Why were my Social Security Disability benefits denied?

There are many reasons why the Social Security Administration denies benefits, such as:

  • There is not enough evidence to show that the medical condition is serious
  • Your disability will not last at least 12 months
  • You are able to perform some other type of work

In fact, many people are denied after applying for the first time. If you have received a denial letter, reach out to Drew L. Johnson, P.C. Attorneys At Law to discuss your options.

What is a disability hearing?

If the Social Security Administration has denied your claim, you have the right to request a disability hearing. After a hearing is requested, it can take up to 18 months for the Oregon Social Security hearings office to set a hearing date. You will be informed of your date and place of hearing at least 75 days in advance.

What happens at the hearing?

An administrative law judge will run the hearing. The judge’s job is to make an independent decision based on the evidence in your case. This evidence includes medical records, other documents, and testimony you and others give at the hearing. The judge will question you about your disability. The hearing is private and is held in a small conference room. The only people at the hearing will be the judge, the judge’s assistant, you, your representative, and any witnesses. The judge will usually also ask a “vocational expert” to testify and sometimes also ask a “medical advisor” to testify. The hearing will be tape-recorded.

Can I be represented at the hearing?

You can attend the hearing with a lawyer. You do not have to have a lawyer, but if you can get a lawyer to represent you, you have a better chance of winning. It is important to obtain an attorney with experience in representing Social Security disability claimants.

How should I prepare for the hearing?

It is usually very important to prepare for a Social Security hearing. Your chances of winning the hearing are much better if you take time long before the hearing to:

  • Gather the medical evidence you need, whether it is obtaining existing records or asking your doctors to record their professional opinions
  • Think about the testimony you will give
  • Assemble a list of witnesses who can provide information about your disability

Your attorney will help you understand what to expect during the hearing and take care of most of the preparation.

What evidence do I present at the hearing?

You need to prove that you have a serious medical problem that has lasted or that will last for at least 12 months, or will result in death, and that keeps you from working. You do this with:

  • Medical evidence
  • Your testimony
  • The testimony of witnesses

Although the Social Security Administration (SSA) helps you gather medical information for your case, they sometimes they do not have all the medical information that is available. It is important that your SSA file has all of the medical information in your case (from your treating doctor, medical specialists who have seen you, any hospital records, etc.). If you think there is anything else the judge should see before making a decision in your case, you can ask the judge if you can add that information after the hearing.

What will I testify about at the hearing?

During your testimony, you can expect to provide the following information:

Medical Condition: The judge will ask how your medical condition makes you feel. you should tell the judge about the symptoms your experience such as pain, dizziness, numbness, nausea or paralysis as well as you can. For example, if your case involves pain, you might be asked:

  • Is the pain burning, stabbing, crushing, sharp, throbbing, radiating, or aching?
  • Do your activities affect the pain?
  • What do you do to relieve the pain?
  • What medicine do you take for pain?
  • How well does the medication work?
  • Are there any side effects from the pain medication?

Medical History: The judge may ask you how often you see your doctor, what sort of treatment your doctor provides, what medication you are presently taking, how often you take each medication and whether there are any side effects.

You may also be asked to describe the symptoms and treatment of your medical condition since it began. You may be asked what your doctor has told you about your problem, but the judge won’t ask you medical questions about your disability.

Physical Abilities: If you have a physical disability, the judge will ask you a lot of questions about what you are able to do. For example, you may be asked:

  • How far can you walk before resting?
  • How long can you sit and stand at one time during an eight-hour day?
  • How much can you lift?

Mental Abilities: The judge will ask about your ability to understand, carry out and remember instructions, to use good judgment, to respond appropriately to supervision, co-workers, usual work situations, and changes in your work setting.

Education and Training: The judge will ask you how far you went in school, if you have had any training in the military, if you can read and write, and if you have had any job training.

Work Experience: The judge will ask you about the jobs you have had during the past 15 years. If your condition caused you to miss a lot of work or caused you to stop working, you should explain this.

