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Ten Reasons Why Your Social Security Disability Claim Could Be Denied

Appealing for benefits is best done under the guidance of an experienced disability lawyer.

Why was my Social Security Disability Income Claim Denied?

Author Attorney Greg Reed:

Each year the Social Security Administration denies approximately 60 – 70% of initial claims for Social Security Disability Income. There are many reasons why this could happen, even when an applicant’s claim is valid.

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Each year the Social Security Administration denies approximately 60 – 70% of initial claims for Social Security Disability Income. There are many reasons why this could happen, even when an applicant’s claim is valid.

  1.   Your injury or illness does not qualify you as disabled.
  2. The Social Security Administration defines disability as “the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” In order to be eligible for Social Security Disability benefits, you must prove that you have an illness or injury that prevents you from working and that illness or injury will last for at least 12 months or result in death. If you have an injury or illness that is not severe enough or will not last long enough, you will not be considered disabled. For example, if you break your leg, the fracture will most likely heal within six months and you will not qualify for SSDI. However, if the fracture is complex and fails to heal, lasting at 12 months or longer, you may be approved.

    If you have been denied disability don’t give up! Contact a Disability lawyer at 512-454-4000 for a free consultation and get the benefits you deserve.

  3.   You do not meet non-medical requirements.
  4. If your income is too high or you have insufficient work credits, you will not be eligible for Social Security benefits. You receive work credits for each year that you earn wages and pay FICA taxes. These work credits are required in order to receive Social Security Disability benefits. Social Security allows you to work part time and still receive SSDI as long as your earnings are under substantial gainful activity or SGA. For 2019, the amount of monthly income you can receive is $1,220; if you earn more than SGA, you will not be approved for SSDI or your benefits will be terminated.

  5.   Incomplete claim forms.
  6. Filing for Social Security Disability benefits can be confusing and time consuming. The number of forms that must be completed may seem daunting, but it is very important to read through each one and fill in all required details.

  7.   Lack of medical evidence.
  8. In order to qualify for SSDI, you will have to prove that your condition prevents you from working. You will need to provide medical records and documentation from your doctors confirming your disability and detailing how your condition affects your work life.

  9.   Prior denials.
  10. If your initial claim is denied and you file a new claim instead of appealing Social Security’s original decision, you may be denied again. Though it may seem like a good idea to start from scratch, a claims examiner might note that your previous claim was denied and just deny it.

  11.   Failure to follow treatment.
  12. If you are not taking prescribed medications or following treatment as directed by your medical providers, Social Security will not be able to determine that you would be disabled had you followed recommended treatment. It is very important to show that you are keeping medical appointments, taking medications as directed, and following through on recommended therapy.

  13.   Failure to cooperate.
  14. If you fail – or refuse – to provide any requested medical records to Social Security, your claim will be denied. Your medical records are the backbone of your claim. Also, Social Security may need more information about your condition because your doctor’s records are incomplete or because you have no regular medical provider. In some cases, Social Security will ask that you be examined by one of the agency’s doctors. This is called a consultative examination and is conducted at government expense. If you refuse to comply and the SSA is forced to make a determination based on incomplete medical records, you may be denied disability.

  15.   Your disability is caused by drug addiction or alcoholism.
  16. You cannot receive Social Security Disability benefits if a drug or alcohol addiction prevents you from working. Also, if drug or alcohol abuse is a key factor in your disability and your condition would improve if you stopped using drugs or alcohol, your claim will be denied.

  17.   The Social Security Administration cannot locate you.
  18. If you have moved or your phone number has changed, you must contact Social Security immediately and update your contact information. If Social Security cannot contact you to discuss your claim, they will deny your application.

  19.   You have been convicted of a crime.
  20. If your disability was the result of committing a felony (or made worse by committing a felony) you are not eligible for disability benefits. You cannot receive disability benefits while incarcerated, though you may be approved and begin receiving benefits after you are released from prison. Also, if you are on probation, you will not be not entitled to benefits for any month you violate the terms of your probation.

Many people with an illness or injury have difficulty filling out the required forms and navigating Social Security’s filing process.

In many cases, if the applicant had sought legal assistance, their claim would not have been denied. If you need help filing for Social Security Disability benefits, or have filed and been denied, be sure to consult a qualified disability attorney. An experienced attorney can help fill out forms and gather medical evidence to support your claim, strengthening your chance for approval.

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Disability benefits are an important source of income for those who are unable to work. If you are not able to work due to accident or illness, you may be eligible for Social Security Disability or Long Term Disability benefits. If you have applied for benefits and been denied, contact the attorneys at Bemis, Roach and Reed for a free consultation. Call 512-454-4000 and get help NOW.

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Greg Reed disability lawyer
Author: Attorney Greg Reed has been practicing law for 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion Gold rated by Martindale Hubbell. Through his extensive litigation Mr. Reed obtained board certification from the Texas Board of Legal Specialization. Greg is admitted to practice in the United States District Court - all Texas Districts and the United States Court of Appeals-Fifth Circuit. Mr. Reed is a member of the Travis County Bar Association, Texas Trial Lawyers Association, past Director of the Capital Area Trial Lawyers Association, and an Associate member of the American Board of Trial Advocates. Mr. Reed and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.

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