Top Reasons You Are Denied Disability

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Top Reasons You Are Denied Disability

Being denied Social Security Disability benefits is very common. If you’re just preparing to apply for SSD, understanding why claims are denied will help you strengthen your application and fill in any gaps that can lead to denial. If you’ve already received a disability denial, knowing why is the best preparation for a successful appeal. 

Common Reasons You May Be Denied

You have too much earned income.

Social Security disability benefits are intended for people whose medical limitations prevent them from engaging in substantial gainful activity (SGA). If you’re earning more than the amount the Social Security Administration (SSA) has designated as the SGA cut-off, you won’t be eligible for SSD benefits. The cut-off amount changes every year. For 2024, the earnings cut-off is $1550/month for most applicants, and $2,590/month for blind applicants. 

Note that this isn’t a hard limit on income, but only on income from work or self-employment. Other types of income, such as income from a family trust or passive investment income, don’t count. 

You don’t have sufficient work credits. 

Social Security disability benefits are only available to those who have worked and paid into Social Security. If you don’t have sufficient work credits, you won’t be eligible for disability benefits. Most applicants will need at least 40 work credits, which is often shorthanded as 10 years because you can earn a maximum of four work credits per year. A certain number of “recent’ work credits are also required. For most applicants, this means 20 credits in the 10 years leading up to the disability. However, work requirements are reduced for younger workers. 

Unfortunately, if you don’t have sufficient work credits, you won’t be able to qualify for SSD unless you are able to continue working long enough to accumulate those credits. But, mistakes happen. If the SSA says you lack credits, carefully review your work record. 

You don’t cooperate with the process. 

When you have an application pending, you’re required to keep the SSA up to date on certain matters, such as making sure they have current contact information for you. You may also be asked to provide additional information or documentation, or even be scheduled for a medical examination. If you don’t do your part, your claim will likely be denied. 

You will be able to reapply for Social Security disability benefits if your claim is denied because you didn’t cooperate with the process. However, that can add months or even a year or more to the process of securing SSD benefits. You will also lose out on any back benefits that may have been available for the time leading up to your denial.

Abuse of drugs or alcohol. 

Drug addiction and alcoholism are not considered disabilities qualifying a person for Social Security disability. While substance abuse doesn’t automatically disqualify a person from receiving benefits if they can establish another qualifying disability, the analysis can be complicated. The applicant must establish that the other condition is disabling in and of itself, not considering the symptoms and limitations caused by drug or alcohol use. In some cases, these denials are supportable because, without the substance abuse, the claimed condition wouldn’t be sufficient to support a finding of disability. But, it’s easy for the SSA to get this wrong. If you have substance abuse issues, it is important to consult an experienced disability benefits advocate–ideally before your initial application.

Gaps in your medical care or non-compliance. 

SSD benefits are meant for people who are unable to support themselves because of a disability. If the symptoms and limitations associated with a medical condition are only disabling because the applicant isn’t taking medication, attending physical therapy sessions, or otherwise following the instructions of medical professionals treating the condition, the SSA will likely deny your claim. The reason for the denial will typically be that they cannot determine that your condition renders you unable to work because your symptoms and limitations might be alleviated if you comply with your treatment plan. 

Ideally, you will have kept up with your treatment and complied with your doctor’s recommendations all along, creating a solid record of the severity of your condition when you are doing everything right. If you haven’t done so and you have been denied disability benefits because of it, your best next step is to start following doctor’s orders and building that record right away.

Insufficient medical documentation. 

 Your medical condition and the limitations it places on your ability to earn a living are at the core of your SSD claim. And, it’s the most difficult element to prove. The more concrete medical information you can produce, such as test results, the more straightforward proving your claim will be. But, some conditions aren’t diagnosed with imaging or blood tests. In those cases, more subjective evidence such as doctors’ notes and information from people in your life who observe your limitations in daily life. 

One important step in ensuring that you have sufficient medical information and documentation to support your claim and to avoid being denied is to be familiar with the standards set forth for your condition in the Social Security Blue Book. 

Give Yourself the Benefit of a Disability Benefits Advocate

Suppose you’re just applying for Social Security disability benefits. In that case, an experienced advocate can help you put together the strongest application possible, including ensuring that you have provided as much of the right type of medical documentation as possible. The advocates at Disability Help Group have extensive experience fighting for SSD benefits and have a thorough understanding of the process. We also know what type of evidence is required to prove different SSD claims to help you avoid being denied.  

If your claim has already been denied, we can help you put together the strongest appeal possible. This includes helping you identify additional information to submit with your request for reconsideration, recommending that you seek additional medical testing or take other actions, and helping you submit the necessary information in advance of a hearing before an administrative law judge and choosing the right witnesses. 

To learn more about how we can help you after you’ve been denied SSD, call us right now at (800) 800-3332 or fill out our contact form and we’ll get in touch with you.

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