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My Disability Is Legitimate, But My Social Security Disability Claim Was Denied. Why?
Key Takeaways
Millions of Americans who apply for Social Security disability benefits programs face an inefficient system with shockingly high rates of initial rejection, long waiting periods, poor customer service, and a vast backlog of claims. When you're dealing with the physical, emotional, and financial hardships of a disability, the last thing you need is a bureaucratic nightmare of denials and skepticism of your claim's validity. Every day, thousands of Americans confront a system that often seems indifferent to their struggles. Beyond the tangible financial losses, the unfair denial of disability benefits carries a greater cost - the debilitating stress of drawn-out applications, the frustration of unexplained denials, and the looming fear of being unable to provide for yourself or the people who need you.
As we explore the challenges of applying for SSDI benefits and the numerous lives destroyed by denials, remember that you deserve to benefit from the system you've paid into for years. If your claim has been denied by the Social Security Administration, our social security disability attorneys are prepared to provide you with expert representation. Our attorneys' legal expertise and professional guidance can make all the difference in the notoriously complex SSDI appeals process - and they will not rest until you obtain the benefits you need to continue your life.
Understanding SSDI and SSI: A Critical Lifeline for Disabled Americans
Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) serve as a critical support network for those faced with debilitating medical conditions that prevent them from maintaining regular ("gainful") employment. These two programs are more than just government initiatives - they represent our country's commitment to protecting our most vulnerable citizens and providing them with the financial support they need to live.
The SSDI program functions as a form of insurance for workers who have contributed to the Social Security system through taxes during their working years. This program ensures that those whose disability has forced them out of the labor market continue to have a steady source of income. SSI fills in the gaps left by the SSDI program, supporting low-income individuals who have never been able to work or haven't earned enough credits to qualify for SSDI. While SSDI is funded by income taxes, SSI is funded by general taxes and considers factors like age, blindness, and disability, coupled with limited income and resources. The combined impact of these benefits is transformative. They offer an economic lifeline to millions of Americans, reducing financial stress and helping pay for essential medical treatments, medications, and everyday living expenses. Furthermore, they provide a sense of financial independence, dignity, and security in situations that would otherwise be marked by uncertainty and hardship.
Supplemental Security Income (SSI) payment amounts for 2023
| Eligible Individual | $10,970.44 | $914 |
| Eligible Couple | $16,453.84 | $1,371 |
| Essential Person | $5,497.80 | $458 |
Social Security Disability Insurance (SSDI) average payment amounts for 2023
| Disabled Former Workers | $20,182.59 | $1,681.88 |
| Spouses of Disabled Workers | $4,895.90 | $407.99 |
| Children of Disabled Workers | $5,699.33 | $474.94 |
Who is Eligible for Social Security Disability Benefits?
Eligibility criteria for disability benefits are carefully defined and (often harshly) enforced by the Social Security Administration. To be considered disabled by SSA standards, you must meet the following criteria:
A. You're unable to perform the work you previously performed due to a medical condition.
B. Due to your medical condition, you cannot adapt to other forms of work.
C. Your disability has lasted or is expected to last for at least one year or is expected to result in death.
It's worth noting that these programs are not designed to support individuals with short-term or partial disabilities - only those with long-term disabilities that prevent them from any substantial employment may qualify. Thus, those with temporary disabilities or those who can still engage in part-time work, regardless of how limited, might not meet the SSA's strict definition of disability.
The majority of Social Security disability beneficiaries in December 2022 were disabled workers (85%), followed by disabled adult children (13%) and disabled widow(er)s (2%).
Navigating the SSDI Application Process
The process of applying for Social Security Disability Insurance (SSDI) begins with submitting an initial application, a task that can be done online, by phone, or in person at a local Social Security office. This application is comprehensive and requires detailed information about your work history, education, personal data, and most importantly, your medical condition. It's important to keep in mind that success is often found in the details: comprehensive medical evidence, accurate work history, and excellent communication with the SSA can significantly influence the outcome of your SSDI application. Persistence, precision, and patience are key to navigating the SSDI application process.
Once your application is submitted, it is forwarded to your state's Disability Determination Services (DDS) office. Here, a team of disability specialists and medical consultants will thoroughly review your claim. They will delve into the specifics of your disability, examine your capacity to carry out work-related activities and assess how your medical condition impacts your professional abilities. This analysis is rigorous and adheres strictly to SSA guidelines for determining disability.
However, this initial submission and review are only the first steps in what can often be a lengthy process. If the claim is denied initially (as are 65% of initial applications) there are several levels of appeal, including reconsideration by DDS (Disability Determination Process), a hearing by an administrative law judge, a review by the SSA's Appeals Council, and even federal court review. This multi-tiered process can span months or even years, testing an applicant's patience and resilience. Our attorneys have years of experience with helping applicants appeal their disability benefits denial. We will provide you with comprehensive, compassionate representation throughout this process.
