Decision is made

TheBears

TheBears

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
I called today since I saw a decision was made online and was told that they can't give me an answer over the phone or online but that I will get a letter by mail with a detailed explanation. I take that as the letter will tell you why you don't qualify and by the way thank you for serving 16 years and being 100% which I know doesn't have anything to do with it. I should have just applied as an illegal immigrant maybe would have had a better chance. Well I am off to self medicate. Better luck to others out there.
 
I got denied as well! Took it real personal too, they listed like 3 of my ailments and said they weren't severe enough. Very cookie cutter. I met with a lawyer and they've been handling my reconsideration. Lawyer says I SHOULD win but no guarantees, also plan on waiting for hearing since most reconsiderations are denied as well.
 
AaronJM1984 said:
I got denied as well! Took it real personal too, they listed like 3 of my ailments and said they weren't severe enough. Very cookie cutter. I met with a lawyer and they've been handling my reconsideration. Lawyer says I SHOULD win but no guarantees, also plan on waiting for hearing since most reconsiderations are denied as well.
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Talk to a lawyer. They only get paid if you win, so they won't even take your case unless they think you have a good chance. That'll tell you your chances right there, if they take you on.
 
AaronJM1984 said:
Talk to a lawyer. They only get paid if you win, so they won't even take your case unless they think you have a good chance. That'll tell you your chances right there, if they take you on.
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Thanks for the advice. I hate having to go through all this shit since it clearly spells out my issues according to the social security REG for my condition.
 
AaronJM1984 said:
I got denied as well! Took it real personal too, they listed like 3 of my ailments and said they weren't severe enough. Very cookie cutter. I met with a lawyer and they've been handling my reconsideration. Lawyer says I SHOULD win but no guarantees, also plan on waiting for hearing since most reconsiderations are denied as well.
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How long as your time process been so far.
 
TheBears said:
How long as your time process been so far.
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I literally received my denial letter right at 90 days. My reconsideration was filed a few days later on June 6th. So I'm only roughly 4.5 months into it.
 
That's okay though because every month that goes by is another 2k added to my tab lol.
 
Did either of you have your package submitted and labeled Wounded Warrior? I talked to my case manager when I was going through the process last year and everything was expedited; 6 months start to finish and received my SSDI payment in February of 2017 and they also gave me retroactive pay dating back to September of 2015. If your still in an active duty status I would contact your case manager to have your case expedited. If you're already out then unfortunately I believe you will be in the fight for the long haul.
 
My SSDI case was crazy I applied so many times when I was in Virginia on active duty going through the PEB with Wounded Warrior and I continue to get denied and I even went through the Expediting process my rating back then was VA 90 and 70 DOD well after I got out I moved to Pennsylvania and I was going through another c&p increase because there were certain things that weren't rated until I got out anyways I got a hundred percent total and permanent from the VA and someone told me to try again for SSDI and by this time I was done dealing with them but I decided to give it one more shot I went down to the office had an appointment talk to them, my case was expedited, and they ended up back dating the award from the day that I got out. I did this all on my own I know it is overwhelming but don't give up.
 
SSDI is probably the hardest to get awarded, but for good reason. The rules explicitly state that you cannot apply if you are still working and that to be given SSDI, you must be unable to work in any capacity (labor, office, etc.). That's a pretty high standard. Having DoD 100%/VA 100% rating does not guarantee SSDI. You must prove that you are unable to work in any capacity.

There is a loophole for "Wounded Warriors" where the SSA recognizes that you may be unable to work and also held on active duty for some period of time. In a normal private sector civilian job, you would be let go, or retained without pay for some period of time. Because of this, SSA allows you to apply for SSDI while still on active duty, however, you must claim "Wounded Warrior" status and prove you are unable to work. If your application implies that you are working in any capacity while still on active duty, they will probably deny it.

Bottom line with SSDI whether you're on active duty or not: You must prove your conditions prevent you from working in any gainful capacity.
 
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ANSU07 said:
SSDI is probably the hardest to get awarded, but for good reason. The rules explicitly state that you cannot apply if you are still working (i.e. active duty) and that to be given SSDI, you must be unable to work in any capacity (labor, office, etc.). That's a pretty high standard. Having DoD 100%/VA 100% rating does not guarantee SSDI. You must prove that you are unable to work in any capacity.

I've seen many times that people recommend applying for SSDI while you're still on active duty, which I've never understood. It goes against their very well stated rules. While there may be a few exceptions made to this rule, it is almost always upheld.
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I considered myself very fortunate to of been approved and receiving SSDI as I am still Active Duty. SSDI is not income based and as you stated it is based on your ability or inability to work. I think that the expedited process is an amazing program for Military members being separated medically as it will aid in the transition out.

ksteele1985 said:
My SSDI case was crazy I applied so many times when I was in Virginia on active duty going through the PEB with Wounded Warrior and I continue to get denied and I even went through the Expediting process my rating back then was VA 90 and 70 DOD well after I got out I moved to Pennsylvania and I was going through another c&p increase because there were certain things that weren't rated until I got out anyways I got a hundred percent total and permanent from the VA and someone told me to try again for SSDI and by this time I was done dealing with them but I decided to give it one more shot I went down to the office had an appointment talk to them, my case was expedited, and they ended up back dating the award from the day that I got out. I did this all on my own I know it is overwhelming but don't give up.
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Congrats on receiving your award.
 
