Why was my Initial Disability Claims Unsuccessful?

Having your initial disability claims application unsuccessful and rejected by the Social Security Administration (SSA) can be quite frustrating.

In fact, approximately one in three applicants will usually succeed in the initial disability claims application.

However, worry not. You are entitled to file an appeal if the initial disability claim is unsuccessful.

In this article, I give useful tips that will guarantee success for your initial disability claims application.

What are the two types of disability claims?

Why was my Initial Disability Claims Unsuccessful?
If you are disabled, you might be entitled to a disability claim

The Social Security Administration (SSA) has two types of federal-funded disability programs.

  1. Supplemental Security Income (SSI)
  2. Social Security Disability Insurance (SSDI)

Supplemental Security Income (SSI)

The SSI is a program for people from low-income backgrounds who are disabled, blind, or above the age of 65.

To qualify for SSI one has to show that they are in need of assistance through supporting evidence or documents. They will also need to prove that they will use the SSI benefits for basic needs.

The monthly benefits given to successful applicants vary from State to State. However, a minimum amount is usually set by the Congress.

The date that one becomes eligible for SSI is always the day on which they make contact with the SSA showing an intention to apply.

Social Security Disability Insurance (SSDI)

SSDI is a program for the blind, disabled, and family members of people who have insured themselves into the program.

The amount that one receives from this program is based on their FICA contributions which are deducted from each paycheck.

For a successful SSDI application, the SSA will usually review one’s recent wage information and their earning history.

Additionally, eligibility for SSDI begins five months after the date of the onset of the disability.

The date of onset is always determined by the Disability Determination Services (DDS).

Why was my initial disability claims application unsuccessful?

Failing to hire a disability attorney is not a reason why your initial claim was unsuccessful.

You can hire an attorney, and the SSA still rejects your initial application.

If your initial disability claims application is unsuccessful, high chances are that you produced insufficient evidence.

Additionally, you might have failed to follow certain steps.

Nonetheless, certain factors can enhance or diminish your chances, including:

Severity and Duration of Impairment

The SSA mandates that your impairment or disability must be severe enough to prevent you from engaging in substantial gainful activity (SGA) for at least a year from the date of onset.

Consequently, the more severe and enduring your impairment, the more likely you are to qualify for SSD benefits.

Type and Quality of Medical Evidence

The SSA heavily relies on medical evidence to ascertain your disability.

Therefore, one needs to furnish objective medical evidence from recognized medical sources—such as doctors, psychologists, or specialists—that illustrates the nature and extent of your impairment.

The more recent, pertinent, and consistent your medical evidence, the more persuasive it becomes. And the less likely that your initial disability claim becomes unsuccessful.

How to Appeal after the initial disability claim was unsuccessful

The SSA gives four opportunities to appeal your initial unsuccessful disability claims application.

  • The first appeal is reconsideration where one requests the SSA to reconsider their appeal.
  • The second appeal is an application for a hearing with an Administrative Law Judge (ALJ). This occurs when one is still dissatisfied with the outcome of the first appeal.
  • The third appeal is made to the Appeals Council to review the decision made at the second appeal.
  • The fourth appeal is done at the US District Court where one files a federal district court action.

During the second appeal, the following two tips can help you.

  • Ensure that your testimony is credible.
  • Find legal representation

Credibility of Your Testimony

If you face an ALJ hearing, you can testify about how your impairment impacts your work capacity and daily activities.

The ALJ evaluates your credibility based on factors like appearance, demeanor, consistency, and cooperation. Honest, detailed, and consistent testimony bolsters your credibility.

In some instances, the ALJ may summon a vocational expert (VE) to testify on whether your age, education, work experience, and residual functional capacity (RFC) permit any feasible employment. RFC gauges your ability to work despite impairment.

The VE employs various sources, including the Dictionary of Occupational Titles (DOT), to identify suitable jobs. If no jobs align with your RFC, then you have a disability.

Legal Representation

Why was my Initial Disability Claims Unsuccessful?
An attorney can help you increase your chances of a successful appeal

As mentioned earlier, hiring a disability attorney does not mean that your initial disability application will not be unsuccessful.

Yet, it is important to hire a disability claims attorney as they significantly increase the chances of a successful appeal.

According to a U.S. Government Accountability Office (GAO) study, applicants with legal representation at hearings were nearly three times more likely to be granted benefits than those without representation.

Conclusion

Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are federal programs that provide monthly payments for disabled people.

As they are distinct programs with different benefits and eligibility rules, it is important to differentiate between the two.

Accordingly, the SSDI program gets its funding from workers and employers.

Over time, these funds build up credits that allow workers to claim disability benefits should they suffer a qualifying disability.

Since the funds depend on contributions from individuals and their employers, people who want to claim such benefits should have a qualifying work record.

On the other hand, the SSI program is available to disabled individuals without a qualifying work history.

Therefore, for a successful SSI disability claims application, one needs to show evidence of disability and that their income and resources are barely enough to meet their needs.

By following the tips provided in this article, you increase the chances of success in your initial disability claims application or the subsequent appeal.

I hope the article has been helpful.