Disability Benefits

Disability Benefit Fraud

Disability Benefit Fraud - Just One Reason Why Your Claim May Be Denied

There are a number of reasons why your application for Social Security disability benefits may be denied. We've listed a few of them in this article. First, though, a word to the wise. If you obtain payments by lying or submitting false paperwork, or through the dishonesty of a Social Security employee, this is considered disability benefit fraud, and your payments will be terminated and you will probably be legally prosecuted. Please don't go there.

You can also be denied benefits because you earn too much money. The limit for a Social Security disability benefits applicant who is not blind is $860 per month in wages. This is called the substantial gainful activity limit or SGA. Investment income doesn't count, just earnings from work. Blind individuals are allowed to make about $600 per month more (the figure is adjusted every year). For Supplemental Security Income (SSI) disability, the earnings limit of combined wages and benefits was $1291 in 2006. There can be various adjustments to this figure depending on the state you live in, whether you have work-related expenses, etc., so it would be wise to check with Social Security to see exactly what the figure would be in your case.

If your disability is caused by drug or alcohol addiction (referred to as DAA), your claim will be denied. Basically, if you would not be considered disabled if you ceased to use alcohol or drugs, then Social Security will deny benefits. Corroborating evidence, usually taking the form of medical records showing treatment for some form of alcohol or drug abuse, is usually required. Just the fact that you have made a statement to the examiner admitting alcohol or drug addiction is normally not considered acceptable evidence.

Being imprisoned or having been convicted of a crime can cause the denial of disability benefits. If a person has been injured while in prison, or convicted of a felony and is in prison, or was injured in the comission of a felony for which they've been incarcerated, they won't receive benefits. In certain cases, benefits can start once the individual is released from prison.

If you don't follow physician's recommendations for treating your illness or injury, you can lose benefits. There are allowable exceptions, such as having a very low IQ or certain types of mental illness, if the prescribed therapy is amputation of an extremity or of extreme magnitude like an organ transplant, or if the prescription is for major surgery and you've already had a major surgery that didn't work.

These are just a few of the possible causes of a denied disability claim. There are many more possibilities, but we don't have space to list them all here. However, if you cooperate with your physician and Social Security, provide good evidence of your claim, and don't engage in disability benefit fraud, you have a pretty good chance of having your claim approved the first time around. If it doesn't go that way, find out what the problem is and address it via an appeal.