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Social security disability claim denied

allit
allit Member Posts: 119
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UPDATE 2/20/25: the local office was closed because of a snow storm (no more working from home I guess) so we called the national line and waited on hold for 2 hours (yes that’s right, can’t wait to see if AI decreases wait times in the future) just to find out that the person on the phone didn’t seem to be able to find any record of our call on 12/31/24 where we gave them all the medical info. So now we just printed the forms and medical records and will hand deliver them to our local office when they are open.

UPDATE 2/19/25: we received the denial letter in the mail that says “Under the law the applicant is responsible for furnishing medical evidence to support the disability claim. Our records show that you have been requested to furnish signed authorizations to disclose information to SSA and an Adult Disability Report”. That’s laughable because when we completed the application online and when we spoke to a SS representative on the phone, there was absolutely no mention of these two requirements. We’ll be going to our local office today to start the appeal process.

ORIGINAL POST 2/7/25: Has anyone who recently applied for Social Security Disability with a pending decision before the new administration took office just have their claim denied?

My wife submitted her application only about a month ago. Then we spoke with a representative at the Social Security office and she went over all of our information and said we would probably get a response in about 6 months. She gave us the impression that an Alzheimer’s diagnosis is likely to be approved for disability. We were prepared to wait several months for a response. But yesterday we received notice that she was denied.

My concern is, with what’s going on now with the new administration, they are just automatically denying everyone with the intent being that people will have to reapply for review under their administration.

When I did a search to see if I could find anything, I found an article from 2020 that would suggest it’s possible that this new administration is going to be more likely to deny claims.
I’m not asking this question to be political. But I would like to know if others are having their recent claims denied.

https://nosscr.org/trump-administration-quietly-goes-after-disability-benefits/

Comments

  • elainechem
    elainechem Member Posts: 181
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    What was the reason for the denial? The President has said that Social Security is not going to be impacted.

    My hubby had EOAD. His first application was denied because we applied too soon. You can't apply until after you've been unable to work for 5 months. I reapplied for him at 5 months and one day and he got approved.

    You have to be certain that you have adequate medical documentation about her disability. Also, she needs to have a long enough work history to qualify for Social Security. I know a man whose wife had EOAD, but she couldn't get SSDI because she had always been a stay at home mom and didn't have a sufficient number of employed quarters to qualify.

  • elainechem
    elainechem Member Posts: 181
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    That article you referenced was published in 2020. My son gets Social Security disability benefits under my late husband's account because he has autism. His income hasn't been impacted.

  • allit
    allit Member Posts: 119
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    Thanks that makes me feel better. Although when we spoke to the rep at the SS office, she did not mention the 5 month off work requirement.

  • allit
    allit Member Posts: 119
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    hi yes I realize the article was from 2020 but I’m thinking if it was considered in 2020 it most likely will be considered in 2025 with all the federal cuts happening and anticipated

  • trottingalong
    trottingalong Member Posts: 516
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    often social security disability denies the first application, so immediately submit the next one and be very detailed about diagnosis and what she is unable to do on her own. I am surprised though about denying with a diagnosis of dementia. I would recommend calling again and mention the following. That is on ssi website.

    The Social Security Administration (SSA) has added Younger/Early Onset Alzheimer's to the list of conditions under its Compassionate Allowances (CAL) initiative, giving those with the disease expedited access to Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).

  • Timmyd
    Timmyd Member Posts: 3
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    Consider using a social security disability attorney. I found myself unable to navigate the process successfully on my own and I believe the attorney fees for social security disability representation are capped by law.

  • JoseyWales
    JoseyWales Member Posts: 629
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    My advice is to use an attorney. I used one to help get DH SSDI. We applied shortly after he quit working, before the 5 month mark. Attorney said he'd be denied the first time, but he was approved. We just had to wait that 5 months to get his first check. He qualified for Medicare 2 years after his first check.

    The attorney I used charged 50% of back pay due. Since DH was approved before he even got his first check, we owed the attorney nothing. Really! I used the same office to redo our wills, PA, etc. Get all that in place before your wife is too far along.

  • allit
    allit Member Posts: 119
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    We were looking at it again today and the denial says it’s non-medical denial. When we looked up info about non-medical denial, we found out there could be a couple of reasons for that. We’ll call the office on Monday and see if they can give us the reason over the phone or if have to wait for the letter to come in the mail. Either way, we’ll submit a request for another review.

