The Social Security Administration denies about 65% of initial Social Security Disability Insurance (SSDI) applications. Reasons for denial are wide-ranging, from simple mistakes in the application to a lack of supporting evidence. Understanding why most SSDI claims are not approved may help you avoid common mistakes and maximize your chances for success.
Lack of Sufficient Medical Evidence
Your medical records are an important part of an SSDI claim. You’re expected to provide enough substantial medical evidence documenting your disabling condition and how it has made it impossible for you to perform any job. If your medical records are insufficient or if the claims examiner decides that your medical evidence does not prove that your disability is severe enough to cause limitations, your claim is likely to be denied.
Failure to Adhere to Treatment Recommendations
If you are being treated by a doctor but fail to follow the treatment prescribed when you have the ability to, your benefits may be denied. With gaps in medical care, the SSA examiner may argue that it’s not possible to determine whether your ability to do substantial gainful activity would have been restored if you had followed prescribed therapy. However, there are some exceptions that will be taken into consideration, including mental and physical incapacitation or lack of money to pay for treatment.
You Earn Too Much Income
Income is one of the main factors in establishing eligibility for disability benefits. A health condition must have impacted an individual’s capacity to take part in substantial gainful activity. Your assets and income must be limited enough to qualify for benefits. If you can work and earn over $1350 per month in 2022 (for non-blind people), SSA may turn down your SSDI claim.
Prior Denials on Your Application
If you have been denied before, you may make the mistake of just filing a new SSDI claim rather than filing an appeal. Unfortunately, a previous denial increases the likelihood that an application will be rejected. You’re better off appealing an old claim than filing a new one.
Your Disability Is Temporary or Isn’t Severe Enough
SSDI benefits are available only to those with severe disabilities who are genuinely unable to work. According to SSA, a disability must be severe enough to last at least 12 months and hinder you from working. For instance, if you have a disabling bone fracture, your claim may be denied because most bone fractures heal in less than a year. Conversely, if you have painful arthritis that cannot be improved surgically, your impairment would likely be considered severe enough. Each case is evaluated on an individual basis.
Failure to Cooperate
During the review process, the SSA may send requests for additional information about your impairments. Also, they may require you to undergo a medical examination by an SSA doctor at government expense. If you refuse to release the required documents, fail to show up for the examination, or otherwise fail to cooperate with the SSA, your SSDI claim will be denied.
Enlist the Help of an Attorney
One way to strengthen your claim and maximize your chances of success is to work with a Social Security Disability lawyer. An experienced lawyer will make sure your application is completed correctly and promptly, and they can represent you at the hearing if this is necessary. If your claim is denied, they can help with the lengthy and complicated appeals process. Taking the time to find an attorney who has prior experience in this kind of work will greatly improve your chances of receiving the benefits you need.