Monday, May 18, 2009

Why are Most Disability Cases Denied?

If you attempt to deal with the shortened version of this question, "Why are disability cases denied?", you'll come up with a variety of answers.

In general terms, some cases may be denied because the determination has been made that a claimant can return to their past work. In other cases, a social security disability denial may be issued because while it was concluded that a claimant could not return to one of their former jobs, it was nonetheless concluded that they could, based on their age, education, work skills, and level of functional limitations, transition to some type of "other work".

In more specific terms, we can say that some cases are probably denied because a claimant's doctor failed to provide a residual functional capacity statement that might have sufficiently spelled out just how limiting a claimant's medical or mental condition is, and how their current and anticipated level of functioning rules out the ability to engage in work activity. And, in yet other cases, we can say that a disability denial may have occurred because the claimant's work history was not properly identified.

However, in this post, we're not dealing with the shortened version, but the longer version of the question which is "Why are most disability cases denied?". And the answer to that question is very simple, though it comes in two parts:

1. A lack of medical evidence.

2. A lack of medical evidence that sufficiently documents the existence of functional limitations that effectively rule out a person's ability to work and earn a substantial gainful income, either at a job they've done in the past, or at some other type of work for which they might be suited based on the vocational factors we mentioned in the second paragraph.

Of course, this highlights, once again, two very important things to keep in mind for individuals who are filing for disability and even individuals who are considering applying for disability.

One is to make sure that when you apply for disability (or do an appeal) you supply detailed and accurate information regarding your history of medical treatment. Because even if you have been treated, if the disability examiner working on your case cannot access those medical records, they might as well not exist.

Secondly, make sure that you seek treatment for your condition or conditions, whether they are physical, mental or both. Sometimes, this can seem pointless to individuals with chronic conditions for which there are few, if any, treatment options. And continuing to seek medical treatment for such an impairment can seem particularly pointless when a claimant's own doctor has released them under the rationale that they cannot help them any further.

However, from a disability claim processing standpoint, the only thing that really matters is that you have medical evidence to back up your claim for disability. Because without the proof that comes from medical record documentation, a claimant's rationale for applying for disability benefits is nothing more than a set of allegations. Which is why SSA uses the phrase "alleged onset date" (AOD) of disability and when a disability claim is approved the operative phrase then becomes "established onset date" (EOD) of disability.

Return to the Social Security Disability SSI Benefits Blog

Other Posts

Should I Appeal my Social Security Disability Denial, or get a Lawyer First?
Social Security Disability Hearing Decisions
Social Security Disability Appeal Deadlines
Is it worth appealing a Social Security Disability denial by an Administrative Law Judge?
Should you appeal a disability denial if your condition is improving ?
Social Security Disability and Taking Your Medications
What does Social Security Disability consider a Mental Impairment?
Social Security Disability List of Impairments
Social Security disability reviews



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