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Reasons Why Disability Claims are Denied

  • By:The Law Center for Social Security Rights
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Millions of people apply for Social Security Disability benefits each year. Out of those millions of applications received by the Social Security Administration, the bulk of cases are denied at the initial level of the disability claim process. Why are so many Social Security Disability claims denied? The reasons for a denial of disability benefits vary from one claim to the next, but there are some common reasons for a claim to be denied. If you are applying for Social Security Disability benefits it is important to understand some of the reasons why the Social Security Administration denies so many claims. The common reasons a Social Security disability benefits claim is denied are as follows:

#1: Lack of Medical Evidence

Many Social Security Disability claims are denied due to a lack of solid medical evidence. If you want to qualify for disability benefits you will need to prove that you are unable to work due to your disabling condition. In order to do this, you must have medical records that show your disability prevents you from work activity. The medical records kept by your primary care physicians are very important in determining the success of your claim for Social Security Disability benefits. Additionally, any specialist’s records are very helpful.

Many people assume that Social Security will send them to doctors who will gather the evidence needed for Social Security Disability benefits. This isn’t the case. Even if you are sent for a medical exam by the Social Security office, many times these reports are not very helpful to the claim.

#2: Prior Denials

Many people think that filing a new disability claim is a better alternative than appealing a denied one. This is not always the case. In some situations, a claim will be denied when the person reviewing the claim sees that you applied for Social Security Disability and were denied benefits before. Because of this, it is important that you go through the appeals process rather than filing a new claim for Social Security Disability altogether if your initial claim is denied. Of course there are exceptions.

#3: Your Income

Any income that you have from working matters when applying for disability benefits. Some people who apply for benefits work part time and earn money during the process. However, if you are working and earning more than $1,260.00 per month when you apply for Social Security Disability, your claim will most likely get denied as this is considered work.

#4: Failure to Follow Treatment

If you fail to follow the treatment prescribed to you by your doctor, you are increasing the chances of getting denied. The reason for this is that the examiner will not be able to accurately determine whether or not your condition actually prevents you from being able to work if you are unwilling to cooperate with treatment. If there is a valid reason for not following through with the treatment prescribed by your doctor, you can bring this up during the appeals process.

#5: Failure to Cooperate

No matter how you feel about the people handling your Social Security Disability claim, it is in your best interests to cooperate with them during the application process. If you fail to provide the Social Security office with requested documentation or fail to show up to your scheduled medical exams, your claim will likely be denied. Because of this, it is important to remain in contact with the person handling your case and provide any and all documentation requested in a timely manner.

Social Security disability applications face an overwhelming high denial rate upon initial evaluation. Typically, the best chance for a successful appeal comes at the disability hearing level, where you have the chance to speak with an administrative judge about your condition. Given the complexities of the appeals process, it is incredibly helpful to get a Social Security disability lawyer to help you navigate the course and ensure that you have everything you need so that you are in the best possible place to win your case.

Posted in: Denials, Hearings

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