Top Reasons Why Social Security Disability Claims Get Denied

When applying for Social Security Disability, you face a formidable reality: nearly 70% of initial claims are denied. Common pitfalls include insufficient medical evidence, with claims often weakened by vague or sporadic documentation, and inconsistent or incomplete information, which can lead to questioning of claim credibility. Failing to meet SSA criteria, such as conditions not lasting at least 12 months or earning above the SGA threshold, can also result in denial. Additionally, failure to cooperate with the SSA, including neglecting to provide requested information, can hinder the application process. By understanding these common mistakes, you can take steps to improve your chances.

Insufficient Medical Evidence

Facing a denied Social Security Disability claim can be disheartening, but it’s often a result of insufficient medical evidence.

You’ve likely invested time and effort into your application, only to be rejected due to lack of extensive documentation. The Social Security Administration requires substantial medical records to demonstrate a clear diagnosis and its impact on your ability to work.

Unfortunately, vague or sporadic documentation can noticeably weaken your claim. It’s vital to understand that detailing limitations rather than just medical conditions can make a considerable difference in your application success.

To avoid this pitfall, it’s important to gather and submit thorough medical evidence, including detailed notes from healthcare professionals. This documentation should show substantial interference with work-related activities, making it clear that your disability prevents you from working.

Don’t underestimate the importance of consistent follow-up medical treatment and robust records from healthcare providers. A lack of these can diminish the credibility of your disability claim, leading to rejection.

Consider enlisting the help of our experienced social security disability lawyers to handle documentation gathering, ensuring all necessary medical evidence is presented effectively to the SSA. By doing so, you’ll enhance your approval chances and take a vital step towards securing the benefits you deserve.

Inconsistent or Incomplete Information

A single inconsistency or omission in your Social Security Disability application can be enough to raise a red flag, leading to a denial. When you provide inconsistent information, the Social Security Administration (SSA) may question the credibility of your claim, resulting in denied benefits. For example, discrepancies among your medical records, employment history, or personal statements can create suspicion.

It’s vital to guarantee that your application is thorough and accurate to avoid such issues. You must provide detailed information about your disabilities and treatments to support your claim. Failing to do so can result in insufficient evidence, causing the SSA to reject your application.

Additionally, missing documentation, including medical opinions or required forms, can lead to claims being deemed incomplete and subsequently denied. To avoid these pitfalls, it’s important to maintain clear and consistent communication throughout the application process.

Respond promptly and accurately to SSA requests for additional information, and double-check your application for any inconsistencies or omissions. By doing so, you can greatly improve your chances of a successful claim. Confirm that your medical records and other documentation are consistent and complete to support your claim.

Failing to Meet SSA Criteria

To qualify for Social Security Disability, your condition must meet the Social Security Administration’s (SSA) strict criteria, and failing to do so will likely result in a denied claim. The SSA requires that your disability lasts at least 12 months or results in death. If your condition is deemed short-term, your claim is denied.

It’s vital to provide thorough documentation and medical evidence to support your disability claim. The SSA assesses whether your condition greatly impairs your ability to perform basic work activities, such as standing, sitting, or lifting. Consulting with experienced legal counsel can help you navigate these complexities and improve your chances of approval.

If your condition doesn’t meet the SSA’s criteria, you may still qualify for SSDI if you can demonstrate that your disability prevents you from engaging in any substantial gainful activity (SGA). However, if you’re earning above the SGA threshold, currently $1,550 per month in 2024, your claim may be denied.

It’s important to understand the SSA’s criteria and make sure your condition meets the requirements. Failing to meet the SSA’s criteria is a common reason for claim denials. If your claim is denied, you can appeal the decision and provide additional evidence to support your claim. A thorough understanding of the SSA’s criteria can help you navigate the application process.

Earnings Exceed SGA Limits

Even if your condition meets the SSA’s strict criteria, your claim can still be denied if your earnings exceed the Substantial Gainful Activity (SGA) threshold. The SSA sets this threshold, which was $1,470 per month for non-blind individuals in 2023. If your earnings surpass this limit, it may indicate that you’re capable of engaging in work, disqualifying you from receiving disability benefits.

The SGA threshold is adjusted annually to reflect the changing economy, and for $2,590 for blind individuals and $1,550 for non-blind individuals in 2024.

If your income exceeds the SGA limit, you must provide substantial evidence demonstrating that your disability notably impairs your capacity to work despite earning above the threshold. Self-employment income is also considered when evaluating SGA. Even if your earnings are sporadic, consistent income above the threshold can result in a claim denial.

To avoid this, it’s crucial to thoroughly document your income and provide detailed explanations of how your disability affects your ability to work. By understanding the SGA limits and their implications, you can better navigate the application process and avoid a claim denial due to earnings exceeding the SGA threshold.

Failure to Cooperate With SSA

Cooperation is key when dealing with the Social Security Administration (SSA). As an applicant, you’re expected to be responsive and forthcoming with information to facilitate the processing of your claim.

Failure to cooperate with SSA requests can greatly impede the progress of your application, leading to claim denial or substantial delays. If you fail to attend scheduled consultative examinations or don’t provide additional medical documentation when requested, the SSA may view your claim unfavorably.

It’s vital to maintain open lines of communication and update your contact information to avoid miscommunication. Ignoring SSA inquiries or neglecting to respond to requests for information can be perceived as obstructive, potentially resulting in an automatic assumption of ineligibility.

To avoid claim denial due to failure to cooperate, make sure you’re prompt in responding to SSA requests and attend all scheduled appointments. By being cooperative and communicative, you can help facilitate a smoother application process and increase your chances of a successful outcome.

Where to Get Help When Denied Social Security Disability

Navigating the complex landscape of Social Security Disability can be daunting. From gathering substantial medical evidence to ensuring consistency and completeness in your documentation, there are numerous pitfalls that can jeopardize your chances of approval. Understanding and meeting the SSA’s criteria, adhering to the SGA limits, and maintaining full cooperation with the SSA are crucial steps to increase the likelihood of a successful claim.

However, if you are denied, you don’t have to face this challenging process alone. Rue & Ziffra and our nationally board-certified SSD attorney, Luis Gracia, are here to guide you every step of the way. With our extensive experience and dedication to helping clients secure the benefits they deserve, we can provide the support and expertise you need to strengthen your case.

Take control of your life today. Contact Rue & Ziffra and Attorney Luis Gracia to ensure that every aspect of your Social Security Disability claim is expertly managed. Your path to securing the benefits you deserve starts with a simple step. Reach out to Rue & Ziffra now and protect your right to a fair and successful claim.