If you are living with a disability that impacts your daily life or prevents you from obtaining consistent or full-time employment, you are not alone. Approximately 61 million people over the age of 18 in the United States have a disability,[1] which is about 26% of the adult population. Disability in South Carolina has an even broader impact at 31% of adults[2]. For some people living with a disability in South Carolina, it’s not an easy road to access the help and financial support they need.
If your application for Social Security Disability benefits has been denied and you are preparing for the appeals process, Burnside Law Firm, LLC can be your advocate. Our legal team will have compassion for your care and dedication to your case.
Approval Rates and Application Issues
Social Security Disability is notoriously difficult to be approved for on the first try. The vast majority of first-time applicants or applications being submitted for the first time are denied benefits. In fact, during the period from 2010 through 2019, the Social Security Administration (SSA) only approved an average of 21% of initial claims[3]. The good news is that denial in the initial application stage is not the final decision on your disability claim. You have the option to appeal, and there can be multiple opportunities to obtain your disability benefits.
Most Common Technical Denials
The SSA denies disability claims for a variety of reasons, although they will usually fall into two categories – technical denials and medical denials[4]. If your claim for disability in South Carolina has been rejected, it may be unrelated to your actual medical condition and be categorized as a technical denial. Again, the exact reasons will vary, but some examples are:
- The applicant’s income is too high.
- The SSA could not locate or reach the applicant[5].
- Some part of the application was incomplete or inaccurate.
- Insured status was not met.
If a representative from the SSA has tried to contact you and failed to reach you, that may result in a denied claim. Further, missing documentation or including information that was incorrect can also lead to a denied disability claim. We know that this can be overwhelming and confusing, especially during an already difficult time. For those living with a disability in South Carolina, our disability attorney in Columbia is more than happy to offer guidance and support while you go through this challenging process.
As you may already know, the SSA has income limits and specific guidelines for how they calculate income. You must stay within a certain range in order to qualify for Social Security disability benefits. They have very specific rules[6] about how much income you can earn in order to be approved for and even continue receiving disability benefits.
Most of these are pretty straightforward, but what about insured status? This is calculated based on what’s called quarters of coverage[7]. SSA will look at how much time you’ve worked and whether or not you’ve earned enough quarters of coverage to be considered insured.
Most Common Medical Denials
Suppose you have been denied based on medical reasons. In that case, it may be due to a lack of medical evidence, an incorrect diagnosis, failure to follow medical advice or treatment, or unclear medical documentation. However, even if you do everything right in terms of document submission and following your doctor’s orders, claims are sometimes denied.
The following are common reasons for denial of Social Security disability benefits that fall into the medical category:
- Your condition or impairment has been deemed non-severe.
- Your disability isn’t included in the SSA’s listing of impairments[8].
- Your condition is expected to be short-term.
- You are expected to be able to work despite your disability.
Appeals and Reconsiderations
There are four appeal levels offered by the SSA[9] for those who have been denied Social Security disability benefits. First is a request for reconsideration. This is essentially asking for a redo of the initial application stage. In a reconsideration, your application will be reviewed by an additional person who had no part in the first determination. You can submit new information during this reconsideration if you wish to do so.
In the event that the reconsideration does not change the outcome of your disability claim and you wish to elevate your appeal to the next level, you can request a hearing by an Administrative Law Judge. You may also have the option to request a review of the judge’s decision. At this stage, the Appeals Council may make a number of decisions. They may deny or dismiss your request for review, return your case to the judge, or issue a new determination on your claim.
In some cases, a claim can go even further than this into a Federal Court review. A civil action must be filed in Federal District Court to appeal a decision made by the Appeals Council. This is the last and final option for appealing the denial of your disability claim.
Many people claiming disability in South Carolina go through at least one of these appeal stages. If you are unsure what the steps and requirements are for requesting reconsideration or initiating an appeal, please reach out to Burnside Law Firm, LLC. We have extensive experience with meeting SSA requirements and will ensure your appeal is prepared correctly. Contact us today to schedule a free consultation.
[1] Centers for Disease Control and Prevention. Disability Impacts All of Us. https://www.cdc.gov/ncbddd/disabilityandhealth/infographic-disability-impacts-all.html
[2] Centers for Disease Control and Prevention. Disability Impacts South Carolina. https://www.cdc.gov/ncbddd/disabilityandhealth/impacts/south-carolina.html
[3] SSA. Outcomes of Applications for Disability Benefits. https://www.ssa.gov/policy/docs/statcomps/di_asr/2020/sect04.html
[4] SSA. Outcomes of Applications for Disability Benefits. https://www.ssa.gov/policy/docs/statcomps/di_asr/2020/sect04.html
[5] SSA. Program Operations Manual System. https://secure.ssa.gov/poms.nsf/lnx/0411010075
[6] SSA. Working While Disabled: How We Can Help. https://www.ssa.gov/pubs/EN-05-10095.pdf
[7] SSA. Insured Status Requirements. https://www.ssa.gov/OACT/ProgData/insured.html
[8] SSA. Listing of Impairments. https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm
[9] SSA. Disability Benefits: Appeal a Decision. https://www.ssa.gov/benefits/disability/appeal.html
