Top Reasons Why Disability Claims Are Denied

Submitted by rsg on Wed, 03/14/2018 - 12:39

The Social Security Administration (SSA) receives millions of disability applications each year. The criteria for total disability as defined by the SSA is stringent, and only approximately one-third of claimants are approved at the initial application level.

While the reasons for a denial vary from person to person, knowing in advance what pitfalls to avoid when applying for Social Security Disability Insurance (SSDI) benefits may be helpful. The following are the most common reasons why Social Security Disability claims are denied:

Applicant Is Not Disabled for 12 Months

The SSA defines disability as the inability to work due to a physical or mental impairment which has lasted or can be expected to last for a continuous period of no less than 12 months. Individuals who have a condition that is likely to resolve in less time, such as a knee replacement, will not be approved for SSDI benefits.

Applicant Is Still Working

When an individual becomes disabled, their financial obligations do not go away. As such, many people continue to work while they apply for Social Security Disability Insurance (SSDI) benefits. While this is understandable, individuals whose income exceeds the Substantial Gainful Activity (SGA) allowance will be denied coverage.

If you are working and earning more than $1,350 (or $2,260 if you are blind), your claim will likely be rejected. The SSA will assume that you can work, and thus you will not be considered disabled.

Learn More: Appealing After A Denial

Top Reasons Why Disability Claims Are Denied

Applicant Waited Too Long to Apply

Adjusting to a new medical condition can take some time. Often, individuals are not sure if their health will continue to decline or improve. As a result, many people wait to apply for Social Security Disability benefits. This could be a huge mistake.

The SSA relies on the most recent health information when evaluating new claims. If you wait to apply for SSDI benefits, it is likely that pertinent medical information will become outdated, thus reducing your chance for approval.

Applicant Did Not Provide Sufficient Medical Evidence

When applying for Social Security Disability, the burden of proof falls on the applicant to demonstrate the severity of their condition. Each claimant must have substantial medical documentation that clearly illustrates an inability to work due to their current health status. If you are unable to provide adequate medical evidence to the SSA via medical records and physician notes, you SSDI claim may be denied.

Applicant Failed to Follow Recommended Treatments

Applicants who have established a strong working relationship with their healthcare providers have a much higher chance of being approved for disability benefits. Individuals who have not followed recommended treatments might face an uphill battle when applying for SSDI benefits.
If a claimant does not cooperate with a treatment plan, it may be difficult for an examiner to determine if an inability to work arises from a medical condition or a lack of compliance with medical treatment.

Applicant Did Not Work with A Disability Attorney or Advocate

While many Social Security claims have been won without the assistance of a Disability Attorney, many cases that could have been won have been lost. A qualified Social Security Attorney can ensure that you do not fall into any of the above traps when applying for SSDI benefits.

When applying for Disability benefits, it’s essential to be accurate and to ensure that you have checked and double-checked all of your documents. A Disability Lawyer can be your second set of eyes.