How Do They Decide If I Still Have a Qualifying Disability?
Dec. 22, 2022
If you have become disabled and need financial support, you might be considering applying for Social Security disability benefits. However, before you apply for benefits, you need to determine whether you have a qualifying disability. Just because you cannot work does not guarantee that you are eligible for disability benefits.
There are many factors the Social Security Administration (SSA) considers when deciding whether an applicant has a qualifying disability. Our Social Security disability attorney at Rushing Law Firm, PLLC can help you take the guessing game out of your Social Security Disability Insurance (SSDI) application. Contact our office in El Dorado, Arkansas, to discuss your unique situation and determine whether you have a qualifying disability. We also help clients with SSDI applications in Ouachita County, Union County, Ashley County, and Columbia County.
Reasons Your SSDI Application Can Be Denied
Having a condition that does not meet the SSA’s definition of a “qualifying disability” is not the only reason the SSA may deny your SSDI application. Some of the most common reasons your application for disability benefits can be denied include:
You missed the filing deadline.
You make mistakes when filling out the application form.
You failed to provide sufficient medical evidence to prove that you have a qualifying disability.
You failed to cooperate adequately with the SSA.
You did not follow your doctor’s orders.
You became disabled while under the influence of alcohol or drugs or during the commission of a crime.
However, just because your SSDI application is denied does not mean there is no way you can receive disability benefits. Depending on the reason your SSDI application was denied and whether you have a qualifying disability, you may be able to appeal the SSA’s decision.
What Happens During an SSA Review?
Even if your SSDI application has been approved, the SSA will periodically review your case to determine whether you still have a qualifying disability or if your condition has improved. During an SSA review, the agency will request:
Your treating doctor’s name, phone number, and address;
Patient record numbers from hospitals where you received medical care since your SSDI application was approved; and
If you returned to work since the last review, the date when you started working again and the pay you have received.
The purpose of the SSA review is to determine whether you are still eligible for disability benefits. If you worry that the SSA will decide to stop or suspend your disability benefits after conducting the review, speak with an attorney to discuss your legal options and learn what you can do to continue receiving disability benefits.
What Can Cause Benefits to Stop?
If the SSA has approved your application for disability benefits, the agency can still decide to stop your benefits. According to the SSA’s website, there are two things that can cause the agency to stop or suspend your disability benefits:
You work at a level considered “substantial.” SSDI recipients can be given a nine-month Trial Work Period (TWP) to test their ability to work while continuing to receive disability benefits. If the SSA considers that the recipient is able to work at a “substantial” level after completing the TWP, the agency can stop the benefits. The earnings that the SSA considers “substantial” are subject to annual changes.
Your medical condition has improved. If the SSA decides that the recipient’s medical condition has improved and he/she no longer has a qualifying disability, the agency can stop the benefits.
People who receive disability benefits are responsible for promptly reporting to the SSA when there are improvements in their medical condition or when they return to work while receiving the benefits.
What If You Disagree With the SSA’s Decision?
The SSA recognizes four levels of appeal. It means that if your SSDI application was denied and you disagree with the SSA’s decision, you can go through the four levels of appeal to fight for the benefits to which you are entitled:
Reconsideration. The first level of appeal is called “reconsideration.” As the name suggests, you can apply for reconsideration to have another SSA worker independently review your case. You can also submit new medical evidence for reconsideration.
Administrative law judge hearing. If reconsideration does not help and the SSA still thinks you do not have a qualifying disability or otherwise denies your claim, you can request a hearing with an administrative law judge. The judge will make an independent decision based on the evidence in your case.
Appeals Council. If your application for disability benefits is still denied after the second level of appeal (the hearing), you can request a review by the Appeals Council. You can submit new evidence, if you have any, to convince the Appeals Council that you are entitled to disability benefits.
Federal court. Finally, if your claim is denied after the three levels of appeal, your final recourse will be going to a federal court.
If your application for disability benefits was denied, consider contacting our Social Security disability attorney at Rushing Law Firm, PLLC in El Dorado, Arkansas, to review your options for an appeal and fight for the benefits you deserve.
Trusted Guidance When You Need It Most
If you are unsure whether you have a qualifying disability to receive SSDI benefits, our Social Security disability attorney at Rushing Law Firm, PLLC can help. We can assist you with every step of the application process and strengthen your case. If your claim is denied, we can walk you through all four levels of appeal until you get the benefits you deserve. Schedule a free case evaluation to get experienced guidance.