  • SDianeL
    SDianeL Member Posts: 1,225
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    I was also concerned so I looked into it. nothing has changed with Social Security, Disability or Medicare. President Trump has stated many times since 2015 that he will not touch SS or Medicare. The cuts are for waste and fraud. So far they have cut $1Billion dollars per day and are just getting started. They haven’t said where the money went but looks like both parties may have been getting kickbacks. You can follow what the cuts are for on Twitter (X) under DOGE- Dept of Government Efficiency. The more waste and fraud they find the more secure our benefits will be including our Veterans benefits. Not to worry. I stopped watching the news. Please let us know what they say about the claim denial. Hugs.

  • Bestillmylove
    Bestillmylove Member Posts: 9
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    My husband applied last year in March. He was denied in one month. He lost his job February 26, 2024. This is what I did:

    We already had a neurologist (not a good one) but I insisted on the following below and got referrals for all.

    1. Had a psychosocial evaluation done. (super important) especially for young onset
    2. Pet Scan Amyloid
    3. Spinal Tap

    All tests came back positive for Alzheimer.

    I hired a SS disability attorney (nothing but a name stamp for me). I had them refile in May. I fed the attorney ALL information and in addition to them submitting I submitted as well to SS because I did not trust their speed. He was awarded after a 5-month waiting period. He received back pay and the attorney only received $981.00 that was taken out of back pay. His first official payment was Nov. 2024 and has been seamless since. We live in PA.

    Now Medicare - 2year waiting period. Which is so frustrating.

  • allit
    allit Member Posts: 119
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    Thank you, I appreciate the tip. Several people in our support group also said to get an attorney. Sounds like money well spent.

    I wish there was a fast track to get people on Medicare. I wonder why there is a 2 year requirement? How did they decide on that?

  • blacksparky
    blacksparky Member Posts: 41
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    So glad you were finally able to get social security. You hit it on the spot referring to the things you did. We finally will start Medicare on March 1st. It was frustrating having to wait but the good news is the 2 year waiting period starts from the time you filed. If you got back pay to a certain date, that’s when the waiting period starts.
    After paying over $600 a month for my DW for insurance we now will pay the $185 social security takes out for Part B. It’s like getting a raise. 🥹

  • Bestillmylove
    Bestillmylove Member Posts: 9
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    I wish I knew why there is a 2-year waiting period for Medicare. From what I have read online and what they said when he started receiving SSD it is standard. I am going to reach out to SS and see if there is any way I can get him on sooner. He is never getting better and only getting worse. Why should we have to wait. I am currently paying for Cobra - through his last place of employment. I am also going to post in the group to see if anyone has any experience or suggestions on receiving sooner.

    Good luck and if I can help you in any way please reach out.

  • Carl46
    Carl46 Member Posts: 462
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    I worked for the SSA when disabled beneficiaries first got Medicare in 1972. The 2-year requirement was a compromise between the congressmen who didn't want disabled people to have Medicare until age 65 and those who wanted to give it to disabled people when they became disabled. It is the law so it would take legislation to change it.

    We don't discuss politics or religion in polite company, so I'll leave it at that.

  • Bestillmylove
    Bestillmylove Member Posts: 9
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    Just so I understand there is no way around the 2-year waiting period? No matter the condition of the individual who is receiving disability. I am assuming these individuals like my husband has to go out to the marketplace after their cobra runs out. Just doesn't seem right.

    Thank you for sharing.

  • v3
    v3 Member Posts: 185
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    https://www.healthcare.gov/people-with-disabilities/coverage-options/

    Nope, no way around the 2 years. May be worth shopping the marketplace to see if you can do better than COBRA . At least pre-existing conditions are no longer excluded- that restricted so many people for so long.

  • trottingalong
    trottingalong Member Posts: 516
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    others have stated they did receive social security under the Compassionate Allowances Act much quicker than the two years. You can look it up on the social security webpage. You do not have to wait for two years, some have received it within a few months. read below.

    “Thankfully, since 2010 Social Security has helped by adding Alzheimer’s disease to its Compassionate Allowances Initiative. The initiative identifies debilitating diseases and medical conditions so severe they obviously meet Social Security’s disability standards. Compassionate Allowances allow for faster payment of Social Security benefits to individuals with Alzheimer’s disease, mixed-dementia and Primary Progressive Aphasia.”

