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Why Are so Many SSD Claims Denied in PA?

Dennis Plank Bankruptcy AttorneyBy Dennis L. Plank, Attorney

Social Security Disability benefits were created to help individuals who cannot work due to an injury or prolonged illness. The program pays benefits to qualified individuals and certain family members if the claimant has worked long enough and recently enough and has paid Social Security taxes on their earnings.

This program currently serves millions of Americans. But securing those benefits is complicated and requires thorough documentation of citizenship, social security status, recent employment, and medical conditions.

Pennsylvania is committed to providing these benefits to deserving citizens, but the state has struggled with fraudulent claims. PA has become more detail-oriented than ever to prevent payments to undeserving individuals, rejecting claims that contain even slight errors. And because the SSD department is understaffed and overwhelmed, the explanation of a denial may be hard to understand or even nonexistent.

However, Pennsylvania does give applicants 60 days to appeal denied claims. Identifying common errors may help applicants rectify issues. Because timeliness and accuracy are critical to successful appeals, the Law Offices of Going and Plank specialize in assisting clients in appealing denied SSD claims. Here are some of the most common errors we find in these cases.

Paperwork and Documentation Issues

When applying for SSD benefits, allow plenty of time to compile documentation, complete the paperwork, and check for accuracy. It’s imperative to ensure that details, dates, or numbers do not conflict from one form to the next. Even the slightest discrepancy, such as a misspelled name or incorrect phone number, can result in a denial.

The process requires a series of detailed records and accurate documentation. In addition to personal information about their households, applicants must provide employment records that include earnings, dates of employment, military service, and records of workers’ compensation.

Applications also require accurate medical information, such as the names, addresses, and phone numbers of doctors, caseworkers, hospitals, and clinics involved; the dates of all visits; laboratory and test results; all diagnosed conditions; and all medications and other treatments, their purposes, and dosages along with any side effects.

And lastly, the application will need to include information about birth certificates or other proof of citizenship, U.S. military discharge papers if the applicant served before 1968, W-2 forms or self-employment tax returns, and any relevant award letters, pay stubs, or settlement agreements.

Prior Social Security Disability Denials May Reduce Results of Future Approvals

Some people choose to file a new SSD claim instead of appealing an existing one. This strategy can backfire. Multiple applications can be interpreted as a red flag and may decrease the likelihood that the application is approved. 

Earnings, Income, and Unemployment Benefits

Social Security Disability benefits are awarded to people who are unable to work. If applicants continue to work, have other income sources, or exceed the earning limit, they may be deemed ineligible for benefits.

Some applicants file for unemployment benefits to provide income while waiting for SDD. However, by definition, unemployment benefits in Pennsylvania are awarded to people who can work and are actively seeking a job. If receiving unemployment, the applicant has self-identified as “able to work,” which usually makes them ineligible for Social Security Disability.

Some exceptions make it possible to collect both unemployment and SSD, such as certain types of limited capacity. Our Lancaster County offices can help clients determine if such exceptions exist for their individual situations.

Medical Assessments and Recommendations

After any injury or illness, it is critical to get an assessment by a doctor and follow orders for treatment, especially if those orders will eventually restore the ability to work. Failing to take medication or follow a prescribed physical regimen can make it appear that the applicant is not trying to return to employment.

Remember also that applying for disability benefits is a claim that this person cannot work. Therefore, if that applicant takes any type of paid job, even if it’s only part-time, the Social Security Administration may assume the applicant can earn a living and deny their claim.

Missed Deadline for Social Security Disability Claim

The Social Security Disability claim process has strict deadlines. Even after submission is completed, applicants may receive requests from the Social Security Administration to submit additional information or documentation within a very short time frame.

For this reason, it’s essential to watch for such requests and respond to them as soon as possible. Failure to meet any deadlines associated with the initial submission or additional requests could be denied.

Denied-SSD-Pennsylvania

If an SSD claim is denied, the applicant has 60 days to file an appeal. In some cases, it is possible to receive an extension to this deadline for “good cause,” such as illness, incarceration, or misunderstanding. An experienced SSD attorney can help applicants determine the best course of action in such cases.

Don’t Appeal a Denied Claim Without the Help of a Lancaster County Lawyer

Appealing a denied SSD claim is complicated, and there are many opportunities for mistakes. That’s why the Law Offices of Going and Plank help clients through the process. We don’t charge attorney fees unless we successfully recover Social Security Disability benefits. We also assist in preparation for the hearing of the appeal.

Contact the Law Offices of Going and Plank in downtown Lancaster today for a free consultation and find out if we can help appeal a denied claim.

 

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Want to find out more about appealing a denied social security disability claim? Read these articles:

Appeal Denied Social Security Disability Claims

Social Security Disability Claims are Often Denied due to Paperwork Errors. We Give Tips for Better Applications Here.

It’s True. Many Social Security Disability Claims are Denied in PA. But You can Appeal Denied Claims if You Meet These Strict Deadlines.

Why so Many Social Security Disability Claims are Refused Because of Paperwork Errors

Social Security Disability Claims: 5 Mistakes to Avoid

Don’t Give Up: Tips for Fighting Denied Social Security Disability Claims

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Maybe remove the first sentence in this graphic, because there’s no context to “such requests.”



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