Why Disability Claims Are Denied: Common Reasons

Applying for Social Security Disability benefits, either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), can be complicated. While these programs are designed to provide much-needed financial support to those unable to work due to disability, most initial applications are denied. In fact, an average of 67% of first-time applications were denied from 2010 to 2019.

Today, the percentage of disability claims that are denied is typically between 60% and 70%. This means that most people applying for benefits will receive a negative response.

There are several reasons why SSI and SSDI claims are denied, and many of them have nothing to do with whether a person has a disability or not. Instead, applications may be rejected due to incomplete medical records, insufficient work credits, or technical eligibility issues. Because the disability determination process is strict and documentation-heavy, even small mistakes can result in a denial.

If your Social Security Disability (SSD) claim has been denied, it does not necessarily mean you are not eligible for benefits. Many people who receive an initial denial later obtain benefits through the appeals process. Understanding why disability claims get denied and what steps to take next can significantly improve your chances of getting the benefits you need.

The experienced attorneys at Leventhal, Sutton & Gornstein guide individuals through this challenging terrain. Whether you’re applying for the first time or filing an appeal, we can help you avoid common pitfalls and get the best chance of securing the disability benefits you deserve.

Common Reasons for Denied Social Security Claims

• Lack of Medical Evidence: One of the primary reasons for denial is insufficient medical evidence. The Social Security Administration (SSA) requires extensive documentation to understand the severity of a medical condition and its impact on an applicant’s ability to work. Incomplete or vague medical records can lead to a denial.
• Failure to Meet Disability Listings: The Blue Book, or Listing of Impairments, contains medical conditions that can automatically qualify for benefits. If an applicant’s impairment doesn’t meet the specific criteria outlined in one of the listings, the claim may be denied.
• Income & Employment: If an applicant engages in Substantial Gainful Activity (SGA), they will be considered ineligible for disability benefits. It is crucial to prove that the claimant’s condition prevents them from earning a living wage.
• Failure to Follow Treatment: If an applicant does not follow prescribed medical treatment, the SSA may determine that their condition could improve with compliance and deny their claim.
• Residual Functional Capacity (RFC): The SSA may evaluate an applicant’s RFC to determine their ability to perform work-related tasks. If the SSA believes the individual can perform some kind of work, their claim may be denied.
• Previous Denials Without Appeals: If an applicant previously received a denial but did not file an appeal within the required timeframe, they may lose the opportunity to continue that claim. When a new application is filed without appealing the earlier denial, this can delay the claims process. It may also increase the likelihood of another denial.
• Incomplete or Incorrect Application: Disability claims require detailed information about medical history, work history, and financial circumstances. Missing information, inaccurate details, or paperwork errors can lead the SSA to deny the claim.

Another common reason Social Security Disability claims are denied involves SSDI work history requirements. To qualify for SSDI, applicants must have worked long enough and recently enough to earn sufficient Social Security credits. If an applicant doesn’t have enough credits, the SSA may deny their claim.

SSI claimants may also face denials due to financial eligibility limits. SSI is a needs-based program with strict income and asset thresholds. If a person has income above the allowed limit or owns resources such as investments or property that exceed SSA guidelines, their application may be denied.

How Leventhal, Sutton & Gornstein Can Help

Navigating the process of applying for Social Security benefits requires a deep understanding of the system. Our disability attorneys have the knowledge and experience needed to help clients avoid pitfalls that can lead to denials.

• Our lawyers work closely with claimants to ensure that all necessary medical evidence is gathered and properly documented, leaving no room for ambiguity in the application.
• We thoroughly understand disability listings and RFC assessment criteria. Our team crafts compelling arguments demonstrating how our clients meet eligibility standards, maximizing their chances of approval.
• Our attorneys are well-versed in the appeals process. We guide clients through the necessary steps to present a strong case at all stages of appeal.

Get Help If Your Social Security Disability Claim Was Denied

If you applied for Social Security Disability and were denied, you’re not alone. Many people receive a denial after their first application. However, many of these claims are later approved during the appeals process. Our experienced disability lawyers can help you understand why your claim was denied and what steps to take next.

Leventhal, Sutton & Gornstein helps clients throughout the Philadelphia area with disability applications and appeals. We can gather crucial medical evidence, prepare your case, and communicate with the SSA on your behalf.

Our lawyers have helped thousands of people with Social Security claims and handled hundreds of cases in federal court. If your claim was denied, contact us today for a free consultation. Learn how we can help you pursue the SSI or SSDI benefits you deserve.