Why Was I Turned Down?

Most people who apply for disability benefits are turned down at least twice.  This is part of the process and par for the course.  The numbers change from year to year, but roughly speaking 70% of people are turned down on the initial application.  Those are the official numbers, but in our experience it seems that a much higher percentage than that are turned down on initial application. We have seen people with terminal cancer or double amputations who were turned down at the initial level. The moral of that story is: do not take that form denial letter personally. At the first stages of the decision making process, your claim goes to a state run organization called Disability Determination Services (“DDS”).  At least that is true in the Carolinas.  DDS is overwhelmed.  It is most probable that the person who processed your application did not have the time to really think through all the nuances of what is going on with you.  Unless it is crystal clear and beyond controversy that you meet some very specifically worded regulations, odds are you will be denied.  Your doctor is writing his office notes with an eye toward treating you, not helping you win your disability case.  Even if your doctor is very supportive of your application for disability benefits, your doctor just does not know the right way to phrase things to help you get approved.

The only way to make some headway in getting your benefits is to appeal that initial denial.  Most people are then denied a second time at what is called the “reconsideration” level.  Again, this happens roughly 80% of the time.  After you have been denied a second time you appeal that denial and request a hearing before an Administrative Law Judge.  The approval rate between judges varies greatly.

The bottom line in winning a disability case is to have your doctors acknowledge that your conditions are severe enough to meet the regulations that govern disability, which are highly complex.  It is helpful to have a lawyer aid you in making that happen.