August 1, 2014

My claim was denied. Why?

Filing an application for SSDI or SSI benefits is a challenging and oftentimes frustrating process.  You have the opportunity to apply for benefits three different ways – in-person, on the telephone, or using the internet.  The third one is by far the most convenient and efficient of the three, and the first is the most inconvenient as you may have to drive for hours to reach the SSA office that you fall under the jurisdiction of.  There are two charts that follow.  They are the most current statistics issued by the SSA through 2009 (first chart) and 2005 (second).

The first one will give you an idea of what to expect where the waiting periods of the different application stages are concerned.  The second lists the percentages of approvals, denials, and appeals in each of the 4 stages relative to this information.

Level

name

waiting period

1

initial application

101 days

2

reconsideration period

no data available

3

hearing

491 days

4

Appeals Council

261 days

5

Federal District court

no data available

level

approval %

denial %

% of appeals

Initial Application

10

75

12

Reconsideration

12

86

2

Hearing

2

12

98

Appeals Council

33

7

goes to Federal District Court -

no further appeals

Suffice it to say, you can easily see why the application process, before you get approved or denied in the first stage (or in the ensuing stages) can be stressful and very tedious.  Be prepared.  On the average, 75% of all the initial applications filed will be denied and just because there is a likelihood that this can happen to you, fight the urge to be discouraged, give up, and just quit trying.

So what are the reasons that your eligibility for SSDI benefits may be denied at the initial application? Here are the 5 most common reasons that this happens:

  • your medical or mental condition does not meet an SSA listing
  • your benefits application may list numerous medical and/or mental impairments but no main condition is listed
  • if you have filled a benefits application out prior to this one, some judges or ALJ’s will automatically deny your current application
  • if you have worked since the diagnosed onset of your condition, you could be denied
  • if the judge or ALJ who hears and reviews SSDI cases has stacks of claimant files on his docket, he may just randomly deny several in order to save time

Although some or all of the above reasons may sound petty or unjustifiable, that is just the way the process works and you need to be prepared for any outcome negative or positive.