What is an SSDI Denial Letter?

A denial letter for Social Security Disability Insurance (SSDI) is a document sent by the Social Security Administration (SSA) explaining why an individual’s claim for SSDI benefits has been denied.

The reasons for denial may include missing paperwork, a problem with the deadline, incomplete documentation, or the SSA’s assessment of the applicant’s alleged impairment.

So, if you’ve applied for Social Security Disability Insurance (SSDI) benefits and received a letter, you may be wondering what it signifies and what choices are available to you. Understanding the letter for SSDI is critical in determining your course of action.

ssdi denial letter

The denial letter is a document that explains why your disability benefits application has been turned down. It outlines the reasons for the rejection. It provides details about the evidence considered in making this determination. Additionally, it clarifies your right to appeal the decision and outlines the steps involved.

The denial letter might contain terminology and legal jargon that could be challenging to comprehend. It’s important to read through the letter and seek legal assistance if you have any inquiries or concerns.

Keep in mind that you can still receive SSDI benefits after a denial. You have the option to challenge the decision and to provide further evidence to support your case.

That is why you need legal counsel. Talk to an SSDI lawyer about how to go forward with an appeals process. Even filing forms online can become confusing. Therefore, getting legal help is imperative.

How an SSDI Lawyer Might Argue Your Case?

Your lawyer can present an argument to help you better support your claim. For example, if the SSA concludes that you’re not impaired but can work, your Social Security disability attorney can help you in your dispute by doing the following:

Assert how your medical condition hinders your ability to hold employment.
Collect additional and updated medical evidence to support the claim. This evidence may have been overlooked or was unavailable during the initial claim.
Make sure their request is answered before the 60-day deadline.
Contact medical experts who can support your need for SSDI benefits.

Appealing the Denial

Your lawyer’s argument will challenge the SSA’s denial of your SSDI benefits. They can further support this dispute by doing the following within the 60-day appeal period:

1. Learn the Reasons for the Denial. Your attorney will read the dental notice and take note of all important information. They’ll make sure it aligns with your records and check for any omissions in the application or in the evidence.

2. Request an Appeal. The quickest and easiest way to request an appeal is online. You can also download appeal forms from the Social Security Administration’s website.

3. Request a Hearing. If your reconsideration appeal is denied, you can file an appeal known as a disability hearing request. This involves presenting your case in front of an administrative law judge. You can submit this request online by completing the form HA 501 AARP, SS Disability Access, and sending it.

4. Prepare for the Hearing. Your SSDI lawyer will collect all records, work history documents, and any other evidence that supports your claim. Consider hiring a disability lawyer to represent you during the hearing phase to make things go more smoothly.

5. Comply with the Deadline. Time is a critical factor when appealing the denial of a claim, so make sure to initiate your reconsideration within 60 days of receiving the denial letter.

Common Reasons for SSDI Denials

Below are some common reasons why your application for Social Security Disability Insurance (SSDI) might be denied;

1. Insufficient Medical Evidence. Your medical records need to demonstrate that you have a qualifying disability that prevents you from working. If your medical evidence is incomplete or doesn’t persuasively support your claim, it could lead to a denial.

2. Failure to Comply with Treatment. If you haven’t followed the treatment for your condition, such as not taking medication or attending therapy appointments regularly, it may result in a denial of your application.

3. Earning Above the Threshold. To qualify for SSDI, your disability must keep you from working. If you earn an income above the threshold allowed for SSDI benefits, it could lead to a rejection.

4. Insufficient Proof of the Severity of the Disability. Your disability must be severe enough to prevent you from working for 12 months. Otherwise, you’ll be deemed ineligible.

5. Involvement in a Criminal Activity. Being incarcerated or having a record can affect your ability to claim SSDI benefits and may potentially lead to a denial.

6. Failure to Cooperate. If you fail to provide information or attend doctor’s appointments as requested during the application process, your benefits may be refused.

7. Having a Drug or Alcohol Addiction Related Disability. Having a disability caused by drug or alcohol addiction can prevent you from receiving SSDI.

How Long Can It Take to Get Approved?

You may have already waited six months for the receipt of your denial letter. That’s because the SSA can identify some conditions more quickly as being disabling. Certain factors influence wait time, including the complexity of your medical condition or if there is a backlog.

Reconsideration Time Frame

If your application is initially denied, you have 60 days to have your case reconsidered. During this phase of the process, it’s essential to update your medical details. It will take an extra three to five months to hear a decision for your claim.

The Hearing Phase

Next comes the hearing phase if your claim is denied again. Once more, you have a 60-day window to request a hearing before an administrative law judge or ALJ. At this point, your lawyer might schedule testimonies from medical experts or other professionals to support your claim. It may take 12 to 18 months before your case is heard in this forum.

Appeals and Federal Court Review

The appeals and federal court phase is the fourth chance you’ll have to have your case heard. Most cases do not reach this stage. However, if you are denied during the hearing phase, you can take one more step in the appeals process and file a complaint in federal court.

Again, you’ll have 60 days in which to comply. It usually takes about six months to two years to have your case heard. This is the last chance you’ll have to make your case for an appeal, as the verdict that is rendered is final.

Schedule an Appointment with an SSDI Lawyer Now

By getting legal help, you can move forward more positively about your SSDI denial letter. Get the legal assistance you need now. Contact Dyer, Garofalo, Mann & Schultz to set up a consultation now.

Before establishing Dyer, Garofalo, Mann & Schultz L.P.A., Doug Mann, a top Ohio Injury Attorney served as a bodily injury claims adjuster at a major insurance firm. With over 40+ years of experience, Doug’s background has proven invaluable in securing maximum cash settlements for his clients swiftly. Since leaving the insurance industry, Doug has devoted his entire legal career to assisting injured clients during their times of greatest need.