UNDERSTANDING YOUR DISABILITY DENIAL LETTER

 

If you've ever applied for Social Security disability, chances are you have received a denial letter.

At first glance the letter seems like a lot of legal mumbo jumbo. It may not make sense.

However, you need to read the letter thoroughly to find out why Social Security denied your claim. Understanding why the claim was denied is the first step to a successful appeal.

In most denial letters, the reason for the denial is given on the last page of the letter, and often in the final paragraph.

After 20 years in Social Security practice, we have found the 3 main reasons that disability claims are denied:

1. We find that you do have some impairments and you are not able to perform your past work. However, there is other work in the national economy that you could do.

This is a Step 5 denial. It most often occurs with claimants who are under age 50. Perhaps your past work was really demanding and you can no longer sustain it. However, if there are other, easier jobs in the national economy that you theoretically could perform, Social Security will deny the claim. Younger individuals are only disabled in Social Security's thinking if they are unable to do any type of full-time work.

2. We find that you have some impairments; however, you are still able to perform one or more of your past relevant jobs.

This is a Step 4 denial. Social Security believes that you are able to perform at least one of the jobs you have performed in the past 15 years. In this case, they will usually consider the easiest job you had within the 15 year period. For instance, if you had a desk job with very little walking, standing or lifting--Social Security will find that you could still perform that job.

3. You state that you are unable to work because of (list of conditions). We have been unable to obtain sufficient medical evidence to make a favorable decision on your claim.

Here, it is likely that you are being denied for one of two reasons:

a) Your application didn't list doctors or other providers who have records to verify your severe medical conditions, OR

b) The doctors you listed simply did not respond to Social Security's request for records.

Social Security will usually contact medical providers twice (usually by mail) to request records. If the records do not arrive within a few months, the claim is denied. It is important that you check with the Disability Determination Service (DDS) in your state to be sure that records from your medical providers have been sent in. Often, you (the patient) can contact the doctor or hospital and convince them to send the records in. Don't just assume that Social Security got all the records they need to make a decision. Often they do not.

The Forsythe Firm represents individuals who need disability benefits. One of our jobs is to make certain that the medical evidence needed to get a fair, accurate decision is submitted to Social Security. We work with doctors and other providers to obtain these records in a timely manner.