Many people are surprised when they receive a denial letter from Social Security. In fact, most first-time applications are denied. Here are the 10 most common reasons.
1.You Don’t Meet the Non-Medical Requirements
Not every disability denial is based on your medical condition. Sometimes Social Security denies claims because the person doesn’t meet the program’s non-medical rules.
For example, you may not have enough work credits to qualify for SSDI benefits. Or, if you’re applying for SSI, your income or resources may be over the program’s limits.
Before Social Security even looks at your medical records, they must first determine whether you meet these basic eligibility requirements.
2. Your Medical Records Don’t Support Your Claim
This is the biggest medical reason people are denied. It’s not enough to tell Social Security that you don’t feel well enough to work, or even that your doctor has advised you not to work. Your medical records must show your symptoms, your diagnosis, the medical evidence that supports this diagnosis (like X-rays, lab results, and clinical tests), and, most importantly, how your health problems limit what you can do.
3. You Are Still Working Too Much
If you are earning more than Social Security’s monthly limit, you usually won’t qualify for disability benefits no matter how serious your medical condition is.
4. Social Security Believes You Can Still Do Your Past Work
The SSA must be convinced that you can no longer perform any job that you held within the last five years. If they believe that you could return to any of those jobs, your claim will likely be denied.
5. Social Security Believes You Can Do a Different Job
Even if you can’t return to your last job or any others you have held in the last five years, Social Security will consider whether you could adjust to or be retrained for other work. To determine this, they look at your age, education, work experience, and your medical limitations.
6. Your Medical Condition Is Expected to Improve Within A Year
To qualify for disability, your condition must be expected to keep you from working for at least 12 consecutive months or result in death. Short-term disabilities do not qualify. If the SSA believes that your health could improve enough in the next 12 months to allow you to return to full-time work, your claim will likely be denied.
7. You Don’t Have A Consistent Record of Medical Treatment
If you rarely see a doctor or have stopped treatment without a good reason, Social Security may decide there isn’t enough evidence to prove you are disabled.
8. You Missed a Deadline
There are very strict time limits involved with a disability claim. Missing an application or appeal deadline can force you to start over, which may cost you months or even years of benefits.
9. You Didn’t Cooperate With Social Security
If you don’t complete and return forms, attend a consultative examination (if you are scheduled for one), or provide information requested by SSA, your claim may be denied.
10. Your Medical Records Are Incomplete
Sometimes important medical records never make it into your file. Missing records can make it look like your condition is less severe than it really is. If Social Security doesn’t have all of your medical evidence, they can’t consider it when making a decision.
Don’t Give Up
A denial does not always mean you are not disabled. Many people are approved after filing an appeal. The key is finding out why you were denied and fixing the problems before the next decision.
If you’ve been denied disability benefits, don’t assume your case is over. With the right evidence, the right strategy, and the right experts at your side, the next decision in your disability case could be the one you are waiting for.