Top 6 Reasons for Social Security Disability Benefit Denials

Although there are many people who should qualify for Social Security Disability benefits, only around 30% are approved the first time they apply. 

Whether you were in the over 60% who got denied or you want to prepare yourself ahead of time (we admire your initiative!), it’s good to be informed of why most applicants received an unfavorable decision. 

Let’s take a deeper look at some of the main reasons for being denied Social Security Disability: 

You earn too much money

The Social Security Administration (SSA) won’t consider your application if you earn more than the “substantial gainful activity” level of $1,220 per month. Remember, they approve people who aren’t able to work because of their disability. They will find your case less compelling if you are working a lot of hours and bringing in a high income.

Sure, you can work a bit when you apply for Social Security Disability, but you can’t be making more than $1,220 per month (for nonblind citizens) as of 2019. Be aware: this doesn’t apply to income you make from investments. They only count the income you receive from your job since they are evaluating if you will be able to continue working or not. 

Failure to show enough medical proof 

To qualify for Social Security Disability benefits, you have to show medical records that prove your disability prevents you from being able to work. 

If your primary care physician doesn’t log in your records that your injury or disability keeps you from working, your claim will most likely be denied. It’s important to tell your doctor how your disability is keeping you from being able to work to have enough evidence for your case. It’s especially helpful if you have doctor’s notes saying you can’t come to work or asking for you to be moved to a modified schedule. 

In short, SSA is looking for: 

• A history of letters from doctors discussing your pain and/or disability.
• Effort on your part to try different medications or treatments to help your injury.
• The fact that despite your best efforts, your disability has reached a point where you can no longer work. 

Refiling after being denied 

Many people make the mistake of filing a new disability claim after they are denied Social Security Disability benefits. This never works because once the person sees you’ve already applied they will immediately deny you or you’ll end up being denied again for the same reason as before. 

Instead of reapplying, you should appeal your denial decision. It’s best to hire a qualified Social Security Disability lawyer to walk you through the process and make sure you turn in the correct paperwork.

Not following your doctor’s suggested treatments

If you have not been following the suggested medications and treatments of your doctors, your claim has a high possibility of being denied. A physician is going to have a hard time determining if your disability is stopping you from being able to work if you’re not taking the medicine that is supposed to help you get better. 

You need to show you’re seeing a specialist for your condition and doing as much as possible to improve and be able to go back to work. 

There are reasons that could be considered acceptable for not committing to the treatment ordered by your doctor. These can include:

• An extreme fear of surgery (confirmed by your doctor)
• Lack of money for treatment
• A severe mental illness
• Religious beliefs that go against medical treatments
• A different doctor disagrees with your doctor’s recommended treatment 
• Needing assistance because of a preexisting condition

It should be noted that you’ll only be denied for refusing treatment if the treatment was supposed to help you get better enough to go back to work. You won’t be denied on these grounds if your physician tells SSA the therapy/treatment they gave you wouldn’t have been capable of improving your condition in order to work. 

SSA can’t get ahold of you

It’s possible you will get denied Social Security Disability benefits if you aren’t communicating with the SSA.

You need to be available to discuss issues related to your application. If you move and don’t update your contact information, they won’t be able to get in touch with you and will deny you benefits. If you have a lawyer working on your case, you won’t need to be as involved with speaking to SSA – but you should keep in close communication with your lawyer. 

Refusing to grant SSA access to your medical records 

The SSA is trying to discover if your disability is serious enough that you can no longer work and should be given Social Security Disability payments. So, naturally, they need access to your medical records to determine if you qualify for benefits. If you don’t give them these records, your claim has a high chance of getting denied. 

It’s possible SSA might want more information about your disability. This could be because you don’t have a primary physician or your doctor’s medical records were not complete. If this is the case, the SSA will ask you to be seen by an SSA doctor in what they call a consultative examination (CE). The cost of the CE is covered by the government, and you might have to go to more than one examination. Failure to show up to your CE or refusing to go altogether could result in your claim being denied. If there’s an issue with the scheduled time or location of your CE, get in touch with your claim examiner and they will have Disability Determination Services schedule a CE that’s a good fit for you time and location wise.

If you’re looking for a Social Security Disability lawyer who will guide you every step of the way in your disability case, reach out to us today. With decades of experience under our belts, we know how to expertly navigate disability claims whether you’re applying for benefits or appealing an unfavorable decision. We work day and night for our clients — and we will fight for you throughout the entire process.