Denied SSDI because i'm on AD still.

Sgt zo

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#21
That's the real reason 7869Jake. Lots of people seem to be surprised that they get denied but they hurry through the application and that's a very critical piece. Thanks .
 

GSWarrior2017

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#22
Just adding in my 2 cents. You were not denied for "still being on Active Duty". You were denied because on the work report form your wording conveyed that you are physically and/or mentally able to continue your military service. VA and military disability have no bearing at all on SSDI.

In short, you were not denied for getting an AD paycheck, you were denied because you yourself told them that you aren't disabled enough to prevent you from working.
Thank you for information. I'm not sure I agree wholeheartedly. I say this with all respect, and in light of my own case. For instance; there is/was no mention of my ability to continue to work or physically function for military employment or any other employment--only the opposite. My disability is of such a severe degree that the only narrative statements and work report comments from me, my employers, my neurosurgeons and several other military supervision ALL stated that I could NOT perform basic functions let alone participate in substantial or gainful employment. It was extremely clear and potently worded. It even went into detail on how I can not even dress myself anymore. ALL of the wording specifically indicated that I have been hospitalized since FEB 2016 and unable to work. There is no way that any other assumption could have been made from the clear information provided in my application. And yet I was still denied--much like the originator of this thread. My denial was classified as a "technical denial."

You stated the following:
"you were not denied for getting an AD paycheck..."
However, the verbatum wording from my denial letter states the reason as:
"because of how much you earn."

That's a bit of a contradiction when considering the SSA's stance on applying while still on active duty and still receiving/"earning" an AD paycheck. The letter also goes on to state the following:
"It is important to know that we have looked only at your work, not your health problems."
This is an arbitrary, blanket statement considering that a vast number of disabled Wounded Warriors that apply do so while in the paid IDES process completely incapable or working or are classified as medically incapacitated. The entire reason for the application in this case is due to health problems directly affecting current or future employability, and yet they admit to not even reviewing my "health problems" at all. My entire package was centered around my health problems and the well-documented, permanent nature of my disabilities and how that has prevented and will prevent any substantial employment. The letter also stated:
"Our records show you meet the earning requirement" "since you are working". But EVERY single portion of my application stated that I am not working at all. Therefore, they either:

A. Didn't read my application in full
B. Misread all of it
C. Used the fact that I was still on the active duty payroll as the sole grounds for denial

I'm not trying to be contentious. I just wanted to post the word for word verbiage of one of the SSA's denials to show that they themselves state that the paycheck/earnings were the main reason for denial--not any wording.Technical denials never make it to the wording review stage.

Most technical denials cannot be appealed. For instance, if you don’t have the work credits to be eligible for SSDI, filing an appeal will not change this. However, in some cases, such as if the SSA made an error in evaluating income or assets, or if the denial was due to a paperwork error or a missing document, an appeal can be filed. In my case, I believe the SSA made an error in evaluating income or assets.

Perhaps I am mistaken. If so, please feel free to correct me on my understanding of all this.

Thanks.
 
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bleacherspy

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#23
GSW... it almost sounds like you applied for SSI and not SSDI if they are talking about making too much money that way. Its just weird, but like some have said, maybe someone at the lower levels didn't pay attention.
 

GSWarrior2017

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#24
GSW... it almost sounds like you applied for SSI and not SSDI if they are talking about making too much money that way. Its just weird, but like some have said, maybe someone at the lower levels didn't pay attention.
The application, claim and letter are titled "Social Security (Disability)." I hope that's correct. We will see how the appeal goes, and I'll post the update.
 

7869jake

Registered Member
#25
I'm going to agree with bleacherspy on that part. SSDI is not determined at all by amount of income, only your ability to engage in substantial gainful activity (SGA) (this can carry a dollar limit in very specific situations I know, however for application purposes it doesn't matter). It seems as though you may have attempted to apply for SSI rather than SSDI.

