Common Reasons Social Security Disability Claims Are Denied

When you apply for Social Security Disability (SSD) benefits, the Social Security Administration (SSA), will examine your claim, check your medical records, and decide whether or not you qualify under the administration’s strict requirements. The SSA denies a large number of applications each year. In the most recent year for which data is available (2015), the SSA denied 71.3% of benefit applications. Knowing the most common reasons for claim denials can help you get an approval your first time around, or appeal a denial.

You Earn Too Much Income to Qualify

The SSA will only give benefits to low-income applicants whose disabilities prevent them from working. Currently, the SSA will only consider applicants who earn less than $1,180 per month in 2018. The SSA permits applicants to work, as long as they earn less than this maximum. Each year, the SSA adjusts this figure. Amounts you earn from investments do not count, as the SSA is only interested in your ability to work, or partake in “substantial gainful activity.”

Your Disability Hasn’t Lasted Long Enough

You must prove that your disability will last long enough to qualify for federal benefits. The SSA must have proof that your disability is severe enough (or a physician believes it will be severe enough) to cause impairment for at least 12 months, or to result in death. Note that there are exceptions if an applicant is blind. If your disability has not existed or likely will not exist for at least one year, the SSA will deny your application.

Your Medical Condition Does Not Qualify as Disabling

The SSA maintains a strict definition of the term “disabled.” To have a disability according to the requirements of the SSA, the injury or disorder must prevent you from doing work you did before, prevent you from adjusting to other work, and have lasted for at least one year. If any of these are not true, the SSA will deem your condition not disabling enough to require financial benefits. A great place to start to find out if the SSA will classify your condition as a disability is the Social Security Blue Book, or the list of conditions the SSA automatically counts as disabilities.

You Didn’t Follow Your Doctor’s Orders

Listen to your doctor and obey all orders, recommended prescriptions, and treatment programs. The SSA will check to see if your disabilities stemmed from or worsened because of your inability to follow your doctor’s orders. The SSA will take this as you being unwilling to help yourself and improve your condition, and typically deem this a reason to deny benefits.

You Won’t Cooperate with the SSA

The SSA will need to find you, contact you, and possibly speak with you about your claim. Make the process as easy as possible for the administration and the Disability Determination Service (DDS), or the organization that determines your medical eligibility. These agencies will need to be able to reach you and communicate with you in a timely fashion. You will also need to grant them access to your medical records and other information about your impairments. Denying access to this information can result in the SSA failing to grant your application.

Drug/Alcohol Addiction or Criminal Conviction Precludes You from Benefits

If your disability stems significantly from a drug or alcohol addiction, you likely will not qualify for federal benefits. The SSA will question whether or not your disability would remain if you stopped using drugs and/or alcohol. If the answer is no, you will not be eligible. The SSA also does not award benefits to certain people with criminal records. If you suffered a disabling injury while committing a felony or while in prison, the SSA will not grant benefits (at least until after your release from prison).

Talk to a Social Security benefits attorney about your denial and find out what you can do to appeal the denial or otherwise dispute the claim.