Four Reasons Social Security Disability Claims Get Denied

Social Security Disability claims get denied

Whether you’re suffering from a physical or mental disability, the process of obtaining Social Security disability benefits can be long and challenging. The Social Security Administration has a strict definition of “disability,” and there are certain criteria each person must meet before an SSDI claim gets approved or denied. Unfortunately, this means that it can take months, possibly years, to navigate the system and figure out how to get your disability claim approved.

How the SSA Defines “Disabled”

According to the SSA, to fulfill the definition of disabled, you must:

  • Not be able to do the work you did before
  • Be unable to adjust to other work because of your mental or physical condition
  • Have a disability that will last for at least one year or result in your death

Additionally, the SSA has its Blue Book, which lists a variety of conditions and the criteria required in order for the condition to be considered a disability. If you have an illness listed in that book, you must prove you meet the requirements. If you suffer from something that isn’t listed, you must be able to prove that your condition is similar enough to one of the listed conditions in the Blue Book and that you fit the SSA’s definition of disability.

Today, Three-Quarters of Initial Disability Claims Get Denied

Data from the SSA shows that approximately 23% of applicants get approved for SSDI on their first try. The rest, which get denied, must then go through the appeals process. This may be a challenging endeavor, but it’s not impossible. It’s helpful to understand why claims may be denied in order to avoid similar situations.

Four Common Reasons Disability Claims Get Denied

Here are some of the most common reasons your SSDI claim may get denied:

Reason #1: The SSA Cannot Locate You

In order to determine whether you qualify for SSDI benefits, the SSA must be able to contact you with any questions about your application. In same cases, they’ll want to have an SSA-approved physician examine you. However, if they cannot easily communicate with you over the phone or by email, you claim may be denied. If your address, phone number or email changes during the claims review process, be sure to let the SSA know.

Reason #2: You’re Younger Than 50

In many cases, the SSA believes that disability applicants under 50 can find some type of work to do, despite their mental or physical disability. Sometimes, the SSA may feel that people younger than 50 choose not to work instead of being unemployed because they’re unable to due to a disability. The good news is is that people under age 50 can be approved for disability benefits. You just need to provide solid medical evidence, and you’ll mostly likely need to go through the appeals process if your initial claim was denied.

Reason #3: You Won’t Cooperate

If the SSA requests additional information pertaining to your case but you refuse, your application for benefits may be denied. (These requests may include copies of your medical records or scheduling a consultative examination.) Without this extra data, the SSA may not feel that they can adequately determine that you are, in fact, disabled, by their official definition. To improve your chances, it’s best to comply with all requests.

Reason #4: Your Claim Lacks Sufficient Medical Evidence

The biggest issue for supporting your claim is providing sufficient and complete medical evidence proving that you are disabled. Without this information, it will be very challenging to get approved for Social Security disability. That’s because the SSA won’t be able to tell if you are truly suffering from a disabling condition and have tried various treatments to improve it. Insufficient medical evidence is the biggest reason for claim denials because this is how you best prove that your condition is so severe it affects your ability to work and sustain gainful employment.

How A Free Legal Consultation Can Help You

Since getting your SSDI claim approved can be complicated, consider speaking with an advocate or attorney who specializes in disability cases. Legal professionals can help you avoid common mistakes and improve your chances of getting benefits approved with your initial application. They may also file an appeal on your behalf, which boosts your odds of reversing an initially denied claim determination decision.

To see if you may qualify for legal assistance, click the button below to get your free benefits evaluation today.

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