Lack of Medical Evidence

One of the biggest reasons for denial is not having enough medical documentation to prove your condition is severe and disabling.

The SSA needs clear evidence showing:

• The diagnosis of your condition
• How long it has lasted or is expected to last
• How it impacts your ability to work
• That you're receiving regular treatment

If you haven’t seen a doctor recently, or your medical records are incomplete, your application may not meet the SSA’s strict requirements.

Your Condition Doesn’t Meet SSA’s Definition of Disability

Even if you have a serious medical issue, the SSA will deny your claim if your condition:

• Isn’t expected to last at least 12 months or result in death
• Doesn’t significantly limit your ability to perform basic work activities
• Doesn’t meet or equal a condition on the SSA’s Listing of Impairments (Blue Book)

It’s not enough to say you’re in pain or unable to work—you need to show functional limitations backed by medical records.

You Earn Too Much Income

For SSDI, the SSA looks at whether you are engaging in Substantial Gainful Activity (SGA). If you’re working and earning more than the monthly limit (which changes yearly), you could be denied—even if your condition is severe.

For SSI, financial eligibility is based on income and assets. If your resources exceed the allowed limit, your application can be denied for non-medical reasons.

Failure to Follow Prescribed Treatment

If you're not following your doctor’s recommended treatment plan—such as taking medications, attending therapy, or following up with specialists—the SSA may conclude that your condition isn’t as severe as you claim.

There are exceptions (e.g., lack of insurance, mental health conditions that affect compliance), but in general, non-compliance can seriously hurt your case.

Incomplete or Inaccurate Application

Simple mistakes on your application can lead to a denial, including:

• Missing documents or forms
• Inaccurate work history
• Contradictory information about your condition
• Leaving out important details about your daily limitations

An incomplete or poorly organized application makes it hard for the SSA to understand the full impact of your condition.

Lack of Communication with the SSA

If you miss scheduled phone calls, appointments, or a consultative exam (a medical exam arranged by the SSA), your claim may be denied for failure to cooperate.

It's important to stay in contact with the SSA and respond to any requests for additional information as soon as possible.

Previous Denials Without New Evidence

If you simply refile a new claim after being denied—without providing new medical evidence or addressing the reason for the previous denial—your new application will likely be denied again.

It’s better to appeal than to start over, as the appeals process keeps your original application date, which could impact your back pay.