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Why Was I Denied Disability For My Mental Illness?

Published by GLmanage

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While many might have the prospective hope that their initial application for Social Security disability benefits will be enough, that’s sadly not the case. The most recent data from February 2024, shows that only 13% of initial applications get approved at the first appeal stage. Fortunately, this rate increases to 30% if the initial application is rejected and then approved, so it’s vital not to give up hope.

Due to the nature of medical treatments and care surrounding physical health disorders, these types of applications are more likely to get approved as well. If you’ve been denied benefits for your mental health disorder, you’re not alone. 

Common Reasons for Denial of Mental Illness Claims

Applications for mental disorders are usually denied due to a lack of evidence surrounding the condition. 

  • Inadequate Treatment Notes: Often, claims are denied due to the lack of detailed treatment records. This includes sparse notes from mental health providers that don’t adequately capture the severity or the impact of the mental illness.
  • Noncompliance with Prescribed Treatment or Medication: If medical records indicate that you haven’t followed the treatment plan or haven’t taken prescribed medications consistently, this can lead to a denial. The SSA assesses how well the condition is managed with treatment.
  • Insufficient Duration: For a mental health condition to qualify for disability, it must be expected to last at least 12 months. If your condition is perceived as short-term or there’s insufficient evidence to predict its duration, your claim might be denied.
  • Episodic Nature of Some Conditions: Certain mental health conditions, like bipolar disorder, have cyclical patterns, showing periods of improvement and deterioration. This episodic nature can make it difficult to prove consistent impairment, which is a key criterion for disability benefits.

Mental Health Conditions That Qualify For Disability

Many mental health conditions can qualify for disability, including:

  • Depression
  • Anxiety Disorders
  • Bipolar Disorder
  • Schizophrenia
  • PTSD
  • OCD
  • Autism Spectrum Disorders
  • Intellectual Disorders
  • Personality Disorders
  • Eating Disorders

It’s essential to provide detailed medical evidence, including treatment records, medication compliance, and how the mental health condition impacts your ability to perform substantial gainful activity (SGA).

What You Can Do When You’ve Been Denied Disability Benefits

If your claim for a mental health condition is denied, it’s important to know the steps you can take to appeal the decision. Here’s a guide to help you through the process:

Physical Steps for an Appeal:

  • Stay Informed: Keep track of any changes in SSA policies or criteria for mental health conditions.
  • Request for Reconsideration: This is the first step where you ask the Social Security Administration (SSA) to review your case again.
  • Gather Additional Medical Evidence: Collect any new medical reports or information not included in your original application.
  • Submit the Appeal: File your appeal online or through your local SSA office within 60 days of receiving your denial notice.

Mental Health Steps to Take:

  • Consult Your Healthcare Provider: Discuss your denial with your mental health provider and ask for additional documentation or a more detailed treatment plan.
  • Stay Compliant with Treatment: Ensure you’re following your prescribed treatment plan as noncompliance can affect your appeal.
  • Keep A Symptom Diary: Document your daily mental health symptoms and how they affect your ability to work.
  • Seek Additional Support: Mental health conditions can be challenging. Having a support system in place is important during this stressful time.

Seeking Legal Support for Your Claim:

  • Get a Disability Lawyer: An experienced disability lawyer can provide significant support. They can help you understand the appeal process, prepare your case, and represent you in hearings.
  • Prepare for a Hearing: If your appeal goes to a hearing, your lawyer can help prepare you for questions from the administrative law judge and argue your case.

If you’re unable to work due to a mental health disorder, then you must know the application process can be quite taxing. To have your disability claim denied after months of tedious phone calls and waiting is nothing short of devastating. 

If you qualify for benefits, then you need an experienced disability attorney to help you with your disability application.

Get In Touch With The Law Office Of Gerard Lynch

For over 30 years, our team at the Law Office Of Gerard Lynch has been assisting Houston residents with their disability claims. We provide personalized guidance in gathering medical records, and testimonials, completing first-time applications to apply for benefits, and representing cases in appeals when SSDI claims are denied.

Snippets of paper reading “Autism Diagnosis” on them.

If you’re filing your first application for a disabling condition or need assistance with an appeal, please contact our Social Security disability lawyers for a free case evaluation now.

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This case was my first time hiring a lawyer but I am glad that the attorney I chose worked diligently with me to help me get the results I was looking for. I am confident in letting the law offices of Gerard Lynch handle my business when needed, and I will be contacting this office when or is there is another matter that I need handled. I, Alexander Foster, am very satisfied with the outcome of my case. The Law Office of Gerard Lynch and I worked together and we achieved the goal that we were striving for. I am so thankful.

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Frequently Asked Questions

Do I have to be disabled permanently to receive Social Security Disability (SSD)?

No you do not. A claimant needs to be disabled for at least 12 months or have a medical condition that is terminal or expected to lead to death. Sometimes a claimant is not disabled permanently but has a certain time frame in which they are disabled from working. For example, a claimant may get into a car accident, need to have multiple surgeries and is out of work for at least one year. That claimant can receive benefits for the period before he or she returned back to work.

It is possible but rare. In a SSD case, medical records are your evidence and that is the proof you have to show the SSA and an social security judge that you do have a severe medical condition that keeps you from working. If you do not have recent medical records, it is much harder to win a case. There is a possibility, though not common, that your case might be approved simply by going to a consultative exam that SSA sends you to, where a doctor gives you a physical or mental examination.

One benefit of working with our office is that we will look carefully at your case and if you do not have enough or current medical records, we can often give you information about low-income or indigent health services where you can go and get medical treatment for free or greatly reduced cost.

Our law firm, the Law Office of Gerard Lynch, only charges our clients if we win their SSD or Supplemental Security Income (SSI) benefits. We charge on a contingency basis, 25% of the backpay, a cap of up to $6000, awarded to a claimant when we win the case. The fees are regulated by the Social Security Administration (SSA). If we do not win their case, we do not charge anything no matter how much work we have done. Once a client wins and their monthly checks begin, they will keep 100% of their checks.

Social Security Disability (SSD) comes from FICA taxes that are deducted from paychecks during the work history of a person. Every month that a person works and reports income to the government, taxes are deducted which are paid into social security. When FICA taxes are taken out of paychecks, most of it goes into the social security retirement fund. However, a smaller portion goes into the social security disability fund. People who become disabled over their lifetime and are not yet eligible to get their full age retirement benefits can get benefits from the disability fund. One difference between Social Security Disability (SSD) and Supplemental Security Income (SSI) is that Social Security Disability (SSD) is like social security retirement – it does not matter how much money a person has or how many assets they have.

Supplemental Security Income (SSI) is a different program for disabled people and it is like a form of welfare. Like food stamps, if you have too much money, assets or property, then you will be ineligible for Supplemental Security Income (SSI) even if you are clearly disabled. Supplemental Security Income (SSI) is for people who are either too young to have paid enough into the system or have not worked recently enough to receive Social Security Disability (SSD). The benefits given to Supplemental Security Income (SSI) claimants come from the general US government fund. To receive Supplemental Security Income (SSI), a claimant has to be equally disabled to a person who receives Social Security Disability (SSD) – the standard for determining disability are the same. The only difference in deciding which claimant receives Social Security Disability (SSD) or Supplemental Security Income (SSI) comes from the amount of money paid into the social security system over one’s lifetime.