WHY SOCIAL SECURITY WON'T PAY YOUR DISABILITY
In this post, I want to discuss why Social Security won't pay your disability claim. It's true that about three-fourths of disability claims are denied. The reason for denials falls into two broad categories: technical shortcomings and medical shortcomings. Since most claims are denied because of medical shortcomings, I will address that area first.
MEDICAL SHORTCOMINGS
The law requires Social Security to have proof of disability. The proof must be such that it satisfies Social Security. This proof must be based on objective medical evidence. The claimant must submit evidence from qualified medical providers, showing the onset, severity and symptoms of the impairments.
For most claimants, the burden of proof is this: You are so impaired that you are unable to perform the demands of any full-time job which exists in the US economy. In short, you cannot perform a simple, entry level, minimum wage job at the sedentary (sit down) level.
Most denials are "Step 5" denials. The denial, on the last page, will say: "The evidence shows that you cannot perform your past work. However, you are able to perform most activities. There are other jobs that you would be able to perform." In short, past work is out but you can do an easier job. Thus, you are not disabled.
In addition to proving that you have a severe medical condition, you must also prove that the symptoms of the condition are so severe that they prevent you from sustaining any full-time work. I could say a lot about how difficult this is to prove--but let me just say this: Get your doctor on board. Get a "residual functional capacity" statement from your doctor as early in the process as you can. This can solve a lot of problems.
Many claimants believe they can convince Social Security all by themselves that they deserve a benefit and all will be well. These individuals are always denied. It isn't about convincing anyone. It is about medical proof. P-R-O-O-F. Get the proof and you can usually win your claim.
TECHNICAL SHORTCOMINGS
A technical shortcoming is a problem which prevents the claim from being medically evaluated. In other words, the claim doesn't meet the requirements for payment even if the claimant is found to be medically disabled. Here are a few examples:
1. The claimant has not worked enough to have insured status for Social Security Disability Insurance (SSDI). In other words, he/she has not paid enough into the system, therefore, is not covered. Medical disability doesn't matter.
2. The claimant is still working at substantial gainful activity; therefore, he or she is not entitled to a benefit, even if medically disabled.
3. If it's a Supplemental Security Income (SSI), the claimant has too much income or financial resources to get a benefit.
4. If it is an appeal of a former denial, the appeal was not timely filed. In other words, the appeal was filed late and missed the deadline. Therefore, it is dismissed without the medical evidence being considered.
MEDICAL SHORTCOMINGS
The law requires Social Security to have proof of disability. The proof must be such that it satisfies Social Security. This proof must be based on objective medical evidence. The claimant must submit evidence from qualified medical providers, showing the onset, severity and symptoms of the impairments.
For most claimants, the burden of proof is this: You are so impaired that you are unable to perform the demands of any full-time job which exists in the US economy. In short, you cannot perform a simple, entry level, minimum wage job at the sedentary (sit down) level.
Most denials are "Step 5" denials. The denial, on the last page, will say: "The evidence shows that you cannot perform your past work. However, you are able to perform most activities. There are other jobs that you would be able to perform." In short, past work is out but you can do an easier job. Thus, you are not disabled.
In addition to proving that you have a severe medical condition, you must also prove that the symptoms of the condition are so severe that they prevent you from sustaining any full-time work. I could say a lot about how difficult this is to prove--but let me just say this: Get your doctor on board. Get a "residual functional capacity" statement from your doctor as early in the process as you can. This can solve a lot of problems.
Many claimants believe they can convince Social Security all by themselves that they deserve a benefit and all will be well. These individuals are always denied. It isn't about convincing anyone. It is about medical proof. P-R-O-O-F. Get the proof and you can usually win your claim.
TECHNICAL SHORTCOMINGS
A technical shortcoming is a problem which prevents the claim from being medically evaluated. In other words, the claim doesn't meet the requirements for payment even if the claimant is found to be medically disabled. Here are a few examples:
1. The claimant has not worked enough to have insured status for Social Security Disability Insurance (SSDI). In other words, he/she has not paid enough into the system, therefore, is not covered. Medical disability doesn't matter.
2. The claimant is still working at substantial gainful activity; therefore, he or she is not entitled to a benefit, even if medically disabled.
3. If it's a Supplemental Security Income (SSI), the claimant has too much income or financial resources to get a benefit.
4. If it is an appeal of a former denial, the appeal was not timely filed. In other words, the appeal was filed late and missed the deadline. Therefore, it is dismissed without the medical evidence being considered.
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