Why Social Security Disability Insurance Claims Are So Often Denied

Social Security Disability Insurance (SSDI) is a lifeline for many Americans who are unable to work due to a disability. It provides financial support to help them make ends meet during a challenging time. However, the road to receiving these benefits can be filled with hurdles. The Social Security Administration (SSA) denies more than two-thirds of initial applications for SSDI, leaving many individuals wondering what went wrong.

Claims for SSDI benefits are often denied due to a determination of lack of eligibility. One key reason is income level. While some recipients are permitted to work part-time, there's a limit on earnings called "substantial gainful activity" (SGA). If an applicant makes more than the SGA amount, which in 2024 is set at $1,550 per month (or $2,590 for blind individuals), their claim will likely be rejected because the SSA deems them capable of working full-time.

Another hurdle lies in the severity of the applicant's medical condition. SSDI benefits are intended for individuals with long-term (lasting at least a year) or life-threatening impairments that significantly limit their ability to perform basic work functions. If a condition is expected to improve within a year, or if an applicant can still perform some type of substantial work, the claim may be denied. In addition, the impairment cannot stem from alcoholism or a drug addiction

Beyond these medical considerations, technical errors can also lead to denial. Incomplete applications, missing information about income and medical history, or failure to disclose all healthcare providers can derail an application. Furthermore, not following a doctor's prescribed treatment plan can raise red flags for the SSA, suggesting the applicant may not be fully committed to managing their disability. Finally, failing to cooperate with the SSA by missing appointments or not being reachable can also result in denial.

Understanding these potential pitfalls can significantly improve your chances of approval. Gather all relevant medical documentation, diligently follow your treatment plan, and fully cooperate with the claims examiner by responding promptly to requests and attending scheduled appointments.

An experienced attorney specializing in SSDI claims can be a valuable asset throughout the process. Disability benefits payments will not begin until you have been out of work for at least five months, so it is important to get the claims process started as soon as possible. If your initial application is denied, your attorney can appeal the decision with your assistance.

Massengill, Caldwell & Coughlin, P.C. assists clients in Bristol, Kingsport and Johnson City and throughout Upper East Tennessee and Southwest Virginia in pursuing SSDI benefits and appealing denials. Call 423-797-6022 or contact us online to schedule a consultation.