ANSU07 said:
SSDI is probably the hardest to get awarded, but for good reason. The rules explicitly state that you cannot apply if you are still working and that to be given SSDI, you must be unable to work in any capacity (labor, office, etc.). That's a pretty high standard. Having DoD 100%/VA 100% rating does not guarantee SSDI. You must prove that you are unable to work in any capacity.

There is a loophole for "Wounded Warriors" where the SSA recognizes that you may be unable to work and also held on active duty for some period of time. In a normal private sector civilian job, you would be let go, or retained without pay for some period of time. Because of this, SSA allows you to apply for SSDI while still on active duty, however, you must claim "Wounded Warrior" status and prove you are unable to work. If your application implies that you are working in any capacity while still on active duty, they will probably deny it.

Bottom line with SSDI whether you're on active duty or not: You must prove your conditions prevent you from working in any gainful capacity.
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Best part though is I claimed that, all T's crossed and eyes dotted and claim still denied. My lawyer basically told me that it's become extremely common that even though active duty meet the criteria, they still get denied. Since they only listed 3 of my 20ish ailments on the denial letter, I think it's safe to assume that they didn't look into my medical record very much. I've got diagnosis of PTSD by 8 different mental health professionals, cycled through ten different meds, have consistent 4 years of weekly/daily therapy, hell I was in a 30 day intensive outpatient program when I filed my initial claim. I understand the correlation between being able to do "some" type of work, but my application clearly stated my work days are "doctors appointments" lol, which is true. Point is, in my opinion they don't give a damn about the wounded warrior claim anymore, atleast not in North Carolina.
 
I would assume/hope that if you have a lawyer he would ensure the proper verbiage was in the claim. He/she should have requested a statement from your treating psychologist or psychiatrist that states:

"Due to the service member's mental health conditions (list them), he is unable to maintain gainful employment."

The key to all of these disability programs is to get the statutory requirements for admission, then have a doctor say that you meet them explicitly and plainly. You have to understand that there is some overpaid bureaucrat on the other end of the application who isn't going to put the effort into understanding the nuances of your case. Saying that your "work days are doctor's appointments" implies that you have "work days" and therefore, are able to "work."
 
ANSU07 said:
I would assume/hope that if you have a lawyer he would ensure the proper verbiage was in the claim. He/she should have requested a statement from your treating psychologist or psychiatrist that states:

"Due to the service member's mental health conditions (list them), he is unable to maintain gainful employment."

The key to all of these disability programs is to get the statutory requirements for admission, then have a doctor say that you meet them explicitly and plainly. You have to understand that there is some overpaid bureaucrat on the other end of the application who isn't going to put the effort into understanding the nuances of your case. Saying that your "work days are doctor's appointments" implies that you have "work days" and therefore, are able to "work."
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It included all of the correct info to include the C&P exam with "Total Social and Occupational Impairment" "unable to obtain gainful employ because of x, y, and z...
 
AaronJM1984 said:
It included all of the correct info to include the C&P exam with "Total Social and Occupational Impairment" "unable to obtain gainful employ because of x, y, and z...
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Interesting, sometimes if there is too much info provided, those statements get lost in the mix so having the bottom line up front is important as well. But, if you had what you said in there, and it was plainly stated along with the supporting medical documentation, I can't fathom why they would deny.
 
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Yep got my official letter today pretty much stating I don't qualify so much for serving my country for 16 years to pretty much getting the cold shoulder. I definitely meet all the requirements especially under maintaining gainful employment guess is time to get a lawyer for the appeal
 
TheBears said:
Yep got my official letter today pretty much stating I don't qualify so much for serving my country for 16 years to pretty much getting the cold shoulder. I definitely meet all the requirements especially under maintaining gainful employment guess is time to get a lawyer for the appeal
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Some people say to get a lawyer for the reconsideration and some say you don't need one yet. You're basically just going to file the reconsideration and for the most part the SSA is going to assign your case to a different case reviewer, they will conduct the same thing as before (hence the reason for the high denial rate). After this denial, you get to go in front of a judge. I chose to get a lawyer at the stage you're at just so they could file the paperwork for me and proofread everything before it went back to the SSA. Personally I recommend hiring an attorney at this stage, hell you've got nothing to lose now.
 
Just got my 2nd denial. It's tough not to take the letter personal. They stated that my conditions are not serious enough and listed them, it kind of made me laugh (back, neck, migraines, ptsd, tbi, both hips, severe panic attacks, major depressive disorder, degenerative disc disease). What does a guy gotta have? Lol. How about a 100% rating from the VA (I have that too). I know that doesn't earn it for you but it's just frustrating. Next step is getting in front of a judge. Hopefully the wait isn't too long.
 
For everyone denied, this is my recommendation. Google the SSDI "blue book" and find the listing for the condition that you are claiming is disabling for SSDI.

For me, it was Myasthenia Gravis, listing 11.12.

For my listing it has detailed criteria for meeting the "marked" level for my specific disease. Yours will vary. Then dig in your records t find notes that say in the same or close wording to the listing or if you can get your doctors to write their notes specifically to clarify how your condition compares to the listing. My notes had close to the SS verbiage but not exact. So SS had me go to an exam with a neurologist to quantify my level of disability due to my disease. Once this was done; I was approved.

Treat SSDI the same way you treat the VA. Both VA and SS have their own specific wording (VASRD, blue book). You have to make your claim and doctors notes closely mirror the correct language. You can't just say, oh I'm 100% VA, so that should be enough for SS.... it's like speaking French vs German.


Hope this helps!!!
 
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