Published by Colorado Springs Social Security Lawyer Tomasz Stasiuk

4 Reasons Why A 100% VA Rating May Not Be Enough To Win Social Security Benefits

Shock to the Going by mike (el madrileño)A 100% impairment rating from the VA is usually a strong indicator that you may qualify for Social Security disability benefits.

However, that still does not make a case a slam dunk. A number of problems can arise which may cause Social Security to deny your case.

  1. Lack of treatment. Social Security expects an individual to try to exercise a reasonable amount of self-help. That means getting regular ongoing medical treatment. Of course, some conditions may not be helped with on-going medical treatment (e.g. a loss of a limb), but others may be.
  2. Non-compliance with treatment. Social Security regulations allow a claim to be denied if the individual is non-compliant with treatment and that treatment is prescribed and estimated to restore functioning to the point that the individual is no longer disabled. In practice though, I see cases denied simply for failure to follow treatment, which is less than the regulations require. Note: there are exceptions that excuse non-compliance with treatment, such as inability to afford the treatment or medication.
  3. Drug or alcohol abuse. This is one of the biggest obstacles to what otherwise might be a fairly clear cut case. Under Social Security regulations, if drug abuse or alcoholism is a material factor contributing to the disability, benefits can be denied.
  4. Family or marital issues. If periods of symptom aggravation coincide with periods of trouble with a spouse or other family matters, it may be difficult for Social Security to separate whether the disabling symptoms come from the underlying impairment (which may allow for approving benefits) or from the situational issues (which may cause a denial of benefits).

None of these problems is necessarily insurmountable. But, the first step in resolving one of these issues is knowing it is there and that it is a potential problem.

This is one of those instances when having an attorney objectively and impartially review your case may be extremely useful. What may seem to you like a minor matter or an easily explainable situation, may turn out to be a major hurdle in approving your case.

Creative Commons License cc photo credit: mike (el madrileño)

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