Reasons for Disability Denial
Every year, millions of people apply for Social Security Disability benefits. About 70 percent are denied disability benefits during the initial application stage. There are many reasons a claim may be denied. Some of the most common reasons are:
- Claim did not meet the basic non-medical requirements.
- The medical condition is not severe enough.
- Lack of medical evidence.
- Previously denied for benefits.
- Fail to follow prescribed treatment.
Understanding why your disability claim is denied can help you in the next stage of your disability application appealing the decision. Plus, to increase your chances of approval, we recommended that you hire a disability representative like Crest SSD to assist you in every step of the process.
In this article, we will take a deeper look at the main reasons why the Social Security Administration (SSA) denies disability claims, what you can do if it happens to you, and how Crest SSD can help with the process.
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Claim Did Not Meet The Basic Non-Medical Requirements
One of the most common reasons applicants are denied benefits is because they are not “insured” by Social Security. The SSA will not even look at your medical records if you do not meet their basic non-medical requirements.
To qualify for Social Security Disability Insurance (SSDI), you must have earned 40 work credits from paying taxes into the Social Security system over several years. You earn four work credits for each year that you earn a certain amount of money, and 20 of the 40 credits must have been earned within the last ten years before your diagnosis.
The SSA will also not consider your application if you currently have steady work and are earning more than the Substantial Gainful Activity (SGA) level. In 2020, that amount is $1,260 per month. In 2021, the amount is $1,310.
The goal of the SSA is to advance applicants through the system who cannot work because of their disability. Therefore, if you are currently working a significant number of hours or receive income above the SGA amount, they will deny your claim.
Medical Condition Is Not Severe
To qualify for SSDI, your physical or mental condition must have lasted at least 12 months or be considered serious enough to result in death. If your medical condition is expected to significantly improve in less than a year, your claim will be denied because Social Security does not award benefits to applicants who are partially disabled or have short-term disability.
The definition of disability under the Social Security Administration requires you to be unable to perform any substantial gainful activity. Therefore, your medical condition must be severe enough to have a significant effect on your ability to do basic work-related tasks. If the SSA does not consider your medical condition severe enough to keep you from working, you will be denied.
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Lack Of Medical Evidence
One of the most important parts of the SSDI application is providing substantial medical evidence. Many applicants fail to provide relevant and complete medical records, leading to a denial.
Complete medical records validate an applicant’s medical condition by capturing how the limitations interfere with an individual’s ability to work. To ensure that the SSA receives sufficient, up-to-date, and complete medical records, contact Crest SSD to speak with a representative that can assist you.
We do not want to see your application denied because of a lack of medical evidence. We’ll help you put together a strong and complete initial claim. We are always glad to help claimants like you succeed.
Previously Denied For Benefits
Applicants assume that filing a new disability claim is better than appealing a denied one. But, in most situations, a claim will be denied again when someone from the SSA reviews your new claim, sees that you applied before, and verifies that you were denied before.
If your initial claim was denied, you should appeal your denial instead of re-applying. Applicants who re-apply or appeal on their own are likely to continue being denied compared to applicants who have help from an experienced Social Security representative such as Crest SSD.
It’s important not to get discouraged. As mentioned before, most people are denied the first time. But, Crest SSD has helped thousands of individuals navigate the appeal process to eventually receive benefits. It is in your best interest to hire a Crest SSD representative to:
- Plan your case strategy.
- Get additional evidence from medical practitioners.
- Formulate legal arguments.
- Prepare your testimony and witnesses.
Every day, Crest SSD helps applicants nationwide who were initially denied receive the benefits they deserve. There are no upfront costs for helping you. Once we succeed at getting your benefits approved, we receive a one-time payment from the past-due “backpay” benefits you are awarded. All future monthly payments are entirely yours.
Was your claim denied? Click here to get help starting an appeal.
Failure To Follow Prescribed Treatment
Another common reason why your application may be denied is if you are not doing your part following the recommended treatment for your condition. If you fail to follow therapy, what your physician has prescribed for you, or even skip a doctor’s appointment when you have the ability to do so, the SSA will deny your claim.
The reason for this is that the SSA examiner will not be able to accurately determine whether your condition prevents you from being able to work. Additionally, the SSA will see the failure to cooperate with treatment as being unwilling to help yourself and your condition.
If there is a valid reason for not following through with the treatment — such as you cannot afford the prescribed treatment — you can bring this up during the appeals process. In this case, you will want to work with Crest SSD to help you present a strong legal argument.
Other Reasons You May Be Denied Benefits
There are a wide variety of reasons why SSDI claims are denied. Other reasons claims are denied include:
- The SSA cannot get in contact with you because you moved or changed your phone number.
- Your disability is due to drug addiction or alcoholism, and this is the reason you are unable to work.
- You are incarcerated, your condition resulted from a criminal conviction, or your condition was made worse by your crime.
- You refused to grant the SSA permission to gather your medical files.
- You can work a different job based on your age, education, and experience.
How a Crest SSD Attorney Can Help
If you believe you were unfairly denied disability benefits, we can help! A Crest SSD representative can guide you every step of the way through your disability case.
When appealing an unfavorable decision, Crest SSD will help ensure the completeness of your application, that you have appropriate medical documentation, and gather any other additional evidence to present to the SSA. Our knowledgeable and experienced representatives know how to navigate disability claims.
If your claim has been denied, reach out to us and initiate the appeals process as soon as possible. Complete this form for a FREE evaluation. Or, call us at the number above right away to speak with a helpful Crest SSD representative to discuss your case in detail.