Why Was My SSDI Claim Denied? Common Reasons and What You Can Do
Did you recently receive a denial in your Social Security Disability Insurance (SSDI) case and you’re wondering why?
My name is Kaitlin Wildoner, and I’m an attorney who helps disabled clients obtain their disability benefits as quickly as possible so they can focus on getting better.
Today we’re going to talk about why some SSDI cases get denied.
Common Reasons SSDI Claims Get Denied
First, it’s important to note that there are an almost infinite number of reasons as to why an SSDI case may be denied. However, here are some of the more common reasons that we see:
1. Insufficient Medical Evidence
Many SSDI claims are denied due to lack of medical evidence.
To qualify for SSDI benefits, there must be medical documentation that substantiates not only the severity and duration of your condition but also the limitations that the condition has on your ability to perform day-to-day activities.
Inadequate medical records or insufficient detail about your condition and limitations can lead to a denial.
2. Failure to Meet Eligibility Criteria
Some claimants don’t meet the basic eligibility criteria for SSDI, particularly the work credit requirement or the definition of a qualifying disability.
If you do not have a sufficient number of work credits or your condition does not meet the Social Security Administration’s definition of disability, your claim may be denied.
3. Substantial Gainful Activity (SGA)
Engaging in substantial gainful activity while applying for SSDI benefits can result in a denial.
If your earnings exceed the substantial gainful activity threshold (which is updated annually), the Social Security Administration may conclude that you are not disabled enough under their rules to qualify for benefits.
4. Non-Compliance or Lack of Cooperation
Failing to cooperate with the Social Security Administration, attend required medical exams, or provide their requested documentation can lead to claim denials.
It’s important that you follow the Social Security Administration’s instructions and meet all deadlines during the application and appeals process.
5. Inaccurate or Incomplete Application
Errors or omissions in your SSDI application can also result in a denial.
Therefore, it’s important that before you submit the application, you review it for completeness and accuracy. You want to submit comprehensive information about not only your medical condition and work history, but also the doctors, hospitals, and clinics that you see, the medications that you take, and what it is exactly that’s preventing you from engaging in substantial gainful activity.
Other Considerations and Next Steps
While these are some of the more common reasons that Social Security disability claims can be denied, there can be other factors at play in individual cases.
If your claim is denied, it’s important that you consult with an experienced Social Security disability attorney who can help you understand the reason for the denial and guide you through the appeals process.
Additionally, if you have applied and/or been denied for Supplemental Security Income (SSI) benefits, there may be separate denial reasons for that program—including that you may exceed the income or asset thresholds set by the Social Security Administration.
Thanks so much for watching!
If you’re disabled and unable to work, we’re here to help. Click this scheduling link or call us directly to schedule a free consultation where we’ll discuss your case and see how we can help you.
