For the uninitiated, making Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI) claims can be daunting. At Kellum Law Firm, we understand the challenges that North Carolina-based individuals face when seeking these vital benefits. In this article, we will delve into the ABCs of SSI and SSDI claims, shedding light on the process and offering insights to help claimants maximize their chances of success.

Before we get into the article and begin to look at reasons a claim might be denied, we should point out that filing a disability claim without the assistance of a disability lawyer can be fraught with challenges and pitfalls that may significantly diminish the chances of a successful outcome. Here’s why it’s inadvisable for individuals to attempt the disability claims process without legal input:

Note – while the claims process and acceptance criterea for SSI and SSD are different, the following points have relevance to both. To understand the differences between SSI and SSD, read this article here: When to file for SSDI versus SSI

Why Use An Attorney For A SSDI SSI Claim?industrial accident attorneys and SSD claims

  1. Complex Legal Procedures: The process of filing a disability claim involves navigating complex legal procedures, including completing extensive paperwork, gathering medical evidence, and adhering to strict deadlines. Without legal expertise, claimants may struggle to understand and fulfill these requirements correctly.
  2. Understanding Eligibility Criteria: Eligibility for disability benefits is determined by stringent criteria set forth by the Social Security Administration (SSA). A disability lawyer has in-depth knowledge of these criteria and can assess whether a claimant meets the eligibility requirements, thereby avoiding the submission of ineligible claims.
  3. Maximizing Benefits: Disability lawyers are skilled in presenting a claimant’s case in the most favorable light to maximize the chances of receiving benefits. They know how to gather compelling medical evidence, obtain supportive opinions from healthcare providers, and effectively advocate for their client’s rights during the appeals process.
  4. Appealing Denied Claims: If a disability claim is denied, navigating the appeals process can be challenging without legal representation. Disability lawyers have experience handling appeals and can identify errors made by the SSA in the initial decision, gather additional evidence, and present a compelling case before an administrative law judge.
  5. Avoiding Costly Mistakes: Filing a disability claim incorrectly or missing crucial deadlines can result in delays or denials of benefits. SS Disability lawyers are familiar with the common pitfalls and can help claimants avoid costly mistakes that could jeopardize their eligibility for benefits.
  6. Handling Communication with the SSA: Disability lawyers act as advocates for their clients and handle all communication with the SSA on their behalf. This includes responding to requests for information, scheduling medical examinations, and representing the claimant at hearings or appeals.
  7. Providing Peace of Mind: Dealing with a disability can be emotionally and physically challenging, and the added stress of navigating the claims process alone can exacerbate the situation. Hiring a disability lawyer provides peace of mind, knowing that a knowledgeable and experienced professional is handling the case.

Seeking assistance from a disability lawyer can significantly improve the likelihood of a successful disability claim outcome. From navigating complex legal procedures to advocating for their client’s rights, disability lawyers play an important role in helping individuals secure the benefits they need and deserve.

Quick Tip: Understanding SSI and SSDI: SSDI and SSI are essential programs designed to provide financial assistance to individuals who are unable to work due to a disability. While both programs offer support to disabled individuals, they have distinct eligibility criteria and funding sources. SSDI is available to individuals who have worked and paid Social Security taxes, while SSI is a needs-based program for those with limited income and resources.

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Top 10 Reasons for Claim Denials:

  1. Lack of Sufficient Medical Evidence: One of the most common reasons for claim denials is a lack of comprehensive medical evidence to support the disability claim. Claimants must provide detailed medical records, including diagnoses, treatment history, and functional limitations.
  2. Failure to Meet Disability Criteria: To qualify for SSDI or SSI benefits, claimants must meet the Social Security Administration’s (SSA) definition of disability, which includes being unable to engage in substantial gainful activity due to a medically determinable impairment expected to last at least 12 months or result in death.
  3. Incomplete Application: Incomplete or inaccurate application forms can lead to claim denials. It’s essential to provide thorough and accurate information on the initial application to avoid delays or denials.
  4. Income and Asset Limitations: SSI benefits are means-tested, meaning applicants must have limited income and resources to qualify. Exceeding the income or asset limits can result in claim denials.
  5. Failure to Follow Treatment Plans: The SSA may deny claims if they believe the claimant has not followed prescribed treatment plans without a valid reason. Compliance with medical treatment is crucial to demonstrating the severity of the disability.
  6. Lack of Work Credits: SSDI eligibility is based on work history and the accumulation of work credits. Claimants must have earned a sufficient number of work credits to qualify for benefits.
  7. Discrepancies in Work History: Inconsistencies or discrepancies in the claimant’s work history can raise red flags for the SSA and lead to claim denials. It’s essential to provide accurate and detailed work history information.
  8. Failure to Cooperate with the SSA: Claimants must cooperate fully with the SSA throughout the claims process, including attending medical examinations and providing requested documentation. Failure to cooperate can result in claim denials.
  9. Substantial Gainful Activity (SGA): Engaging in substantial gainful activity above the SGA threshold can disqualify claimants from receiving SSDI benefits. It’s crucial to understand the SGA limits and how they impact eligibility.
  10. Lack of Legal Representation: Many claimants face challenges navigating the complex SSDI and SSI claims process on their own. Seeking guidance from experienced car accident attorneys like those at Kellum Law Firm can significantly improve the chances of a successful claim.

 

The SSI and SSDI claims process requires careful attention to detail, thorough documentation, and a deep understanding of the eligibility criteria. At Kellum Law Firm, we are committed to assisting individuals in North Carolina with their disability claims, providing compassionate support and expert legal guidance every step of the way. By understanding the SSI and SSDI claims process, and addressing potential pitfalls, claimants can increase their chances of securing the benefits they deserve without a lengthy wait due to an unwarrented appeals process.

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