Failure to Meet the SSA’s Definition of Disability

To be eligible for SSD benefits, you must meet the Social Security Administration’s (SSA) strict definition of disability. The SSA requires that your disability must prevent you from engaging in substantial gainful activity (SGA), and it must be expected to last at least 12 months or result in death. Many applicants are denied because they do not meet this requirement, or their condition is not considered severe enough.

Insufficient Medical Evidence

One of the most common reasons for denial is the lack of medical documentation to support your disability. The SSA requires comprehensive medical records to establish that your condition is disabling. Without detailed evidence from your doctor, specialists, or hospitals, your claim may be denied. This includes missing medical tests, diagnosis, or treatment records.

Failure to Follow Doctor’s Treatment Plan

If you are not following your doctor’s prescribed treatment plan or making efforts to improve your condition, the SSA may assume that you are not as disabled as you claim. Failure to attend doctor appointments, take medications, or follow prescribed therapies can negatively impact your application. It’s essential to demonstrate that you are making efforts to manage your condition.

Working Above the Substantial Gainful Activity (SGA) Limit

The SSA has set a monthly income threshold for individuals applying for SSD benefits. If you are working and earning above this threshold (currently around $1,470 per month for non-blind applicants), your claim will likely be denied. This is because the SSA will consider you able to engage in substantial gainful activity and not qualify for benefits.

Incomplete or Incorrect Application

If your application is incomplete or contains inaccurate information, it could be denied. The SSA requires a detailed application with accurate information about your medical history, work history, and financial status. Missing forms, incorrect information, or errors in the application can result in a denial. Be sure to double-check your application before submission.

Not Meeting the Work Requirements for SSDI

To qualify for Social Security Disability Insurance (SSDI), you must have worked and paid into Social Security for a sufficient number of years. If you do not have enough work history or your work credits are insufficient, you will not be eligible for SSDI benefits, leading to a denial.

Disability Not on the SSA’s Listing of Impairments

The SSA has a Listing of Impairments that includes various medical conditions that automatically qualify for benefits if they meet the criteria. If your condition is not on this list, the SSA will assess whether your condition is severe enough to prevent you from working. If the SSA determines your condition does not meet their criteria, your claim may be denied.

Previous Denial and Failure to Appeal

If you had a previous denial and did not file an appeal, or if you missed deadlines during the appeals process, your application could be denied again. The SSA allows applicants to appeal denials, but it’s crucial to meet all deadlines and provide any new supporting evidence. Missing an appeal deadline can result in a permanent denial.