WHY DOES SSA KEEP DENYING MY CASE?
WHY ISN’T THE SSA GRANTING YOUR BENEFITS?
At Cannon Disability Law, we hear a version of this question every day. People look at their neighbors and believe they should not be getting paid SSDI and SSI benefits. People compare themselves to others and think their illness is worse. Therefore, they believe they should get benefits and can’t understand why the SSA denied their case.
If you are asking yourself similar questions, please remember you may not know all of the details about your neighbor’s medical condition. SSA grants SSDI and SSI benefits for mental health issues, IQ issues, anxiety, or other medical conditions that may not be visible to the eye.
USING THE MEDICAL VOCATIONAL GUIDELINES
Your neighbor may qualify for benefits because they deserve benefits under the Medical-Vocational Guidelines. The GRID Rules allow the SSA to pay benefits based upon a combination of age, education, and transferability of skills.
If your neighbor is over 50 and worked an unskilled job for most of their life and they can no longer do that job, they may qualify for benefits – even if they could do some sort of work. For a description of how the Medical-Vocational Guidelines work, go to our page about the rules for people over 50 years old.
Social Security will make a finding about what you can physically do in a work setting. This is the only way the judge can apply the Grid rules. Usually, a judge will determine your “residual functional capacity” at a hearing. The judge looks to your medical records and the opinion of your doctor to determine what kind of work you can do. The judge will put you into one of the five levels of exertion. The five levels are sedentary, light, medium, heavy, and very heavy. If the judge decides you require an easier type of work and you are over 50 years old, then you may be paid benefits.
IS YOUR NEIGHBOR ON SSI BENEFITS?
If your neighbor has never worked a full time job and they are on benefits, they are probably getting SSI benefits. For example, in 2023, SSI benefits are $914 a month in Utah, but some states pay more than that. The benefit is low, as it puts anyone who receives it at less than the poverty level. SSDI benefits, however, are based upon the amount of money you have earned during your lifetime. If you are a high wage earner, your SSD benefit should be higher than the SSI amount.
MOST CASES ARE DENIED AT THE OUTSET OF THE CLAIM
The SSA has set a goal for all of the judges in the country, telling them that they can only grant an average of 40% of SSD and SSI cases. This means that at every level of the appeal process, people who deserve benefits are denied. Is it fair for judges to deny or grant a set percentage of cases?
Some argue that ALJs should not be swayed by SSA’s goals. Instead, cases should be decided on merit alone. Nevertheless, most cases are going to end up being denied during the appeal process. Then, they must go before a judge at the hearing level. If you were a judge, wouldn’t you feel pressure to comply with what the SSA wants you to do, considering they employ you?
When a judge denies or grants a case, the Appeals Council has the right to review the decision. The Appeals Council can review a case and decide to remand the case back to the judge to make a new decision. They can do this even if the judge grants the benefits. Find out more on our website about Appeals Council review.
THE DIFFERENCE BETWEEN THE SSD & SSI PROGRAMS
The federal government has two different benefit programs. These are the Social Security Disability Insurance (SSDI) program and Supplemental Security Income (SSI). To qualify for either, you must have a mental or physical condition that limits your ability to work for more than one year or that will result in death. Also, to win SSD benefits, you must have enough work credits. The SSI program, however, has income and asset limits.
Funded through payroll taxes, SSDI pays benefits to individuals with a work history. If the SSA approves you for benefits, then you will receive benefits six months after your medical condition began and you were unable to work. The first six months after your onset date is a waiting period. SSD benefits are not payable during that time.
Once your waiting period is over, you can receive your monthly benefit payment. If you receive SSD, then you can also get Medicare benefits. There is a 29 month waiting period for Medicare benefits. The 29 month waiting period is made up of the waiting period and 2 years. Therefore, after the 29 month waiting period, you can get Medicare benefits.
If you file an SSI application and receive benefits, then may also be able to get Medicaid. To receive Medicaid, you must meet your state’s income and asset rules. Medicaid payments, like SSI benefits, begin the date you file your application. There is no waiting period. However, there is also no past due period of benefits prior to the application date. Find out more here about past due benefits.
WHAT OUR LAW FIRM DOES FOR YOU
You do not have to obtain SSD benefits on your own. We can help file your SSD application. Also, we can help you through each of the appeal stages of the Social Security process.
When you leave that up to us, you can focus on your health. Our attorneys and staff can:
- Help you file your application for SSD and SSI benefits
- File an appeal if you receive an initial denial from DDS
- Collect your medical records
- Help you confirm your free SSA Doctor Exam
- Request a Hearing with an SSA judge
- Prepare you to testify at your ALJ hearing
- Represent you at your hearing and question the expert witnesses.
- Read more about job experts here.
- Learn more about medical expert testimony here.
- Request review of an decision with the Appeals Council
- Request review of an Appeals Council denial in Federal Court
If you file your SSD application online at Social Security’s website, then you have 6 months to complete the application. It is best to complete the application quickly. You don’t want to run out the 6 month time limit.
WIN YOUR SSD BENEFITS, EVEN IF YOU GET A DENIAL
Even if you don’t know why the SSA hasn’t granted your case, just remember that almost everyone is denied. All the denial proves is that it is more difficult to win benefits today than it was 20 years ago. But, you can still win benefits. You will need to see your doctor regularly and collect all of your medical records. Additionally, you need to confer with your lawyer so she can help you with your case. If you have questions about your SSD and SSI case, contact us now.
Cannon Disability Law want to be your legal team for you SSD case. We represent clients in Utah, Nevada, Idaho, California and Colorado. Read here about Utah SSD benefits. Nevada SSD benefits are here. You can also learn more about California SSD benefits. If you have a hearing in another state, like Colorado or Arizona, we can come represent you where you live.
The attorneys and staff at our law firm are Social Security law experts. Learn more about the legal team at our law firm on our About Us page.
Take advantage of our free review of your case. All of our cases are done on a contingency fee, which means you don’t owe an attorney fee unless we win your case. If we don’t win you benefits, you will never owe an attorney fee. Consider our success rate and our legal experience, then call us today. If you do, then it will help you to not worry about why the SSA hasn’t granted your benefits.
