It is nearly impossible to win a Social Security disability claim at the application level--where a state agency reviews your medical records and makes the initial decision (the "state agency" level). The state agency that makes this decision is called the "Disability Determination Service" or DDS. Lawyers jokingly call it the Disability Denial Service.
Here is why DDS denies 7 out of 10 applications:
1). No Listing level is met. The Listings are very severe, often life threatening diseases with very strict criteria of proof. About 1 in 10 claimants will meet a listing. If the Listing isn't met in black and white, DDS will deny the claim.
2). The claimant's age is below 50. It is very rare for DDS to approve a claimant under age 50, who are classified as "younger individuals."
3) Sometimes, even with a severe disability, there isn't enough objective medical evidence to approve. This is especially true of diseases like fibromyalgia, chronic pain, chronic fatigue, Lupus, migraine headaches, PTSD, anxiety or depression. There are no definitive laboratory tests to prove these conditions. Therefore, DDS will not make the leap to say that these illnesses are disabling.
4) The decision makers at DDS never meet the claimant; they only see his or her paper trail (medical records, etc.). It's a very impersonal process. There is little or no subjective evidence to take into account.
4) The state agency seems to take the attitude, WHEN IN DOUBT, DENY. SOMEONE ELSE WILL SORT IT OUT. The someone else is an administrative law judge that you encounter at your appeal hearing. This is the first person with whom you have face-to-face contact in the decision making process.
This makes it extremely critical to appeal denials. Take it to the next level and get before an administrative law judge for a hearing. There, you will be able to explain your disability face-to-face. Your representative will be able to explain your case to the judge and point out why you meet the regulations to receive disability payments. This is where most disability cases are won.
Once you are denied at the application level, you have 60 days--and only 60 days--to appeal.
Here is why DDS denies 7 out of 10 applications:
1). No Listing level is met. The Listings are very severe, often life threatening diseases with very strict criteria of proof. About 1 in 10 claimants will meet a listing. If the Listing isn't met in black and white, DDS will deny the claim.
2). The claimant's age is below 50. It is very rare for DDS to approve a claimant under age 50, who are classified as "younger individuals."
3) Sometimes, even with a severe disability, there isn't enough objective medical evidence to approve. This is especially true of diseases like fibromyalgia, chronic pain, chronic fatigue, Lupus, migraine headaches, PTSD, anxiety or depression. There are no definitive laboratory tests to prove these conditions. Therefore, DDS will not make the leap to say that these illnesses are disabling.
4) The decision makers at DDS never meet the claimant; they only see his or her paper trail (medical records, etc.). It's a very impersonal process. There is little or no subjective evidence to take into account.
4) The state agency seems to take the attitude, WHEN IN DOUBT, DENY. SOMEONE ELSE WILL SORT IT OUT. The someone else is an administrative law judge that you encounter at your appeal hearing. This is the first person with whom you have face-to-face contact in the decision making process.
This makes it extremely critical to appeal denials. Take it to the next level and get before an administrative law judge for a hearing. There, you will be able to explain your disability face-to-face. Your representative will be able to explain your case to the judge and point out why you meet the regulations to receive disability payments. This is where most disability cases are won.
Once you are denied at the application level, you have 60 days--and only 60 days--to appeal.
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