When Social Security denies a claim for disability benefits at the initial or reconsideration level, the SSA provides a personalized “Explanation of Determination,” usually on the last page of the denial letter. The rest of the denial letter is a form letter. Often my first contact with a prospective client is after that person has received a letter from Social Security denying disability benefits.
The reasons given in these explanations for denying benefits often leave the recipients bewildered, because the reasons given for the denial can be completely disconnected from the claimant’s reality. The explanations typically do not meaningfully address the issues that keep the person out of work. Needless to say, these denial letters cause a significant amount of distress to claimants.
Unfortunately, I see this all the time.
Here are 4 things to keep in mind if you receive a letter from Social Security denying your application for disability benefits:
1. Realize that it is a form letter. The explanation of determination may be wrong, and will not reflect the severity of your symptoms.
2. Realize that the letter is not binding if you appeal. Social Security will make a new decision on your disability claim, regardless of the wording of that denial letter.
3. The letter sometimes contains helpful information. It can provide a reference point for how Social Security views your claim. The letter lists the medical sources that were considered in the decision, so you know that you need to obtain any missing records that were not reviewed (although the list on the denial letter is not always complete). Often the denial notice will state that you could return to a specific past job, or do other work. This information will give a disability lawyer a starting place to evaluate your claim. Ultimately, your lawyer will review the full Disability Determination Explanation in the claim file, which will give fuller information about how your claim was evaluated.
4. Realize that you may need some help. If you don’t already have the assistance of a Social Security disability attorney, it’s time to talk with one.
Try not to get upset or discouraged by a denial letter. Take action instead! Make sure to appeal the denial within 60 days.