As for your reply, the very first step in the SSI/SSDI process is when a rep looks at your work activity report form SSA-821-BK, and NOTHING else. This individual is not trained at all to consider medical evidence. They will not look at any additional documentation you sent over with the application, and they will not consider additional statements from you, nor your physicians. This step is for one thing. To determine if you have been/are currently engaged in SGA, and if you are unable to work, to determine when the last day was that you were able to work. Medical information, and indeed your entire application, will not be considered and reviewed until it goes to the second step; the Disability Determination Service for your state. There are numerous sections on this form where you are able to convey that you are unable to work, despite receiving an active duty paycheck. This is where you would write that for example, you are bound to a hospital bed, and spend the majority of your day unable to move, except for your physical therapy appointments. It needs to be written out in plain language that you are physically/mentally unable to do any type of work, period.

If you somehow left things open to interpretation, or if you said that you still are able to perform some of your MOS/AFSC duties, then they will definitely deny your claim. This is what I was alluding to when I stated that "you yourself told them that you aren't disabled enough to prevent you from working."
 

7869jake

Registered Member
#26
In my case, I believe the SSA made an error in evaluating income or assets.
I'm not sure where you are getting this from, but please know that if you are applying for Social Security Disability Insurance, your income and assets do not matter. At all. They will never look at nor consider either of these. They are only looking at your ABILITY TO PERFORM SGA. The key word here is "perform", in that even if you aren't getting paid while doing, say, charity work, if that work shows the potential for you to perform SGA, then you will be denied.

I honestly think the most imoportant thing for you to do right now is contact your local SSA office and figure out what exactly is going on. They will be able to tell you if you mistakenly applied for SSI rather than SSDI, and will also be able to tell you why your claim was denied. Please post back and let us know what you find out.
 

GSWarrior2017

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#27
I'm not sure where you are getting this from, but please know that if you are applying for Social Security Disability Insurance, your income and assets do not matter. At all. They will never look at nor consider either of these. They are only looking at your ABILITY TO PERFORM SGA. The key word here is "perform", in that even if you aren't getting paid while doing, say, charity work, if that work shows the potential for you to perform SGA, then you will be denied.

I honestly think the most imoportant thing for you to do right now is contact your local SSA office and figure out what exactly is going on. They will be able to tell you if you mistakenly applied for SSI rather than SSDI, and will also be able to tell you why your claim was denied. Please post back and let us know what you find out.
Contacted the local SSA office. They confirmed that I applied for SSDI (not SSI), and they hold that the denial is solely because I was still on active duty when I applied. The agent stated that I would need to file a new claim since I am no longer on AD. I stated that I was told that the financial aspect should not hold bearing or matter when applying for SSDI as an AD person transitioning out of the military, and he chuckled, said "that's not necessarily true" and then said I'd have to come into the office and talk to a field rep to learn more.

So I tried to start a new application online like he said--got a prompt that said I should not start a new application, but file an internet appeal instead. Clicked on "Internet Appeals" and got a prompt saying I don't qualify to enter an appeal online.

Feel like I'm going in circles.
 
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7869jake

Registered Member
#28
Wow man I feel for you. Just when you're done with the runaround of the military admin side, you have to deal with the SSA runaround. Stick with it for sure though, and get what is owed to you.

That said, do not file another claim. I don't know when you became disabled, or when you applied, but there is a chance that if you re-apply, you could be losing out on some month's payments. It sounds like the rep you talked to is aware of the program, but also is ill informed. Telling you to reapply because you're no longer on AD (as the sole reason) is complete BS. As far as him saying "that's not necessarily true", I'm throwing him a bone when I interpret it as him reaffirming what I have stated above. AD paychecks don't matter, IF you are unable to work while receiving them.

My first thoughts on this are (sorry, not trying to bring you down here) you didn't clearly state on the SSA-821-BK form that you are getting paid but are fully disabled, and the SSA reps are using the wrong words to convey that fact to you. If this is true, it's all on you. I'm under the impression that the work activity form cannot be redone under an appeal for the same claim, in which case someone else on here will need to provide you guidance.

