Why was I Denied for Disability and my Neighbor was Approved?

January 11, 2018 in

Oftentimes people are upset that they received a denial of their disability application when they know multiple acquaintances that have been approved. One of the most frustrating aspects can be when you know your neighbor receives disability benefits and you see them outside mowing their lawn or doing yard work. You may be thinking how can they be disabled and still perform some type of yard work? Thoughts like this are not only unproductive for your situation but they will also frustrate you without helping to approve your claim. One thing to keep in mind is that you cannot always judge a book by its cover. Without reviewing your “neighbors” medical records you cannot say for certain whether they are truly disabled or not. You cannot even say what they are claiming for a disability. Is it based on mental health limitations? Or is it something physical? Maybe they have even been diagnosed with a terminal condition? Being upset about another person’s claim for disability does nothing to progress your claim. It will only distract you from the true goal, which is trying to obtain disability benefits.

If you have been denied the program, you may want to consider the reasons. Generally, there are 6 main reasons people are denied.

Are you currently working? If you are, how much are you earning? You are able to work a small amount and still apply for disability benefits. But if the amount you are earning exceeds a certain threshold you will automatically be denied. The threshold SSA subscribes is called substantial gainful activity or SGA. SGA is a monthly amount of income that exceeds a certain number set forth by the Administration. This amount changes every year. In 2017 SGA is considered to be $1,170 per month. So, if you are earning greater than $1,170 per month you will automatically be denied from the disability program.

Another reason you may have been denied for disability is that your condition is not expected to be disabling for a 12-month time frame. Part of the definition of disability includes a 12-month durational requirement. What this means in effect is that if you are only expected to be disabled for a short time frame such as 6 months, you will not qualify for disability benefits. This is particularly true for individuals diagnosed with some type of cancer. The typical course of cancer treatment includes surgery and then rounds of either chemotherapy or radiation either before or after the surgery. Either way, the total treatment typically takes  6-8 months, thus falling short of the 12-month durational requirement. Certainly, if you have complications with your treatment that extend your conditions and limitations then you may qualify for the program. It will all depend upon how long your limitations continue to be work preclusive.

IF you are not working and your condition has lasted greater than 12 months then maybe the issue is a lack of medical treatment. Medical records are the main piece of evidence used to prove you have a disability that falls under SSA’s definition. If you lack medical treatment because you just have not gone to the doctor you will most likely be denied. SSA follows a general belief that if you are not seeking medical attention then your condition is not severe enough to be disabling. If you do not have medical insurance you can seek treatment through a free clinic, Medicaid, or your state’s social services. SSA likes to see at the very least that you have made attempts to obtain treatment. It is simply not enough to say you have certain medical conditions. You need to be diagnosed by a medical doctor and that same doctor needs to note the limitations the diagnosis causes.

One very simple reason your claim may have been denied is if you were not available for SSA to speak with you. IF you do not have representation then you yourself will be required to provide additional information to the administration. If you do have an attorney then you should expect your attorney to speak with SSA for you. You can expect during the process, SSA will send you several forms concerning your condition and also your work history. SSA may also want to schedule a consultative examination or speak with you directly about your treating providers. If SSA cannot reach you they will more often than not deny your claim. If you move or change your phone number during the application process, be sure to let your representative or someone at SSA knows about the change.

Another simple reason your claim may be denied can be due to a refusal on your part to cooperate with the administration. No matter how frustrated you may be with the process, the best thing you can do is maintain your cool with the employees at SSA. If you vocalize your frustrations you may find your claim denied almost immediately. Employees of Social Security are people. And those people have the power to either approve or deny your claim. It does not help to be rude to someone who is reviewing your claim. You may find your claim denied sooner rather than later due to attitude. That is not to say that your claim may not be approved later on down the line but it certainly will take a lot longer to prove your disability.

One final reason your claim may be denied is if you fail to follow your doctor’s medical advice. If your doctor recommends you take certain medications or undergo a certain type of therapy and you simply refuse, SSA may use that refusal to your disadvantage. The logical question becomes how disabled are you really if you are not even willing to follow your doctor’s advice on how to get better. SSA will make some exceptions if you are unable to follow the medical recommendation due to financial constraints or similar reasoning. Some other excuses include religious beliefs, the psychiatric impairment that prevents you from comprehending, or you have an intense fear of surgery. The best practice is to trust your doctor and to follow their medical recommendations.

I hope this article helps shed some light on the legitimate reasons your claim may be denied. Applying for disability is not an easy process. In fact, you can pretty much expect this to be a lengthy and complicated program. Trying to figure out why your neighbor has been approved benefits and you have not will simply not gain you any ground. The best thing for you to do is obtain an attorney if you have not already done so.