TYPES OF DENIALS: WHY THE BAD NEWS?

Social Security denies claims for many reasons. Knowing the reason can help you overcome the denial and get paid.

TECHNICAL DENIALS. A technical denial is made when the claimant has not filed a proper application, doesn't meet the financial qualifications for SSI, is still working at substantial gainful activity, or tries to appeal a claim after the 60-day deadline for an appeal has passed. A technical denial does not consider whether the claimant meets the medical requirements for disability. In fact, technical denials don't even consider any of the medical records; they don't get that far.

MEDICAL DENIALS. A medical denial means that Social Security examined your medical evidence and found that your impairments are not severe enough to qualify for disability under the regulations. There is a 5-step sequential process that must be used in deciding a disability claim. Most medical denials commonly occur at Step 4 or Step 5 of the sequential process:

STEP 4 DENIAL - Social Security determines that you are able to perform one or more of your past jobs. The will consider work you have done during the 15-year period immediately prior to your application date. "Past Relevant Work" (PRW) is considered if you

--Performed the work on a full-time basis

--Did the work long enough to learn how to do it proficiently

--Earned enough wages to be 'substantial gainful activity' (at least $1,070 per month using 2017 guidelines).

STEP 5 DENIAL: You cannot perform any of your past relevant work (PRW); however, other jobs exist in the US economy that you would be able to perform, based on your residual functional capacity (the most you are able to do in terms of work related activity), your education and your age. IF you are below age 50, and unable to perform your past work, this is a common denial scenario. Denials at Step 5 are less likely for claimants over age 50 because of the Grid Rules which direct a finding of 'disabled' for older claimants.

In Step 5 denials, it does not matter if you can't find one of the other jobs, you couldn't afford to work for what the other jobs pay, you would have to move out of state to get one of these jobs, nobody will hire you for one of the jobs, or you simply aren't interested in doing that kind of work. They key question is: "Would you be able to perform one of these jobs?" If the answer is yes, a denial will likely ensue.

One of the problems at Step 5 is SEDENTARY, UNSKILLED WORK. Sedentary work basically requires the ability to sit for at least 6 hours out of an 8-hour day and to stand and/or walk up to 2 hours out of an 8-hour day. It requires the ability to lift and carry up to 10 pounds occasionally. "Unskilled work" is simple, repetitive work that can be learned with a short demonstration and doesn't require any special education or training. Examples would be: parts sorter, parking garage attendant, or surveillance system monitor. There are hundreds of other sedentary, unskilled jobs in the "Dictionary of Occupational Titles" (DOT), which Social Security and its vocational experts use.