My next thought is that (I HIGHLY DOUBT THIS) the SSA folks that processed your claim should be on SSA themselves... and they made a very serious error due to their own ignorance. This would mean that an individual who does nothing else but work on these claims day in, and day out, is completely unaware of the regulations guiding their own duties... very, very doubtful. If this is the case, I'd recommend at least doing a free consult with a lawyer, as this is something I have no clue how to deal with.
 

GSWarrior2017

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#29
Wow man I feel for you. Just when you're done with the runaround of the military admin side, you have to deal with the SSA runaround. Stick with it for sure though, and get what is owed to you.

That said, do not file another claim. I don't know when you became disabled, or when you applied, but there is a chance that if you re-apply, you could be losing out on some month's payments. It sounds like the rep you talked to is aware of the program, but also is ill informed. Telling you to reapply because you're no longer on AD (as the sole reason) is complete BS. As far as him saying "that's not necessarily true", I'm throwing him a bone when I interpret it as him reaffirming what I have stated above. AD paychecks don't matter, IF you are unable to work while receiving them.

My first thoughts on this are (sorry, not trying to bring you down here) you didn't clearly state on the SSA-821-BK form that you are getting paid but are fully disabled, and the SSA reps are using the wrong words to convey that fact to you. If this is true, it's all on you. I'm under the impression that the work activity form cannot be redone under an appeal for the same claim, in which case someone else on here will need to provide you guidance.

My next thought is that (I HIGHLY DOUBT THIS) the SSA folks that processed your claim should be on SSA themselves... and they made a very serious error due to their own ignorance. This would mean that an individual who does nothing else but work on these claims day in, and day out, is completely unaware of the regulations guiding their own duties... very, very doubtful. If this is the case, I'd recommend at least doing a free consult with a lawyer, as this is something I have no clue how to deal with.
Thank you. I'll have to speak with a lawyer further. I'm not sure what is going on anymore. As far as clearly stating my conditions an inability to work--the SSA agent made it a point to emphasize that no medical information was taken into consideration in my case at all. It was not read over or reviewed by the SSA--my application was rejected at the earliest stage based on my income/AD status alone.

Thanks to you 7869jake and all of you on the board for your support. I am not well enough to deal with this administrative confusion from them. I can barely focus. I will turn this over to a lawyer, and hope for the right outcome.
 

bleacherspy

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#31
I’m gonna send you the SSDI program instructions called POMS and DI’s that specifically talk about Wounded Warriors and military pay with respect to SGA. Take them with you and show them what their own instructions say.
 

GSWarrior2017

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Registered Member
#32
I’m gonna send you the SSDI program instructions called POMS and DI’s that specifically talk about Wounded Warriors and military pay with respect to SGA. Take them with you and show them what their own instructions say.
Thank you. Do you want me to inbox you my e-mail address?
 

oif1vet

Registered Member
#34
Update: I went in for an appeal which was scheduled on 11 January. Of course I prepared all my evidence according to the SSA POMS DI 10505.023 and SSR 84-24. He said he didn’t need to see that and I was there for 5 mins and left with a Form SSA-3033 to take to my supervisor (readiness NCO on AGR). We filled it out as appropriate according to the lack of work I’ve been doing since this process has started. The form is about work activity and whether there is a subsidy or not, really geared towards civilians of course. I believe this form is the ticket to get past that first step of whether or not you’re “working.” Now it shows the decreased value of my work, or lack thereof. I still don’t have a good feeling about the application but I will try to remain positive and I’ll update Tuesday when I drop it off.
 

GSWarrior2017

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#36
Update: I went in for an appeal which was scheduled on 11 January. Of course I prepared all my evidence according to the SSA POMS DI 10505.023 and SSR 84-24. He said he didn’t need to see that and I was there for 5 mins and left with a Form SSA-3033 to take to my supervisor (readiness NCO on AGR). We filled it out as appropriate according to the lack of work I’ve been doing since this process has started. The form is about work activity and whether there is a subsidy or not, really geared towards civilians of course. I believe this form is the ticket to get past that first step of whether or not you’re “working.” Now it shows the decreased value of my work, or lack thereof. I still don’t have a good feeling about the application but I will try to remain positive and I’ll update Tuesday when I drop it off.
I hope it all turns out well for you! Still waiting on news for my appeal.
 

