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Disability Redesign Prototype

Reason For Denial: Not Eligible Medically

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A denial due to not meeting Social Security's standard for being totally disabled is the most common reason a claim is denied. Disputing whether you are disabled will take time, research and preparation.

Whether or not you are disabled, and exactly when you became disabled enough to qualify for benefits, is a very subjective issue despite Social Security's attempts to make it objective. Your goal will be to use records that Social Security hasn't seen, and/or reinterpret records Social Security already has.

  • First, the denial letter will list each doctor whose records were used by Social Security. Check the list against the list of doctors about which you informed Social Security. Then review the list of medical records described in the letter.
  • In order to find medical records that Social Security has not seen, get copies of the medical records each doctor filed, plus copies of any medical records that were not filed or were filed but that Social Security did not list.
    • When looking for additional medical information Social Security has not seen, keep in mind that all of your medical problems do not have to come from the same condition. For example, if you are dealing with a physical condition, consider submitting records from your therapist treating you for depression or other mental condition.
  • Get a letter from your doctor.
    • Show your doctor the denial letter and review the medical records with him or her. Point out where you think the documentation of your symptoms is weak. Also point out items you may have reported to your doctor that didn't make it into the record. Ask your doctor to write a letter identifying from a medical point of view:
    • His/her opinion of your inability to work
    • Exactly what keeps you from working and how each of those items specifically keeps you from working. To learn more, see Physician's Statement.
  • Get third party testimony.

    • Especially if you didn't submit any with your initial application, obtain letters from people you work with as well as people you live with or are close to. Ask them to write their observations about why you can't work and any changes in you they've noticed. Ask them to be specific and to pinpoint dates as much as they recall. For samples, see Affidavits and Statements From Friends And Co-Workers.
  • Pull together other evidence.
    • A great source of other supporting evidence can be work or school records which sometimes contain a wealth of information about job performance and psychological testing. Any records that were generated before applying for Social Security benefits will be given greater weight than those which are generated afterward.
  • If the question is the onset date of your disability (the date your disability started), go through the medical records to show that you had the same symptoms at the earlier time as you did at the time Social Security used to declare you disabled.

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