Receiving a denial letter after filing for Social Security Disability benefits can be frustrating, especially if you’re struggling with a severe medical condition. Understanding the common reasons why claims are denied can help you avoid pitfalls and strengthen your case. Here are six common reasons why SSA might reject your disability claim, and what you can do to improve your chances of approval.
1. Insufficient Medical Evidence
One of the most common reasons for a denial is a lack of sufficient medical evidence. SSA needs detailed documentation from your healthcare providers to verify the severity of your condition and how it limits your ability to work. Without enough medical proof, SSA may conclude that your disability doesn’t meet their criteria.
To avoid this, ensure you’ve submitted complete and up-to-date medical records, including treatment notes, diagnostic tests, and any specialist reports. Working closely with your doctor to provide functional limitations that clearly explain why you cannot work is also essential.
A common mistake is assuming SSA will gather all the necessary medical evidence on their own. Be proactive by requesting and submitting all relevant records yourself or through an attorney.
2. Earning Too Much Income
Another reason claims are denied is that the claimant is engaging in substantial gainful activity (SGA). For 2024, the SGA limit is $1,470 per month. If you’re earning more than this amount, SSA may determine that you’re not disabled, even if you have a medical condition.
It’s important to accurately report your earnings and ensure they fall below the SGA limit. If you’re working part-time or receiving non-work income, be sure to clarify that with SSA to avoid any confusion.
3. Failure to Follow Prescribed Treatment
If you’ve been prescribed treatment by your doctor but have not followed through with it, SSA may deny your claim. This includes missing appointments, not taking prescribed medications, or refusing recommended therapies. SSA may interpret this as evidence that your condition isn’t as disabling as you claim.
To avoid this, make sure you follow all prescribed treatments or have valid reasons if you’re unable to do so (such as side effects from medication). Always communicate with your doctor and make sure they document any challenges you face with treatments.
4. Incomplete or Inaccurate Forms
SSA requires multiple forms to be filled out as part of the application process, including the disability application, work history report, and function report. Incomplete or inaccurate forms can result in delays or outright denials.
A common mistake is rushing through these forms without providing detailed answers. Be sure to include all requested information, and double-check that your answers are consistent with your medical records and doctor’s notes. Discrepancies between your answers and your medical records can lead to confusion and potential denials.
5. Your Condition Isn’t Expected to Last Long Enough
To qualify for disability benefits, your condition must be expected to last at least 12 months or result in death. If SSA determines that your condition is temporary or likely to improve in less than a year, they may deny your claim.
Be sure your medical records reflect the long-term nature of your condition. If your symptoms fluctuate or you have “good days” and “bad days,” ensure your doctor includes this in their reports to show the chronic nature of your disability.
6. Lack of Cooperation with SSA
If you miss deadlines, fail to submit requested information, or don’t attend a scheduled Consultative Exam, SSA may deny your claim. It’s essential to stay in communication with SSA throughout the application process, providing documents promptly and attending all necessary appointments.
Failing to comply with SSA’s requests is a common mistake, and one that is easily avoidable. Make sure to stay organized, keep track of deadlines, and follow up regularly with SSA.
How Working with an Attorney Can Prevent Denials
Disability law can be complex, and it’s easy to overlook important details that might strengthen your case. An experienced attorney, like those at Disability Law Group, can help you avoid common mistakes that lead to denials. From gathering the right medical evidence to ensuring your forms are filled out correctly, an attorney can guide you through the process and improve your chances of approval.
If your claim has already been denied, don’t give up hope. With the right guidance, many claimants succeed on appeal. Contact Disability Law Group today to learn how their experienced team can help you avoid a denial or appeal a rejected claim.
