Understanding What Got Your Disability Claim Denied

Why Was My Disability Claim Denied?

Important: We updated this article in December 2022 with the most current data available and additional helpful tips. The process of applying for Social Security disability can be a long and tricky road, and unfortunately not all cases get approved during the first stage. It’s easy to look over your application, think about your condition, and see all of the reasons you should be granted SSD — and that’s exactly why many people are left asking, “Why was my disability claim denied?”

What Got Your Disability Claim Denied? 4 Common Reasons

Here’s a list explaining what parts of your SSD application likely got your disability claim denied:

Reason #1: Not Enough or Unconvincing Medical Evidence

Because you know your condition so well, you may feel you’ve provided sufficient evidence for someone else to get an understanding of it and how it makes you disabled. However, the truth is that a lack of medical evidence is one of the biggest reasons individuals get their disability claim denied. It’s not enough to simply include the basics or an overview of your illness. You need to provide a thorough and detailed testimonial citing all sources of medical treatment at doctors’ offices, hospitals, clinics and specialty treatment centers. You also must include every provider’s name, what treatment was prescribed and on what date, and how you responded. This list should go back as far as to when you believe your disability started.

Important Tip: Have mental or physical health issues that are hard to prove or see, like chronic pain? Start keeping a daily symptom diary before you apply for benefits. This shows how your symptoms come and go, impact your daily life and limit your ability to work.

Reason #2: Lack of Quality Evidence

Not only should you submit detailed evidence, it should also have substance. This means it’s imperative that you keep up with regular doctor visits, which will be displayed in your records, and you abide by any current treatment plans. Additionally, it’s in your best interest to keep the lines of communication open with your health care providers so they can honestly fill out visit notes with as much detail as possible. The reason for this is because if there’s little written proof to explain your disability, then you can’t very well expect the SSA to believe that you have one.

Important Tip: Ask for copies of the medical records you’ll need to apply for disability at your next doctor’s appointment. If you have a physical injury or illness, ask your doctor to complete a Residual Functional Capacity (RFC) form. For mental health issues, give your therapist or doctor a Mental RFC form to complete and sign.

Reason #3: Failure To Cooperate

In some cases, you may have refused or forgotten to complete a task the SSA requested. If so, that alone may have gotten your disability claim denied. If you did not release your medical records to the SSA, then the agency will likely mark your disability claim denied. Additionally, the SSA may need more information from you to determine your outcome, so it may ask you to undergo a consultative exam to provide the organization with more medical evidence. The SSA may also request one or more completed RFC form(s) to ascertain if there is any sort of work you can do. With this, it will gauge your ability to sit, stand, walk, carry things, file, interact with co-workers and concentrate. Failure to provide these could result in insufficient evidence, which may also get your disability claim denied.

Important Tip: These tests, exams, and records all go into what the SSA calls your “functionality report.” This report basically tells the SSA how much your health problems hurt your ability to work. If you seem able to complete daily living tasks that could also serve as jobs, then to the SSA, you’re not disabled. Provide the SSA with anything that shows how your health problems negatively impact your daily life, relationships, and ability to work.

Reason #4: A Technical Disability Claim Denial

If any of the following apply to your case, the SSA will issue a “technical denial” on your claim. That means you aren’t “technically” eligible, regardless of your health issues or disability status. Here are some major reasons the SSA denies most people benefits:

1. You already get some Social Security benefits each month. That means anything from Supplemental Security Income (SSI) to early retirement, regular Social Security, etc. If you currently get spousal or survivor’s benefits each month, this could also negatively impact your claim.
2. Insufficient Social Security work credits. In other words, you haven’t worked enough years or recently enough to qualify for SSD. If you haven’t worked in at least five years, then you cannot qualify for Social Security disability benefits. Some people work in jobs where they don’t pay Social Security payroll taxes, which is yet another issue. You need active federal disability insurance coverage to get these benefits. For most people, those FICA/Social Security payroll taxes pay your monthly premiums.
3. You make more money each month than the maximum amount allowed. In 2023, that amount equals $1,470/month. In other words, if you’re still working, the SSA will likely automatically reject your claim.

You May Qualify for Legal Assistance

Since this process is tricky and the SSA denies most first-time applicants, consider asking an SSD attorney for help. These professionals have the background knowledge and expertise needed to help you understand what it is that the SSA is looking for and what you need to include your application to have the best chance of an approval. If you already received notice you had your disability claim denied, you can still appeal the SSA’s decision. Social Security attorneys can help with the claim approval process as well as filing appeals.

None of the previous tips provided will help if you do not meet Social Security’s basic definition for disability. This means you’re disabled for at least one year or until death and not be able to work any job that would provide you with gainful employment. If your mental and physical conditions are in the SSA’s Blue Book, then you must meet those specific screening criteria. For other ailments, you must prove you cannot work, which is sometimes challenging (like depression, for example). If you’re still unsure what part of your application got your disability claim denied, a lawyer can review your paperwork for free. Keep in mind that having an attorney file your claim nearly triples your chances for benefit approval. You’ll pay $0 for this service unless the SSA awards you benefits. Then, you’ll only pay a small, one-time fee.

Ready to see if you may qualify? Click the button below to start your free online benefits evaluation now!

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