Why Your SSD Claim Might Be Denied

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Why Your SSD Claim Might Be Denied

If you’re applying for Social Security disability (SSD) benefits for the first time, chances are good your claim will be denied. In 2023, just 29.5% of SSD applications were approved. That probably comes as bad news. But, it’s important to understand that “only 29.5% of claims are approved” is not the same as “you only have a 29.5% chance of getting approved.” Though getting your initial SSD application approved can be a challenge, there are reasons some claims are approved while most are denied. 

The more you know about the reasons SSD claims are denied, the better prepared you’ll be to submit a strong application for benefits. 

Reasons SSD Applications are Denied

To be approved for SSD, you have to meet certain criteria. First, you have to have accrued sufficient work credits to entitle you to benefits. That’s a hard-and-fast rule that there’s no way around. If you don’t have enough work credits, you can’t get SSD benefits, even if you can prove that you’re disabled. 

If you have sufficient work credits, you still have to show that you meet the Social Security Administration (SSA) definition of disability. Here are some of the key reasons an SSD application might be denied: 

The SSD Applicant Makes Too Much Money

To meet the SSA’s definition of disability, an applicant must show that their medical condition (or a combination of medical conditions) prevents them from engaging in “substantial gainful activity” (SGA). To simplify this analysis, the SSA has created a cut-off. In 2024, earned income of more than $1,550/month means you are engaged in substantial gainful activity. That amount is increased to $2,590/month for blind applicants. 

If you earn more than the SGA cut-off, the SSA won’t consider you disabled and your claim will be denied. Note, though, that only income earned from work or self-employment counts. SSD is not need-based, and the SSA doesn’t care if you have income from other sources such as gifts from family, a trust fund, interest on investments, or other non-work sources.

The Applicant Doesn’t Have Enough Medical Evidence

To qualify for disability, an applicant must show that they meet SSA’s definition of disability. There’s more than one way to prove that, but they all start with evidence of a medical condition and what type of symptoms and limitations are associated with it. That requires records.

Depending on the condition, the required records might include diagnostic test results, doctor’s progress notes, and more. If you haven’t sought sufficient medical care or your doctor hasn’t run the necessary tests and therefore you don’t have enough evidence of the diagnosis and limitations associated with it will likely be denied. 

The Applicant Isn’t Following Medical Advice

An applicant who hasn’t kept up with their medical care may be denied for another reason, too–it’s hard for the SSA to know whether a condition is actually disabling if the applicant isn’t receiving property care, taking their medication, or taking other action that might diminish symptoms and make them better able to work. 

If there are steps you should be taking to mitigate the symptoms of the condition and you aren’t doing so, the application will likely be denied. Similarly, if your disability is due to an addiction or may be aggravated by an addiction, you won’t be eligible for SSD while you’re still using the addictive substance or substances. 

The Disability is Short Term

Unlike some other disability providers, the SSA doesn’t offer short-term disability coverage. Even if the applicant is totally unable to work due to a medical condition, they won’t qualify for SSD benefits unless they can show that the disability has lasted or is expected to last for at least 12 months. 

The Applicant is Unresponsive

The SSA may need to communicate with a SSD applicant during the application review process. Sometimes, that’s just to send updates. Other times, the SSA is requesting additional medical information or asking the applicant to schedule a medical exam or undergo a test. 

If that mail is returned because you’ve moved or you fail to respond with the additional information requested or you miss your medical exam without contacting the SSA with a good reason, your claim will likely be denied. 

Submitting a Strong SSD Application

No one can guarantee that your SSD application will be accepted on the first try. The denial rate is high and even those who submit strong applications often have to appeal. However, you can significantly increase your chances of approval by ensuring that you’ve thought through and addressed these and other common reasons SSD applications are denied. 

When you work with an experienced disability benefits advocate like the ones at Disability Help Group, your advocate can help you avoid pitfalls and assemble the strongest possible application and supporting documentation. Our advocates have extensive knowledge of the type of evidence the SSA will be looking for with your SSD application, and can help you pinpoint and address any weaknesses or missing pieces before you apply. 

In some cases, that may be as simple as gathering some older medical records or having someone in your day-to-day life provide information about your condition. In others, it may mean seeking additional medical testing or treatment.

What if My SSD Application Was Denied? 

If your application has already been denied, don’t give up. Many SSD applications that are initially denied are eventually approved. Your advocate will review the reasons for the denial and the evidence you originally submitted and help you supplement that documentation for the appeals process. You have a tight deadline to appeal, though. If you miss your chance, the process starts over, and you could lose back benefits. So, it’s important to contact a disability benefits advocate as soon as possible. 

You can get started right now by calling 800-800-3332 or filling out our contact form here. 

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