7 Main Reasons Social Security Disability Benefits Are Denied

Although millions of people in the country apply for social security disability benefits each year, a small number of applications are approved. At the initial stage of the disability claim process, 30 percent are granted approval by the Social Security Administration.

The question is: why are the majority of social security disability claims rejected?

While the reasons for denial may differ from one claim to another, many claims are rejected due to specific reasons. If you plan to apply for social security disability benefits any time soon, here’s a look at the 7 main reasons why your social security disability claim may be denied:



Insufficient Medical Evidence

A significant number of claims are denied due to lack of or insufficient medical proof.  In order to qualify for social security disability benefits, you must prove that you cannot work due to a disability. As a result, you need solid medical evidence to show that the disability has hindered your ability to perform your work duties.

For instance, you may have been visiting a doctor for months to treat your severe back pain. But if your doctor does not record the pain as restricting your ability to perform work, your social security disability claim will be rejected.  

Many people wrongfully assume that the Social Security Administration will refer them to doctors who will examine and confirm their medical condition. But this does not usually happen. In some cases, even if you are sent for a medical examination by the Social Security Administration, this may still not be enough to prove your disability claim.

Medical records from your primary care physician are crucial for the approval of your social security disability claim. Therefore, you must discuss with your physician how the disability has been preventing you from working.

To increase your chances of approval, your medical record should contain doctor’s notes to excuse you from working or a modified work schedule due to your medical condition. If you had missed work due to your medical condition, make sure you provide evidence that shows the number of days that you remained absent before applying for disability benefits,

Such kinds of evidence will bolster your claims and improve your chances of qualifying for social security disability claims.

Previous Denials

Another misconception among people is that filing a new claim for disability benefits is better than appealing a claim that was previously rejected. But this is wrong.

If it is found during the claim approval process that you had previously applied for social security disability benefits and that your claim was rejected, then you may face the possibility of denial.

As a result, it is much better to appeal to your previous claim denial than to file a new application from the beginning.

Your Income Level

If you have applied for SSI benefits, then this will apply to you. However, the amount of your income won’t be an issue.

Some people who file a claim for SSI benefits may earn money on a part-time basis during the entire process.

However, if you are applying for social security disability benefits and you earning an income of over $880 each month, then your claim can be rejected.

Requests for social security disability claims are approved only for those people who are prevented from earning an income by their disability.

Not Following the Prescribed Treatment  

If your doctor recommended treatment for your medical condition and you fail to follow it, then your disability benefits claim will be rejected by the Social Security Administration.

If you are unwilling to follow treatment, then this will prevent the examiner from determining if your condition has permanently disabled you from working.

If you have a valid reason for not following the prescribed medical treatment, then you can mention it during the appeals process. However, you will require the services of a Social Security Disability attorney in this case.

Not Cooperating

It is important that you extend full cooperation during the application process, no matter how you feel. If you do not cooperate fully then your claim may be denied.

If you do not provide requested documents or fail to perform medical exams that were requested by the Social Security Administration, then your claim will not be approved. Therefore, you should maintain contact with the people handling your claim and promptly comply with their requests. Provide all documents on time and perform all medical tests immediately if you are asked to do so.

Your Disability Is Not Severe Enough

The Social Security Administration approves disability benefit claims for severe conditions, which are expected to continue for at least 12 months or cause death. The only exception to this rule is blindness.

As a result, many claims are denied since they are not expected to last at least 12 months. For instance, bone fractures from motorcycle and automobile accidents often heal within a year. As a result, most claims for social security disability benefits, based on bone fractures, are not approved. However, there may be some very severe cases of bone fractures, which may take at least 12 months to heal. For instance, this could happen as a result of the victim’s advanced age. Such cases are evaluated individually.

You Can Perform Other Jobs That Are Less Demanding

If the claims examiner finds that your disability will prevent you from performing your current job role, then the Social Security Administration will consider other jobs that you can perform even with your medical conditions. If the Social Security Administration believes there are less physically or mentally demanding jobs, which you can perform even with your disabilities then your social security disability claim will be denied.

However, if your social security disability claim was denied even if you fully complied with the Social Security Administration and avoided all of the aforementioned mistakes, then you should not panic. Even if you qualify for social security disability benefits, there is still a possibility of denial.      

You should go through the appeals process and fight the decision. With the help of a qualified social security disability advocate or attorney, you can still appeal successfully and reverse the decision. You can easily head online to find professional help. Get started by clicking here for more info.

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