Applying for SSDI Benefits Is An Uphill Battle for Many
Navigating the application process for SSDI benefits can be harrowing, especially without a steady source of income. The statistics surrounding applicant denials are shocking; in 2023, the SSA made 1.9 million decisions on who qualified for disability benefits. A staggering 61% of applicants were met with heartbreaking denial on their first try. For those who chose to move forward with an appeal, a disheartening 85% of claims were still met with rejection.
Amidst this sea of denials, applicants who pushed even further for recourse, pursuing an Appeal to the Federal Court, were met with mixed outcomes. In nearly 6 out of 10 cases, federal judges remanded the claims back to the Social Security Administration for a new hearing. This process of appeals and remands prolonged an already agonizing wait for thousands of applicants, leaving them disheartened and lacking necessary financial support.
Government concerns about fraud have cast a shadow over the application process, potentially contributing to this astronomical rate of denials. Recent incidents, such as the Eric Conn fraud case, have led to increased scrutiny and skepticism towards legitimate claimants. However, experts in the field, including Som Ramrup, President of the American Association of Administrative Law Judges, emphasize that Social Security disability fraud is infrequent. Michael J. Astrue, former head of the SSA under President George W. Bush, concurs and estimated that less than 1% of disability claims are fraudulent.
The difficulties associated with applying for and receiving benefits are further compounded by the issues currently facing the Social Security Administration. Insufficient funding, coupled with an increasing demand due to an aging population and greater benefit needs, has resulted in operational difficulties such as longer wait times and a growing case backlog. This issue is compounded by inflation, which places more strain on recipients struggling to cover basic necessities with limited benefits in an unstable economy. Additionally, disruptions in the SSA's phone services, a critical lifeline for many applicants, add another layer of frustration to an already challenging process.
Social Security Telephone Stats: Speed to Answer and Call Abandonment Rates
| Average Speed of Telephone Answer for the National 800-Number | 14.98 minutes | 34.57 minutes | 35.83 minutes |
| Percent of Callers Who Abandon the Call | 34% | 43% | Data not available yet |
The Impact of Judges on SSDI Claims
Judges play a pivotal role in deciding the outcomes of thousands of deserving applications. However, concerns have been raised about inherent biases and corruptions within the system. Spencer Bishins, a former SSA insider and disability rights lawyer, revealed that the SSA seems to favor judges who deny a high percentage of cases, while those who often rule in favor of disability applicants may face scrutiny - and are even sent for counseling. This skewed approach creates an environment where judges may feel pressured to prioritize denials rather than genuinely assessing the validity of each claim.
The stark contrast in approval rates among the nation's 1,250 SSA judges further highlights these disparities. Recent government studies revealed that one judge approved an astounding 97% of disability claims, while another approved only 10%. Because SSA judges are pressured to complete 500 to 600 cases each year, it can be incredibly challenging to provide each claim with the thorough examination it deserves. These cases are often complex, with extensive medical reports and conflicting expert opinions. With limited time to research and analyze each case, judges may be forced to make decisions under constraints, affecting the thoroughness and fairness of their rulings.
A 2017 change in judicial rules worsened the likelihood of approval for many applicants. This change eliminated the requirement for judges to explain their decision to weigh one medical provider's testimony over another's. This shift has serious implications for claimants, allowing for subjective interpretations without accountability or transparency. This rule change directly affected Kelly Page - in her case, Judge Stephen Cordovani gave greater weight to the written report of a neurologist, Dr. Steven Goldstein, who had never met or interviewed Page. Goldstein's opinion, which suggested Page could return to work, outweighed the contrary assessment of a Buffalo, New York doctor who had treated and examined her extensively.
How many claims does the Social Security Administration deny?
| Decisions made | 2.8 million | 1.8 million | 1.9 million |
| Perecent of initial applications that are denied | 64% | 62% | 61% |
| Percent of first-level appeals that are denied | 87% | 85% | 85% |
| Percent of claims denied by administrative law judge | 42% | 39% | 30% |
| Percent of appeals to the Social Security Appeals Council that are denied | 85% | 84% | 83% |
| Percent of appeals to the Federal Court that are denied | 34% | 37% | 33% |
Frequently Asked Questions
According to the Social Security Administration (SSA), disability is defined in terms of one's inability to work. Specifically, the SSA considers you disabled if you are unable to do any substantial gainful activity due to a medically determinable physical or mental impairment that has lasted or is expected to last for at least one year or result in death. It's important to note that this impairment must be severe enough to prevent you from performing not only your previous work but also any other type of work considering your age, education, and work experience.
Filing a Social Security Disability claim initiates a multi-stage process. First, you complete an application, which can be done online, over the phone, or in person at your local SSA office. This application requires a comprehensive collection of information, including medical evidence, your work history, and personal information. Once the application is filed, it undergoes an initial review by the Disability Determination Services (DDS) office in your state. If your claim is denied, which is a common occurrence, you have the right to request reconsideration. Should the claim be denied again, you can then request a hearing before an administrative law judge. It's a complex and often long process, which can be navigated more efficiently with the help of an experienced disability attorney.
