disability benefits by any dishonest means, the SSA will terminate your benefits immediately and may prosecute you for fraud.
Pennsylvania Social Security Disability Attorneys
These are not the only ways your Social Security disability claim can be denied, there are many more extenuating circumstances that may come into play. What if your disability is not severe enough? What if you are expected to heal within a year? The answers to these and other important questions are only a click or call away.
Handler, Henning & Rosenberg has been filing Social Security claims since the Social Security Administration was founded. We have provided for the needs of the injured throughout Pennsylvania since 1922, securing millions of dollars for their recovery. Let us help you maximize your chances for receiving benefits.
Contact a proven Pennsylvania Social Security Disability attorney at Handler Henning & Rosenberg today for a free consultation about your SSD claim. Dial (888) 498-3023 or use our short online form to get answers.