Why Was My Disability Claim Denied If My Doctor Agrees That I’m Disabled?

The benefit programs that Social Security offers to Americans with disabilities are important. They allow people to continue living fulfilling lives even after they’ve lost the ability to work. People who are eligible for these benefits receive a monthly income, in addition to health insurance through Medicaid or Medicare.

To ensure that these benefits remain available to people with severe and permanent disabilities, the Social Security Administration imposes strict guidelines on who is eligible and who is not. To be eligible, a person’s condition must prevent them from earning a living wage. The disability must also be permanent, which means that it’s expected to last at least twelve months, or is terminal.

Unfortunately, the process of determining eligibility isn’t perfect, and all too often, people are incorrectly told that they are not disabled. In fact, Social Security sends more rejection letters than it does approval letters.

Understanding rejections from Social Security

Whether you’re applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), you must have a disabling medical condition, one that prevents you from working and isn’t expected to improve in the near future.

These guidelines may seem simple at first glance. Most often, the hard part is proving your degree of impairment to the Social Security Administration. In most cases, this isn’t as simple as having a certain disease or disability. After all, many people with chronic illnesses or other disabilities can still work full-time, so approval is usually given on a case-by-case basis.

Some of the most serious conditions, like certain kinds of cancer or dementia, automatically qualify a person for disability. These approvals are known as “Compassionate Allowances,” and they are most often given for terminal illnesses. Conditions that have variable symptoms or outcomes for different patients, like many autoimmune diseases or psychiatric conditions, aren’t approved automatically.

While a statement from your doctor carries a lot of weight, and may even be required in some cases, it doesn’t guarantee approval. Social Security has its own system for determining eligibility, and while it’s informed by the medical community, it isn’t always in complete agreement. This is often a source of frustration for applicants and their doctors alike.

What to do when you’ve been unfairly rejected

If you’ve been unfairly denied benefits, don’t give up. Many people are rejected the first time they apply, and these same people are often approved later. As long as you appeal the denial within 60 days, you’ll have another chance at approval.

No matter where you are in the process, we are here to help you every step of the way. Reach out to us by phone, email, or text message, and we’ll connect you to a qualified and experienced disability attorney. Schedule a free consultation today!