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4 Reasons Your Social Security Disability Application May Be Denied

For many individuals, Social Security Disability, or SSD benefits, offer critical income that helps them maintain their quality of life through periods of extended or permanent disability. While these benefits are important for many people, relatively few applications for SSDI benefits are approved after the first submission.

In fact, according to Social Security’s own statistics, approximately two-thirds of all SSDI benefits applications are denied at the initial level. In this blog, we explain the four common categories of denials that the Social Security Administration, or SSA, issues.

  1. Disqualification of the Claimant

Certain facts can lead to disqualification for benefits. You may not qualify for SSDI benefits if you fall into one of the following categories.

Failure to Follow Treatment Plan

In order to receive SSDI benefits, you must follow your established treatment plan unless you have a reason that Social Security deems sufficient for not doing so, such as a lack of funds or insurance.  This is called “compliance.”

Income Exceeding SSA Guidelines

If you apply for SSDI in 2018, but you make more than $1,180 each month before taxes and there are no subsidies, your claim can be denied. This number is adjusted each year.

 Injury Related to a Felony Crime

Your criminal record can affect your eligibility for SSDI benefits, as we discussed in our previous blog, “Can You Qualify for Social Security Disability Benefits While Incarcerated?” Additionally, if you have a disability related to the commission of a felony crime, you can never use that injury as the basis for an SSDI application.

Substance Abuse Disability

During the application process, SSA representatives evaluate many factors to determine whether or not a claimant qualifies for SSDI benefits. One of the reasons you may not qualify is that your disability is caused or exacerbated by a substance abuse problem.

  1. Failure to Follow Application Rules

While your application is under review, you must comply with the Social Security application rules. You may receive a denial in the following situations.

Lack of Communication

A Social Security or Disability Determination Services (DDS) representative must be able to reach you during the application process. If you have a Social Security attorney, the representative should go through your legal representative instead. However, if the agencies cannot communicate with you, you may receive a denial.

Missed Appointments

One of the reasons the SSA and DDS need to communicate with you is to set up appointments known as consultative exams. These exams are critical steps in the approval of your application. If you fail to set up or show up to an exam, your claim can be denied.

  1. Issues With Application Content

As with any application form, if you have issues in your SSDI application paperwork, the claim may not go through. Common issues with application content include the following.

Blank Fields

Missing information, such as fields that claimants forget to fill out, can potentially affect the final decision on a claim. Social Security experts recommend having an attorney go over the paperwork before submission to avoid this type of error.

Failure to include all impairments

It is important to know all of your physical and mental diagnoses to determine what work you can do.  For instance, asthma may rule out construction work because of dust.  Some medications may not allow you to work around machinery.  Unless you answer all the questions completely, a fair decision can’t be made.

Previous Denials

Some claimants assume that they should file a new application if they are denied. However, if your form shows that you have a previous denial and chose to re-apply instead of appealing, the new application may not be accepted if there is no change in the information.  You should talk to an attorney about this.

  1. Lack of Evidentiary Support

Even when an individual qualifies for SSDI benefits, he or she must prove that. A lack of evidentiary support almost always leads to a denial. These insufficiencies include the following.

Disabilities That Appear Short-Term

In order to receive SSDI, your debilitating condition must be expected to last for at least 12 months (or result in death). Applications citing conditions or injuries that usually take less than a year to heal often receive denials, unless the applicants present convincing evidence that the issue will last longer than a typical case.  This often happens in trauma cases.

Incomplete Treatment Records

Social Security looks at your medical information for evidence supporting your description of your disability. You must have adequate records to support your claim and you must release the relevant medical information as requested.

The medical information is critical.  Go over your claim with an experienced Social Security attorney to ensure that your evidence is in order, your paperwork is correct, and your application complies with all guidelines as you move forward.

For comprehensive Social Security disability legal services, including help filing your initial application or fighting an SSDI denial, trust Glen Cook, Social Security Attorney.