by The Bainbridge Firm, LLC | Jun 06, 2018 | Social Security Benefits
Common Reasons for Being Denied Benefits
You will receive a technical denial for failing to meet the non-medical requirements for Social Security Insurance if you earn more than $1,090 per month, or have insufficient work credits. If you are applying for Supplemental Social Security Income, you cannot exceed more than $2,000 in the bank as an individual or $3,000 in the bank as a couple. There are also limits to your assets. For example, you can own necessities such as a house and a car, but you cannot own unnecessary things such as a boat or two houses.2
To get approved for benefits, your medical condition must prevent you from working for over a year or result in death. If your medical condition will improve significantly within one years’ time, or the SSA does not believe that your condition is severe enough for benefits, you will be denied. Your conditions must keep you from all work. The SSA makes it hard for people to get disability benefits because it is supposed to be the last resort after all else has failed. Disabled people are not always permanently disabled, and if the individual is not permanently disabled, the government hopes and expects that the individual will recover and go back to work.3
Another big reason people are denied disability is because the individual will not cooperate with the Social Security Administration. If you do not give the SSA permission to obtain medical records and you do not show up for your consultative exams, you will be denied benefits. Consultative exams are ordered when there is not enough medical support from your files to support your claim. It is imperative that there is enough medical evidence supporting your claim and that you have multiple doctor’s opinions. This will increase your chances of being approved.
If you move or change your phone number, make sure you contact the SSA immediately. The SSA needs to always have current contact information in case they need to contact you regarding your claim. If they cannot get into contact with you, you will be denied.
You cannot receive benefits because an alcohol or drug addiction prevents you from going to work. If your condition would improve as a result of you sustaining from drugs and or alcohol, then the SSA will not approve your claim for disability. However, if your condition was caused by drugs or alcohol, but the drugs and alcohol are not the main contributing factor to your condition, there is a possibility that you could be approved benefits. This should not affect your dependents as long as you qualify for disability. Once you have been released, your benefits will resume one month prior to that date as long as you still qualify.
You cannot earn disability benefits while incarcerated. However, there are a few exceptions to this rule. If you are in jail for less than a month, your disability benefits will not end. In order for your benefits to be suspended, you must in prison for 30 days after your conviction. If you are awaiting conviction and are serving time in jail, then your benefits will continue until you have been convicted and served time for 30 days.4
The worst thing you could do to be denied benefits, would be to commit fraud. This includes lying on your application, making false statements at your hearing, and reporting things that are not true about your daily home life. If you are making more money than what you are telling the SSA, or you are lying about an injury you do not actually have, this would be considered fraud. You cannot deceive the government for money and expect to get personal gain. If the Social Security Administration discovers that you knowingly lied or misrepresented any information related to your claim or eligibility for disability benefits, you may face criminal charges for fraud and possible jail time.5
Tips for Getting Approved
Be honest about your limitations. If it is hard for you to get around on a daily basis or focus for long periods of time, the SSA needs to know. Do not try to make your situation and condition seem better than it actually is. Try not to use words like “never”, “always”, and “definitely”.6 Be straight forward with your answers and as consistent as possible. The more detail you use, the more likely you are to be less consistent. If you tell the SSA that you have a hard time being on your feet for more than a couple minutes at a time, you should not tell the SSA that you still cook dinner for your family and love taking your dog on walks. This makes it seem like you can be on your feet a lot longer than what you first led on. The same thing goes for your doctor. If your doctor tells the SSA that you have a hard time concentrating for long periods of time, do not tell the SSA that you spend your evenings doing puzzles. This would contradict what your doctor said and you will most likely be denied benefits because of it. Keep a symptom journal with a list throughout the day of how you are feeling. This would be a good item to refer back to when you go and see your doctor that way you are all on the same page. Ask friends and family about your symptoms. Another person on the outside might notice something you don’t. This especially true when dealing with mental functionality.
The number one things the SSA looks for when deciding to deny or approve a claim is functionality. Mental functionality deals with things such as anxiety, following directions, concentration, interaction with others and stress. Physical functionality deals with things like how well you can walk, sit, stand, lift objects, and perform everyday activities. For example, if two people get the same injury, those same two people will have different functionalities and will most likely deal with their condition in two totally different ways. One person might have a high stress job and not be able to handle the mental functionality of that, while the other has a low stress job but it is more physical. Each person is different and has different abilities, so one individual might be able to handle a situation better than the other. For this reason, the SSA needs to see how each person is able to function based on their daily activities and routines. If you are unable to function at your current job and position, the SSA will try to determine if there is another position similar to the one you currently have but with less difficult tasks. If you are able to function normally in the new position for 40 hours a week, you will be denied disability. Some people are unable to work just during the time they are recovering from their condition or injury, and the SSA will determine how long they will need to be out of work and needing disability. As soon as that individual is able to go back to work, the benefits will end. Whatever the situation, make sure you fill out your functionality report to the best of your ability. Do not leave any fields or answers on the forms blank. If you do, you will automatically be denied.7
What to Expect at Your Hearing
The SSA looks at disability applications all day long, making them excellent at spotting inconsistencies between your claim paperwork and what you say at your hearing.8 More likely than not, the judge will be looking at your functionality report while asking you questions during your hearing. Make sure you come prepared by looking over your report and thinking about questions you might be asked. If your answers do not match up with your report, you will most likely be denied. It is also important to have multiple medical documents supporting your claim. An individual is more likely to be approved if they have five medical documents versus someone who only has one. While there are many reasons people get denied Social Security Disability, 38% of people are denied benefits because of mistakes on their forms.9
1 Susan Kelley, Disability Approval Guide, 10 Most Common Conditions for Social Security Disability Claims (September 03, 2016), https://www.disabilityapprovalguide.com/social-security-disability/getting-approved/functionality-report-the-1-reason-ssd-claims-get-approved-or-denied/?src=org_fb_wcl&utm_source=facebook&utm_medium=organic_post (accessed April 4, 2018).
2 Disability Guide, Why Social Security Disability Claims Are Denied and What You Can Do If It Happens to You. https://disabilityguide.com.common-reasons-socail-security-disability-claims-denied.html (accessed May 24, 2018).
4 Disability Benefits Help, Can I Keep My Disability Benefits If I Go to Jail? https://www.disability-benefits-help.org/faq/keep-disability-benefits-jail (accessed May 8, 2018).
5 Melissa Linebaugh, Disability Secrets, Be Careful Not to Commit Fraud When Applying for Disability (May 8, 2018), https://www.disabilitysecrets.com/resources/social-security-disability/social-security-basics/be-care (accessed May 8, 2018).
6 Susan Kelley, Disability Approval Guide, 10 Most Common Conditions for Social Security Disability Claims (September 03, 2016), https://www.disabilityapprovalguide.com/social-security-disability/getting-approved/functionality-report-the-1-reason-ssd-claims-get-approved-or-denied/?src=org_fb_wcl&utm_source=facebook&utm_medium=organic_post (accessed April 4, 2018).
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