Daily Activities: The judge will ask you several questions to find out how your disability affects you. Possible questions include:

  • How do you spend your time during the day?
  • How well do you usually sleep?
  • Do you take naps during the day?
  • What activities do you do around the house, such as cooking, housework, or gardening?
  • Do you go shopping?
  • Do you drive a car?
  • What hobbies and activities do you currently have?

What types of witnesses may be called during the hearing?

You can have relatives, friends or others  write letters to submit to the judge. Good witnesses are persons who see you regularly and see how your medical condition affects you. The best witnesses are usually not friends or relatives, but someone else who knows you, such as a neighbor or former boss. Witnesses should talk about the activities that you are not able to do.

Usually, the judge will ask a vocational expert to testify at the hearing, at SSA’s expense. A “vocational expert” will testify whether or not your disabilities make a job too hard for you to do, and which jobs you might be able to perform in spite of your disabilities.

Sometimes, the judge will ask a doctor or psychologist to testify at your hearing. The medical advisor is paid by SSA to help the judge decide if you have a serious medical problem that keeps you from being able to work.

What happens once the hearing is over?

It often takes about 2 months to receive a decision from the judge. It is very unusual for a judge to announce a decision at the hearing.

If you win benefits, you will get DIB benefits retroactively depending on the date that you applied and on the date the judge says you became disabled. For SSI, you can only get benefits as far back as the first day of the next month after your application. The judge may also request that you have a “representative payee” if you have trouble handling money. This is a person who gets your checks on your behalf. If a representative payee is recommended you should think about who would be willing to help you in this way. SSA will ask for your suggestions.

If you lose your hearing, you can ask that your case be reviewed by the Social Security Appeals Council. You must make this request within 60 days of your unfavorable hearing decision. Your attorney will normally do this for you. If the Appeals Council refuses to review your case or decides against you, you have another 60 days to appeal to the U.S. District Court in your area. You will need a lawyer to appeal your case to the federal court.

Once I’m on DIB or SSI, what can I do if Social Security tries to stop or reduce my benefits?

If you are getting SSI or DIB, Social Security may review your case at some time to see if your medical condition has improved and, as a result, if you are now able to work.

If SSA reviews your case, and if you are still disabled, try to get medical evidence from your doctor that shows that your condition has stayed the same or is now worse. It is also very important to get a lawyer to represent you if you can.

If Social Security decides to terminate your benefits, you can appeal the decision. You will have 60 days to make a written request for an appeal. But, if the decision is based on medical improvement and you make a request within 10 days, your benefits will stay the same until you have a hearing and the Administrative Law Judge has made a decision on your case. If you receive an unfavorable notice, appeal immediately! If you lose the appeal, you may be asked to pay back the benefits as an overpayment.

What should I do if I receive a notice of overpayment?

You will receive a notice of overpayment if the SSA believes they paid you more money than you should have received. If this happens, you can:

  1. File for reconsideration if you think the amount of the overpayment is wrong or there was no overpayment.
  2. File for a waiver of repayment if you think the overpayment was not your fault and you cannot repay the money. A request for a waiver asks SSA to free you from having to pay back the overpayment.

If you do not want your checks reduced while you are contesting the overpayment, SSA should stop trying to collect the overpayment if you:

  1. Ask for reconsideration or a waiver within 30 days of the date of the overpayment notice, or
  2. Ask for a waiver at a later time. If your request is more than 30 days after the date of the overpayment notice, SSA will probably have started to attempt to collect the overpayment, but they should stop when you make your request.

If the overpayment is not successfully contested, and SSA does not waive the overpayment, and you are continuing to receive benefits, SSA will recover the overpayment from the money you are being paid. If you are not receiving benefits it is very unlikely that SSA will take action against you to collect the moneys. Normally SSA will simply wait until you are again entitled to benefits and recover the overpayment at that time, without interest.

More questions about Social Security Disability disputes? Contact Drew L. Johnson, P.C. Attorneys At Law today by calling (541) 434-6466 to schedule a free initial consultation with a knowledgeable Eugene attorney.