Filing for Social Security Disability Insurance (SSDI) benefits can be a complicated process, and many first-time applicants face the frustration of denial. While it’s true that a large percentage of SSDI claims are initially rejected, understanding the common reasons for denial and how to avoid them can improve your chances of success.
In this blog, we’ll explore the most frequent reasons SSDI claims are denied and offer tips on how to prevent these issues from affecting your application. Contact PLBH at (800) 435-7542 if you need help applying for SSDI or appealing a denial.
Insufficient Medical Evidence
One of the primary reasons SSDI claims are denied is a lack of sufficient medical evidence to prove the severity of your disability. The Social Security Administration (SSA) requires comprehensive documentation to confirm that your condition prevents you from working.
How to Avoid This:
- Maintain Complete Medical Records: Ensure all relevant medical records are included with your application. This should include doctor’s notes, diagnostic tests, treatment records, and specialist reports.
- Get Statements from Your Doctor: A detailed statement from your doctor explaining how your condition affects your ability to work can strengthen your claim.
- Follow Prescribed Treatments: If the SSA sees that you have not followed through with treatments or recommendations from your healthcare provider, they may question the severity of your condition.
Earning Too Much Income
To qualify for SSDI, you must not be engaging in substantial gainful activity (SGA). In 2024, earning more than $1,470 per month (or $2,460 for blind individuals) is considered substantial gainful activity, and earning above this threshold could result in a denial.
How to Avoid This:
- Keep Track of Your Income: If you are working part-time or doing any form of freelance or gig work, be mindful of your earnings. Make sure they stay below the SGA limit.
- Understand the Trial Work Period: If you attempt to return to work, the SSA allows a nine-month trial work period during which you can earn above the SGA limit without losing your benefits. However, be cautious about how much you earn once this period ends.
Failure to Cooperate with the SSA
In some cases, SSDI applications are denied simply because the applicant did not respond to requests for additional information or failed to attend a scheduled consultative examination.
How to Avoid This:
- Respond to Requests Promptly: Stay on top of any requests from the SSA for additional information or clarification. Failing to provide what’s needed in a timely manner can result in a denial.
- Attend Consultative Examinations: If the SSA schedules a consultative exam to further evaluate your condition, it’s crucial that you attend. These exams can be key to proving your eligibility for SSDI benefits.
Short Duration of Disability
To be eligible for SSDI, your disability must be expected to last at least 12 months or result in death. If your condition is temporary or expected to improve within a year, your claim may be denied.
How to Avoid This:
- Ensure Your Medical Records Reflect the Duration: Work with your healthcare provider to make sure your medical records indicate that your condition is long-term or permanent. If your condition fluctuates, this should also be documented, as it can show the long-term impact on your ability to work.
Failure to Provide Complete Information
Applications with missing or incomplete information are often denied. This can include failing to provide a full medical history, leaving out important details about your work history, or not fully explaining the impact of your disability.
How to Avoid This:
- Double-Check Your Application: Before submitting your application, review it carefully to ensure all information is accurate and complete. Missing or incorrect details can delay the process or result in a denial.
- Include a Detailed Work History: Provide a full account of your work history and how your disability has impacted your ability to perform your previous job duties.
Previous Denials and Not Filing an Appeal
Some applicants, after being denied SSDI benefits, simply reapply instead of filing an appeal. However, reapplying without addressing the reasons for your initial denial usually leads to the same outcome.
How to Avoid This:
- File an Appeal Instead of Reapplying: If your SSDI claim is denied, don’t give up. Instead of submitting a new application, file an appeal and address the reasons for denial. An attorney at PLBH can help you prepare for your appeal and improve your chances of success.
Work with an Experienced SSDI Attorney
Navigating the SSDI application process can be difficult, especially if you’ve faced a denial. Working with an experienced attorney at PLBH can help you avoid common mistakes, ensure your application is complete, and improve your chances of receiving benefits. If you’ve been denied SSDI or need help with your application, contact PLBH at (800) 435-7542 for guidance through the process.