What Is An SSDI Denial Letter?

An SSDI denial letter is a document sent by the Social Security Administration (SSA) explaining why an individual’s claim for SSDI benefits may be denied. The SSDI denial letter includes all the basic information about their disability claim, such as:

• Date of their disability onset
• Diagnosis of their disability
• Whether they are currently working or not

The denial letter will also provide the specific reason for the claim’s denial and appropriate instructions on how to appeal the decision. 

Some reasons for denial may comprise missing paperwork, missing the deadline, incomplete documents, and SSA’s assessment of the disabled applicant. An experienced Social Security Disability Attorney may help if you have applied for the SSDI benefits and received a denial letter.

What To Do If You Get a Social Security Disability Denial Letter?

There are 3 phases for appealing in case of denial of disability claim:

• Request for hearing:

A disability applicant must appeal within 60 days to request a hearing before an administrative law judge (ALJ).  It is not mandatory to hire a disability lawyer to represent your case. However, appealing at the court hearing with an attorney representing your disability claim before the administrative law judge (ALJ) will be beneficial and increase your chances of approval. 

If you represent yourself and lose, you may have to apply again. Therefore, legal representation may create a huge difference. They are experts in the appeal and reconsideration process and will prepare your case that will reverse your denial while presenting before ALJ. 

These judges will uphold and overturn decisions based on Social Security Disability Benefits. According to estimates, ALJ grants approximately 50% of disability claims that reach the hearing stage.  

• Appeals Council:

If the ALJ decides you are not disabled, you may file an appeal with the Appeals Council. You must file an appeal within 60 days when the judge decides. The appeals council’s decision depends on evidence, including medical records. The Appeals Council may not allow you to present your disability claim again, except in certain cases. 

• Federal Court Review

You can appeal to the Federal Court if the Appeals Court denies your claim. You must file an appeal within 90 days of the Council’s decision. The federal judges will determine whether the Administrative Law Judge adopted appropriate procedures in your disability hearing process. They will further analyze whether ALJ made any error in denying your disability benefits.

• Do Not Worry After Receiving A Denial

Navigating the SSDI application process can be challenging. You will need to wait three to five months to learn whether you have been accepted or denied. Receiving an SSDI denial letter is not uncommon, as the initial acceptance rate hovers around 24.6%. 

The crucial thing to remember is that a denial doesn’t necessarily mean you’re ineligible. Most people who appeal at the hearing stage are eventually approved. This article will guide you in understanding and responding to your SSDI denial letter, emphasizing the importance of the appeals process.

How an SSDI Lawyer Might Argue Your Case?

An experienced SSDI lawyer may present an argument that will help to support your disability claim. They can help you if you get involved in disputes by the following:

• They will explain how your medical condition prevents you from holding a job.
• Help to gather additional medical evidence that will support your claim.
• Ensure that your application gets answered within 60 days of the deadline.
• Contact medical experts who can help support your SSDI benefits requirement.

Reasons For Denial Of SSDI Application

SSDI applications can face denials for both medical and non-medical reasons, highlighting the importance of addressing various aspects of the application process.

Medical Denials:

• Insufficient Medical Evidence: The most common medical denial occurs when the applicant’s medical records fail to adequately demonstrate the severity and impact of the disability.
• Failure to Meet Blue Book Criteria: The SSA’s Blue Book outlines specific criteria for various disabling conditions. If your medical condition doesn’t align with these criteria, it can result in denial.
• Medical Improvement Expected: If the SSA anticipates that your medical condition could improve within a year, it might result in a denial.
• Failure to Follow Treatment: If you haven’t followed prescribed medical treatments without a valid reason, the SSA may question the seriousness of your disability.

Non-Medical Denials:

• Engaging in Substantial Gainful Activity (SGA): If the SSA believes you can perform substantial work despite your disability, your application may be denied on non-medical grounds.
• Lack of Cooperation: Failure to provide necessary documentation, attend medical exams, or respond to SSA inquiries can lead to a non-medical denial.
• Inability to Contact You: Your application may be denied if the SSA cannot contact you for additional information or clarification.

Understanding the specific nature of the denial is crucial for preparing a targeted appeal. Seeking guidance from a disability attorney can help navigate the complexities of medical and non-medical denials.

How Can A Disability Attorney Help You?

If your SSDI application is denied, an SSDI Lawyer can be a crucial ally in your appeal. They possess the expertise to navigate the complex legal process, gather necessary evidence, and present a compelling case before an administrative law judge (ALJ). 

Their knowledge of disability law and experience with the appeals process significantly improve your chances of overturning the denial and securing the benefits you deserve.