The amount of compensation you receive from Social Security Disability benefits is based on your average lifetime earnings before your disability began, not the severity of your disability or your current income. This is calculated using a complex formula that takes into account your Social Security earnings record. While the average monthly disability benefit is around $1,358, the amount can vary significantly depending on your individual circumstances.
Medical evidence forms the backbone of a Social Security Disability claim. This evidence should comprehensively document your physical or mental impairment and its impact on your ability to work. Such evidence typically includes medical records from doctors, hospitals, therapists, or other medical providers, lab test results, imaging studies, and a detailed account of the treatments you've received and your body's response to them. Additionally, statements from healthcare professionals regarding your ability to perform work-related activities can be very helpful.
Yes - the SSA encourages recipients of SSDI and SSI benefits to gradually transition back into the workforce if at all possible. The SSA offers work incentives for SSDI recipients in the form of a "Trial Work Period" (TWP). During the TWP, you can work and earn any amount without jeopardizing their SSDI benefits, as long as your disability still meets the SSA's definition. The TWP lasts for nine months within a rolling five-year period. Following the TWP, there is an extended period of eligibility during which you can work and receive benefits for all months you earn below the substantial gainful activity (SGA) threshold (an earnings limit set by the SSA each year). However, if your earnings exceed the SGA limit, your benefits may be affected.
For SSI beneficiaries, working can affect benefits differently. As SSI is a needs-based program, any income earned from work may reduce your benefit amount. The SSA will count your earnings, and a portion of them will be deducted from your SSI payments, based on a specific formula. Regardless, you will still retain your Medicaid coverage.
If you have further questions, consult with our attorneys to understand the specific rules and work incentives that might apply to your situation. Working while receiving disability benefits can be complex, and professional guidance can help you make informed decisions about your employment and benefits.
When the Safety Net Snaps: Struggles of Denied SSDI Applicants
After a life-altering brain aneurysm in 2016 and a subsequent stroke during a corrective surgery, New York native Kelly Page faced severe memory loss and impairments that left her unable to work the job she loved or pick her son up from school. Despite extensive testimony from medical providers, her initial application for Social Security disability benefits in January 2018 was rejected by the Social Security Administration (SSA). Almost two years later, the SSA finally approved Page's claim, only to halt her benefits in early 2020 after a random review ruled that she was never disabled. Page, whose job loss had cost the family $38,000 a year, was forced to start the entire disability claims process from the beginning.
Page's experience is not unique. SSDI applicant Leah Biggins Charache, a former Army combat nurse who served her country in the aftermath of the 9/11 attacks, faces a continued dispute of her claim by the SSA, despite being classified as 100% disabled by Veterans Affairs due to post-traumatic stress disorder (PTSD) and the devastating loss of her infant son in 2013. Similarly, applicant Kristi Curran's late ex-husband, Michael J. Curran Jr., a retired state trooper, endured a traumatic brain injury after slipping on ice in 2016. After a three-month coma, he spent the rest of his life in nursing homes, entirely dependent on care and support. While the family was initially awarded disability benefits, they were taken away in 2019 due to a simple clerical error on a tax return. Despite providing all the necessary paperwork and evidence to rectify this mistake, they faced years of resistance by the SSA before his benefits were eventually reinstated.
If Your Application Has Been Denied, Call Wettermark Keith
If you’re grappling with the financial and emotional repercussions of a denied SSDI claim, we urge you to contact Wettermark Keith immediately. During your free consultation, your lawyer will carefully review the details of your case to identify any issues or mistakes in your initial application. If you choose to proceed with legal assistance, your attorney will gather evidence to strengthen your claim - including work history, income information, and medical records - and collaborate with healthcare providers to obtain detailed professional opinions about your disability and its severity. They will guide you through the appeals process, represent you at hearings, and serve as a reliable, compassionate source of legal counsel. Don’t hesitate - contact Wettermark Keith at (877) 715-9300 or via our website chat or online form to schedule a complimentary consultation with our legal team.
With offices located throughout Alabama, Tennessee, and Florida, we have an excellent reputation as one of the most accomplished personal injury firms in the country. Our reach is not only regional but includes a diverse range of practice areas, including premises liability law, personal injury cases, auto wrecks, trucking wrecks, insurance dispute claims, nursing home abuse, medical malpractice, on-the-job injuries, social security disability, and veterans’ disability claims, to name just a few. At Wettermark Keith, we believe in taking cases personally. Our purpose is to advocate with care and compassion- to tell our clients’ stories and make their voices heard. Our lawyers do this by building strong relationships based on constant communication and an unwavering dedication to truth and trust. You should never wonder what’s going on with your case. We will keep you in the loop and treat you like family- because to us, you are.
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