Disability BenefitsWhat to Do if your SSDI Claim is Denied After an Accident?

October 11, 20230

For those who rely on Social Security Disability Insurance (SSDI), being denied a claim can be financially devastating for them. However, it does not mean there is no way around it because a denied SSDI claim is not necessarily a permanent obstacle. Let’s elaborate more on the steps you can take to remedy the situation next.

Understand Why Your SSDI Claim Was Denied

When the Social Security Administration (SSA) denies a claim, they are legally obliged to let the claimant know the reason behind their decision. The reason(s) should be included in the Denial Notice they send to everyone who was not accepted. If you have received your denial notice from the SSA, it should have the following sections:

  • Description of the claimant’s medical condition.
  • List of all disabilities considered by the SSA while assessing the claim.
  • All medical examination records and the claimant’s medical history assessed by the SSA.
  • A reason and an explanation in support of their decision to deny the SSDI claim.

Read through the reasons cited and the explanation given carefully, because your appeal against the denial will be based primarily on that part.

Get to Know the Common Reasons Why SSDI Claims are Denied

The following are among the most common causes given by the SSA to deny a SSDI claim.

  • High Income: The claimant’s current income is above the substantial gainful activity (SGA) limit.
  • Cannot be Located: The SSA was not able to locate, contact, and/or interview the claimant.
  • Refusal to Release Medical Records: The claimant refused to release/disclose the relevant medical information to the SSA for verification and assessment.
  • Refusal to Go through Consultative Examinations (CE): The claimant refused to undergo consultative examinations requested and paid for by the SSA.
  • SSDI Requirements Not Proved: The claimant did not prove sufficiently that they have a disability that will last for at least 1 year or can be considered potentially lethal.
  • Failure to Follow Prescribed Treatment – Claimant did not undergo treatment prescribed by qualified medical personnel.
  • Addiction: Claimant’s condition is a result of or was worsened by their abuse of and addiction to alcohol and/or drugs.
  • Criminal Activity: The claimant has a criminal record that disqualifies them.

Check the Reasons Cited against Verifiable Facts

Check the reasons cited and the explanations given against documented facts to figure out if there is a discrepancy. SSA records can be outdated, erroneous, and even completely wrong at times, so checking the reasons cited by the SSA for denying your application against verifiable facts is the first step towards launching a strong appeal against it. Note that it is invariably better to appeal a denied SSDI claim than it is to reapply.

Appeals have a considerably higher chance of getting approved by the SSA compared to reapplying for SSDI. Even if the reasons cited are accurate and in line with facts, they can be successfully appealed against. For example, if the claimant was denied because they did not follow the treatment advised by their doctor, financial inability can be cited as a justifiable cause. However, if the claim was highly inconsistent to begin with, that’s when you may wish to reapply with the aid of experienced SSDI attorneys.

If you wish to know more about the SSDI claims and appeal process, call us now for a free consultation on (617) 263-0860.

To meet your Boston SSDI legal representation team at the Mass Injury Group, visit us at: 15 Broad St #800 Boston, MA 02109.

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