Were you denied social security benefits in Florida?
Supplemental Security Income, commonly referred to as SSI, is a disability program based on age/disability and limited income and/or resources. The other disability program, Social Security Disability Insurance Program, is commonly referred to as SSDI. SSDI provides disability benefits to persons who are blind or who are insured through their work-related contributions.
SSI denial reasons vary depending on the applicant, but there are commonalities — and some that come up more frequently than others. In fact, SSI denial is very common when someone is first applying.
Did you know that around 2/3rds of claimants are turned down the first time?
But just because someone is initially denied social security disability does not mean they cannot receive it. That is what the appeals process is for — to ensure those who qualify convincingly correct any issues with their application or the complex process.
What you should do after getting denied social security benefits will depend on the reasons the disability claim was denied.
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5 Most Common SSI Denial Reasons
Here are 5 of the most common SSI denial reasons:
- You didn’t return all the necessary forms to the SSA
- Your medical conditions would not last at least 1 year
- Your assets or income are over the limit
- Your medical conditions were not severe enough
- An important deadline was missed
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You didn’t return all the necessary forms to the SSA
The SSA requires multiple forms to apply for SSI. They are long and require a substantial amount of time and information. Whether or not they did not send them all to you or you did not find all the appropriate forms online, it does not matter. They still require that all forms be filled out and submitted within their strict deadlines.
Example: Suppose you’re applying for SSI due to a physical disability. Along with the basic application form, the SSA also requests a Medical Release Form (SSA-827), allowing them to access your medical records, and a Work History Report (SSA-3369) detailing your employment background. If you submit your application without the SSA-827 because you couldn’t locate it online, your application process could be delayed or denied for incomplete documentation.
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Your medical conditions would not last at least 1 year
For someone to meet the basic definition of disabled, your disabling condition should be expected to last at least one year (or end in death). Depending on the illness or injury, there may be a positive prognosis with medical treatment.
Example: Consider a scenario where you’ve suffered a significant knee injury from an accident. Initially, the prognosis suggests a lengthy recovery period that might extend beyond a year, qualifying as a disabling condition under SSA criteria. However, after undergoing surgery, your medical team updates your recovery timeline to six months based on your rapid improvement and the successful outcome of the procedure.
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Your assets or income are over the limit
There are low SSA limits for assets or income that some individuals applying for social security benefits may go over. The maximum allowed is $2,000 per year. Assets would include, for example, household goods, stocks, bonds, cash, savings, and real estate beyond one property.
Example: Imagine a situation where an individual applying for SSI has $1,500 in a checking account, a car valued at $5,000 (which does not count against the limit), personal belongings (which generally are not counted), and recently inherited stocks worth $1,000. Initially, this person’s liquid assets total $2,500, exceeding the SSI eligibility limit of $2,000 for an individual.
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Your medical conditions were not severe enough
Your medical condition must meet the conditions of an official listing of a disability. Many conditions need further analysis, and this can be part of the appeals process. Here is a listing of impairments that are recognized by the SSA.
Example: Let’s say you have been diagnosed with carpal tunnel syndrome, which causes pain and numbness in your hands and arms. While this condition can be debilitating, it may not automatically qualify as a disabling condition under the SSA’s official listing of disabilities without further evidence demonstrating severe and persistent limitations.
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An important deadline was missed
There are deadlines that must be adhered to in the application process. This is another of the top SSI denial reasons that applicants face. Even if you missed a deadline due to health reasons, you could still be denied social security disability.
Example: Imagine you were hospitalized and recovering from surgery around the time you needed to submit your Request for Reconsideration (SSA-561) after your initial SSI application was denied. The deadline to submit this request is 60 days from the date you receive your denial notice. Due to your hospitalization, you submit the request on the 65th day, five days past the deadline. Despite the legitimate reason for your delay, the SSA may deny your reconsideration request.
How to Appeal Your SSI Denial
When appealing your SSI denial, you must file an official request with the Social Security Administration. This is called a Reconsideration Review and must be performed within 60 days from the date of your denial letter. If this request is denied, then you can appeal next for an Administrative Law Judge (ALJ) review. If you receive another SSI denial, you submit another appeal to the Appeals Council. If the Appeals Council will not hear your case, the last step is to file for a Federal Review.
It is recommended to have a Social Security disability attorney throughout the appeals process.
How Long Does an SSI Denial Appeal Take?
The length of time for the SSI denial appeal can vary, but the Reconsideration Review should be performed within six months. Some cases only take about three months, depending on how many cases have been filed at the time. The ALJ level often takes up to one year. If your case gets up to the Appeals Council or Federal Review level, expect about six months per level.
It’s important to note that the overall timing for an SSI denial appeal can also be influenced by the complexity of the case, the backlog of cases at the specific office handling the appeal, and the need for additional medical evidence or expert testimony. Appeals that require a hearing before an Administrative Law Judge (ALJ) may have longer wait times due to scheduling constraints.
How Do You Start the Appeals Process for Social Security Benefits?
You can get the appropriate appeals forms at your local Social Security Administration office or find the forms online at the SSA website. If you fill out paper forms, they can be taken back to the office or mailed. The forms can also be submitted online.
It is important to have information on the appeals forms that speak to SSI denial reasons. Depending on the particular reason for your SSI denial, this information may be very different. Having comprehensive, relevant information on your forms is key to winning your appeal. This is important for all appeals, including denials based on medical conditions.
When starting the appeals process, one crucial step is to carefully review the denial letter you received. This letter not only explains why your claim was denied but also outlines the specific steps you need to take to file an appeal. The letter will indicate which form you need to submit (for example, the Request for Reconsideration, Form SSA-561-U2, for the first level of appeal), the deadline for submission, and any additional documentation you might need to provide to support your appeal.
Federal Payment Amounts
The monthly maximum Federal amounts for SSI in 2024 are $943 for an eligible individual, $1,415 for an eligible individual with an eligible spouse, and $472 for an essential person. These amounts represent an increase from previous years, reflecting the COLA. The COLA for Social Security and SSI benefits has increased by 3.2 percent in 2024, affecting more than 71 million Americans.
Was Your SSI Denied? Why Hire a Social Security Claims Attorney?
If you are dealing with an SSI denial, it is highly advised to hire a Social Security Claims Attorney. The appeals process is complex and has strict deadlines and rules that must be met and adhered to each step of the way.
Your attorney will take the lead and ensure the comprehensive details included in your appeal are as strong as possible and relevant to the SSI denial reasons you received from your initial application. They will also monitor the process closely and ensure all strict deadlines are met. Also, utilizing powerful communication skills, they will represent you at the hearing in front of the judge. Social Security claims attorneys lead as aggressive advocates on your behalf throughout each step and serve as powerful experts to help you win your appeal and receive social security benefits.
Golden Key Law Group has handled numerous SSI denial cases and is well-versed in obtaining the medical and vocational evidence necessary to support a favorable outcome on your behalf. We have the experience and expertise you need to try your case, cross-examine vocational experts, and navigate the complex, demanding process.
We work with clients in both Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) cases.
Contact Golden Key Law Group to set up a consultation. Our expertise offers our clients a significant advantage, resulting in a higher percentage of favorable decisions.
*No attorney fees or expenses are charged to the client unless you receive a favorable outcome.