When you apply for SSDI or SSI, you’re likely more than well aware why you feel you should receive benefits. But it can be useful to understand the reasons why you may be denied disability benefits. Some of these reasons may be beyond your control. However, you may also be able to avoid mistakes that could lead to a denial.
In this article, we outline the eight most common reasons for the Social Security Administration to deny disability benefits, so you can avoid or prepare them. If you have a denied claim or have questions about the filing process, contact Barnes Cadwell Law today.
1. You Make Too Much Money
If you can perform “substantial gainful activity” (SGA), the SSA believes you can earn enough to get by and will not consider you disabled. For the non-blind, the SGA limit is $1,180 in 2018 (adjusted annually). Investments and Social Security don’t count, and your total SGA limit may vary if you’re self-employed.
2. You Aren’t Hurt Badly Enough or Won’t Be Disabled Long Enough
To acquire benefits, you must convince the SSA your disability will last more than 12 months. Most bone breaks, for example, do not count; nor does an illness expected to be short-term, no matter how financial devastating it might be. If you fail to heal or remain ill more than six months, however, the SSA may reconsider your case.
3. The SSA Can’t Find You
The SSA and Disability Determination Services (DDS), which determines medical eligibility, need some way to communicate with you about your case. They won’t go out of their way to look for you, either. If you can’t handle things yourself, assign someone a Power of Attorney (POA) to deal with them. Also, make sure the DDS and SSA have their contact info. If you move during the determination process, make sure they have your forwarding address. Don’t count on the postal service to forward your mail.
4. You Won’t Cooperate
The SSA requires you to give them access to all your medical records so they can investigate you and make their determination. They may also want their doctor(s) to conduct one or more consultative examinations (CEs) of their own prior to awarding benefits. If you refuse any of these requests, then you’ll be denied disability. Keep in mind that in most cases, the SSA and DDS are willing to work with you to make your CEs as convenient as possible.
5. You Haven’t Followed Doctor’s Orders
If you’re under a doctor’s treatment, but can’t or won’t follow their prescribed therapy, the SSA can deny disability benefits. However, there are acceptable medical excuses (for example, a severe mental illness that hinders compliance) as well as non-medical excuses (such as lack of ability to pay for treatments, or because they conflict with your religious beliefs). Check with your state for a list of acceptable excuses. Incidentally, the SSA can deny your claim for failure to follow therapy only if it was a therapy expected to restore your ability to perform SGA. Fad or unproven therapies don’t count.
6. You’re an Alcoholic or Addict
The SSA denies coverage to anyone whose disability is based on or caused by substance abuse, or for which that abuse was a contributory factor — especially if you wouldn’t suffer disability if you stopped using. However, if your disability would still exist even if you had never become an alcoholic or addict, you might receive benefits.
7. You’re a Convict or Ex-Con
If you’ve spent time in prison, you may be denied disability benefits. If the disability occurs while in prison for a felony, you will be denied unless you are a member of a rehab program approved by the court that may help you get a job after release, and you will leave prison reasonably soon. You will also be denied disability benefits if you suffered an injury during a felony and are in jail for that crime. You cannot get benefits for an injury sustained in prison. However, you can probably get benefits after release due to that injury.
8. You Committed Fraud
If the SSA decides you obtained benefits by committing fraud, or had someone at the SSA commit fraud on your behalf, they can terminate those benefits without warning at any time.
Denied Disability by the SSA? Contact Us
If you feel the SSA has unfairly denied you much-needed disability benefits, and you live in the Indianapolis or South Bend areas, call Barnes Caldwell Law today. It’s a struggle to survive without income when you’re disabled. If you have a denied disability claim, we may be able to help.