  • trottingalong
    trottingalong Member Posts: 516
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    Thankfully, since 2010 Social Security has helped by adding Alzheimer’s disease to its Compassionate Allowances Initiative. The initiative identifies debilitating diseases and medical conditions so severe they obviously meet Social Security’s disability standards. Compassionate Allowances allow for faster payment of Social Security benefits to individuals with Alzheimer’s disease, mixed-dementia and Primary Progressive Aphasia.

    people ion this site have received this within a few months.

  • Carl46
    Carl46 Member Posts: 462
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    No way around it. There is the marketplace, and there is Medicaid (for what it's worth) for people who run out of money before the two years is up. There are two countries in the developed world that do not have universal health insurance. The USA is one, and the Republic of South Africa is the other. It doesn't seem right to me either, but that is how it is.

  • BethL
    BethL Member Posts: 921
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    edited February 14

    Allit, commenter Elaine said, "My hubby had EOAD. His first application was denied because we applied too soon. You can't apply until after you've been unable to work for 5 months. I reapplied for him at 5 months and one day and he got approved." You indicated your denial was a non-medical denial. Has she been off work for 5 months?

    I found this online (article dated 2023):

    "Non-Medical Requirements for SSDI

    • You must have earned enough qualifying work credits.
    • You must have worked a job in your lifetime that paid into the Social Security fund.
    • You must not be able to work the previous jobs you have performed in the past.
    • You must not be able to perform any other type of work available in the national economy.
    • If you are working in 2023 and your earnings average more than $1,470 ($2,460 if you’re blind) per month, you generally cannot be considered to have a qualifying disability, according to the Social Security Administration.
    • If you are blind or have limited vision, special program rules apply. This may be the case if your vision problems alone or combined with other health problems prevent you from working.
    • You do not necessarily have to be a citizen to qualify for SSDI benefits if you have the correct amount of work credits.
    • As a non-citizen, you can qualify for SSDI benefits if you can prove that your impairments prevent you from working, that you are lawfully living in the United States, and that you have paid into the Social Security system.

    Remember, Social Security work credits are based on your total yearly wages or self-employment income. You can earn up to 4 credits each year. The amount needed for a work credit changes from year to year. In 2023, for example, you earn 1 credit for each $1,640 in wages or self-employment income. When you’ve earned $6,560, you’ve earned your 4 credits for the year."

    I hope this helps. Beth ps. I was trying to get this font to bold, and some of it would not.

  • BethL
    BethL Member Posts: 921
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    You indicated it was a non medical denial. In addition to below listed, she must have been off work for 5 months, Here are some reasons for a non medical denial:

    Non-Medical Requirements for SSDI

    • You must have earned enough qualifying work credits.
    • You must have worked a job in your lifetime that paid into the Social Security fund.
    • You must not be able to work the previous jobs you have performed in the past.
    • You must not be able to perform any other type of work available in the national economy.
    • If you are working in 2023 and your earnings average more than $1,470 ($2,460 if you’re blind) per month, you generally cannot be considered to have a qualifying disability, according to the Social Security Administration.
    • If you are blind or have limited vision, special program rules apply. This may be the case if your vision problems alone or combined with other health problems prevent you from working.
    • You do not necessarily have to be a citizen to qualify for SSDI benefits if you have the correct amount of work credits.
    • As a non-citizen, you can qualify for SSDI benefits if you can prove that your impairments prevent you from working, that you are lawfully living in the United States, and that you have paid into the Social Security system.

    Remember, Social Security work credits are based on your total yearly wages or self-employment income. You can earn up to 4 credits each year. The amount needed for a work credit changes from year to year. In 2023, for example, you earn 1 credit for each $1,640 in wages or self-employment income. When you’ve earned $6,560, you’ve earned your 4 credits for the year. You can find more information about this here.

  • v3
    v3 Member Posts: 185
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    I believe the follow-up issue is NOT getting SSDI. BUT the two year wait for MediCARE coverage to kick in , if one is under 65.

    May be worth shopping the marketplace to see if you can do better than COBRA . At least pre-existing conditions are no longer excluded- that restricted so many people for so long from shopping.

    Also, try calling health insurance brokers for ideas,.

Commonly Used Abbreviations


DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
Read more