Why Does Government Deny Social Security Disability Benefits
Kiplinger’s recent article entitled “3 Main Reasons Why the Government Denies Social Security Disability Benefits” says three main issues are the primary contributors to the high denial rates and prolonged appeals process:
- Applicants fail to satisfy work history requirements. Anyone who pays FICA payroll taxes long enough, is typically insured for SSDI. However, that doesn’t mean they’re eligible for benefits. To meet the SSA definition of disability, one must have physical or mental impairments that prevent them from being unable to perform any substantial gainful activity (SGA) for at least 12 months or have a terminal diagnosis. SGA encompasses work performed for pay or profit, and for 2022, the monthly benefit one would receive after qualification is set at $1,350 a month, or $2,260 if you are blind.
- Applicants provide incomplete documentation. Detailed medical evidence is required to document a disability and its impact on the person’s ability to perform SGA—it’s a crucial part of the SSDI application. This should include diagnoses, medical tests and results, treatment history, prescription drugs, surgeries, ER and doctor visits and other relevant medical details to show not just that you have a problem, but also that you’ve been receiving regular medical treatment for your issue. This, along with details about how a disability influences your activities of daily living, is especially significant if you have an invisible disability, such as mental disorders, neurological conditions or cognitive dysfunctions caused by injury or disease. Regular monthly treatments and drug therapies with specialists and mental health professionals are an important part of your claim.
- Applicants not knowing they have the right to an SSDI representative. The SSA doesn’t tell initial applicants they have the right to retain a representative to assist them. As a result, most people try to navigate the complicated program on their own. You need an advocate to tell the story of your disability and its impact on you and your family. Less than 30% of applicants have an SSDI representative to help them apply. Those individuals are 23% more likely to get their application approved. It also means getting benefits in six months compared with a year or two!
Representatives are taking on more SSDI cases resulting from long COVID symptoms that have exacerbated physical and mental impairments. Long COVID may affect up to 30% of COVID patients, or an estimated 25 million people in the United States, especially those with respiratory disease, diabetes and cognitive issues.
Reference: Kiplinger (July 16, 2022) “3 Main Reasons Why the Government Denies Social Security Disability Benefits”