7869jake

Registered Member
#37
Update: I went in for an appeal which was scheduled on 11 January. Of course I prepared all my evidence according to the SSA POMS DI 10505.023 and SSR 84-24. He said he didn’t need to see that and I was there for 5 mins and left with a Form SSA-3033 to take to my supervisor (readiness NCO on AGR). We filled it out as appropriate according to the lack of work I’ve been doing since this process has started. The form is about work activity and whether there is a subsidy or not, really geared towards civilians of course. I believe this form is the ticket to get past that first step of whether or not you’re “working.” Now it shows the decreased value of my work, or lack thereof. I still don’t have a good feeling about the application but I will try to remain positive and I’ll update Tuesday when I drop it off.

You should not have had to appeal your case to get that form. It is a standard form that EVERY case uses if they indicate that they have worked (or are working) since they claim they became disabled.

Very, very troubling that they didn't give this form to you on your initial application. This is why education on this process is so important. You need to read up as much as possible on all of the forms required, and the process in whole, so that you can make sure someone on the other end isn't screwing up on your package. It's unfortunate, but the SSI/SSDI system will not hold your hand during your application. You need to be (metaphorically) standing over their shoulder the entire way through. Read more, protect yourself.
 

GSWarrior2017

PEB Forum Veteran
Registered Member
#38
Wow man I feel for you. Just when you're done with the runaround of the military admin side, you have to deal with the SSA runaround. Stick with it for sure though, and get what is owed to you.

My next thought is that (I HIGHLY DOUBT THIS) the SSA folks that processed your claim should be on SSA themselves... and they made a very serious error due to their own ignorance. This would mean that an individual who does nothing else but work on these claims day in, and day out, is completely unaware of the regulations guiding their own duties... very, very doubtful. If this is the case, I'd recommend at least doing a free consult with a lawyer, as this is something I have no clue how to deal with.
Update: After doing an inquiry with key officials and showing them the regulations and laws regarding the processing of these applications, I received a call from the Social Security office to admit that they made a mistake in processing my claim. They said that it should have never been denied administratively and that it should have made it past the technical review stage easily (as my case is well documented and clear). They asked me some questions to confirm what my back-pay date should be, went over the application line by line, apologized, resubmitted for me and pushed it through to the final step in only one day. Now, I am just awaiting the final decision.
 

7869jake

Registered Member
#39
Update: After doing an inquiry with key officials and showing them the regulations and laws regarding the processing of these applications, I received a call from the Social Security office to admit that they made a mistake in processing my claim. They said that it should have never been denied administratively and that it should have made it past the technical review stage easily (as my case is well documented and clear). They asked me some questions to confirm what my back-pay date should be, went over the application line by line, apologized, resubmitted for me and pushed it through to the final step in only one day. Now, I am just awaiting the final decision.

Glad to hear you fought through it! Congrats! I'd keep on them at least once a month until you're approved.

It is very troubling to hear that the agent that handled your case was completely unaware of their own guidelines... shocking in fact. Especially so since a large percentage of SS employees are vets themselves.
 

Warrior644

PEB Forum Veteran
Registered Member
#40
Update: After doing an inquiry with key officials and showing them the regulations and laws regarding the processing of these applications, I received a call from the Social Security office to admit that they made a mistake in processing my claim. They said that it should have never been denied administratively and that it should have made it past the technical review stage easily (as my case is well documented and clear). They asked me some questions to confirm what my back-pay date should be, went over the application line by line, apologized, resubmitted for me and pushed it through to the final step in only one day. Now, I am just awaiting the final decision.
Indeed, this is excellent news and congratulations! Being "positively proactive" definitely paid off for you; good deal for sure!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 
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