Four Factors That Get Considered in an SSDI or SSI Appeal

If you were denied access to Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits, you may be able to appeal that decision to gain access to those benefits. However, the appeals process can be complicated, and its rate of success can depend on a variety of factors. Here are four factors that get considered in SSDI or SSI appeals:

  1. The existence (or lack thereof) of medical evidence
    • One of the most common reasons people are denied SSDI or SSI benefits from the Social Security Administration (SSA) is a lack of medical evidence for their disability. There could be a number of reasons for this, including negligence on the part of an examining physician, or a lack of testing to confirm the nature of your condition. It may also be the result of you applying before you had all the necessary evidence to confirm your condition. Whatever the reason, however, the SSA will not grant disability benefits without sufficient evidence. By contrast, if you can present new evidence that was not available when you first applied, that could be grounds for an appeal.
  2. The degree to which your disability impairs you
    • It is not enough to have a medical condition that impairs your ability to work or function. You also need to demonstrate that your condition impairs you to the degree that you cannot handle daily tasks or work in a job for which you are otherwise qualified. This means you can be denied benefits, for example, if the SSA believes your condition could be manageable if it received adequate medical treatment. You could also be denied if they determine you could still work with reasonable accommodations on the part of your employer. If you obtain new evidence of your disability, or your disability worsens to the point where you can no longer work, that can be grounds for an appeal for your SSDI or SSI benefits.
  3. Your past income or work credits
    • Both SSDI and SSI carry economic requirements to qualify for their benefits. SSDI requires you to earn a certain amount of “work credits” through paid work, a portion of which goes into Social Security taxes. SSI requires you to have below a certain income level and to have less than a certain amount of money in combined assets. If you fail to meet these economic criteria when you apply, you may not receive SSDI or SSI benefits. On the other hand, if your economic situation changes, or you can show you did qualify at the time you first applied, you may be able to gain those benefits on appeal.
  4. Your current economic status
    • Circumstances change, including your economic circumstances. While you may not have been able to qualify for SSDI or SSI when you first applied, you may be able to if your economic status has changed since you first applied. Your overall income may have changed, for example, or you may have managed to earn just enough work credits to qualify for SSDI. Alternatively, your overall assets may have fallen below the level where you may qualify for SSI, especially once you apply many of the various exceptions to SSI’s income requirements. The only way to be sure, however, is to consult an attorney experienced in these issues who can advise you on the best strategy going forward.

 

If you or a loved one need assistance applying for SSDI or SSI benefits, it is important that you seek the guidance of an experienced Social Security Disability benefits lawyer. The lawyers at Sullivan & Kehoe, LLP have over 50 years of combined experience between its attorneys and are available to you or your loved one in obtaining Social Security Disability or Supplemental Security Income benefits. To schedule a consultation with our New York Social Security Disability benefits lawyers, call (631) 823-7155.

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