Applying for disability benefits can be a complex process, and many claims are denied on the first attempt. Whether due to missing medical documentation, technical errors, or eligibility misunderstandings, these denials can be frustrating. However, understanding the most common reasons claims are rejected can help you avoid mistakes and improve your chances of approval when filing for disability.

Common Reasons for Disability Claim Denials

Disability benefits provide financial support to individuals who can no longer work due to a medical condition. However, even legitimate claims can be denied if they do not meet strict requirements. Knowing the common reasons for denials can help applicants prepare a stronger case.

Lack of Sufficient Medical Evidence

One of the most frequent reasons for denial is a lack of medical documentation proving the severity of the disability. The Social Security Administration (SSA) requires clear evidence that an applicant’s condition significantly limits their ability to work.

How to Avoid This:

• Ensure your doctor provides detailed medical records, test results, and treatment history.
• Keep a record of all medical visits, prescriptions, and specialist referrals.
• Request written statements from healthcare providers outlining how your condition prevents you from working.

Filing Errors and Technical Mistakes

Disability applications require detailed information, and any missing or incorrect data can lead to denial. Even simple clerical errors may result in a rejected claim.

Incomplete or Incorrect Application Forms

SSA applications involve extensive paperwork, and missing information can cause delays or outright denials.

How to Avoid This:

• Carefully review your application before submitting it.
• Double-check that all required documents are included.
• If needed, seek help from a legal professional to ensure the accuracy of your submission.

Failure to Follow Prescribed Treatment

Applicants must demonstrate that they are actively seeking treatment for their condition. If an individual does not follow a doctor’s prescribed treatment plan, SSA may assume their condition is not severe enough to warrant benefits.

How to Avoid This:

• Follow all medical recommendations, including medication, therapy, and treatment plans.
• If you are unable to follow treatment due to financial hardship or other barriers, document the reasons and inform SSA.

Eligibility Issues and Benefit Limits

Not everyone qualifies for disability benefits, even if they have a serious medical condition. Certain financial and medical criteria must be met.

Earning Too Much Income

Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) have strict income limits. If an applicant earns more than the Substantial Gainful Activity (SGA) threshold, they may be denied benefits.

How to Avoid This:

• Check the current SGA limit before applying.
• If working part-time, keep earnings below the allowable threshold.

The Disability Is Not Expected to Last 12 Months

SSA requires that a qualifying disability must last at least 12 months or be expected to result in death. If an applicant’s condition is likely to improve within a year, they may not qualify for benefits.

How to Avoid This:

• Obtain a medical statement confirming that your condition is long-term and significantly impairs your ability to work.
• Provide documentation of ongoing medical treatment.

Steps to Strengthen Your Disability Claim

Taking the right steps when applying for disability benefits can improve the likelihood of approval. Being proactive can help avoid unnecessary delays and denials.

Work Closely with Your Doctor

Medical evidence is the foundation of a successful disability claim. Ensure your doctor understands SSA’s requirements and provides thorough documentation.

Keep a Detailed Medical Record

A well-documented history of treatment, including doctor visits, medications, and symptoms, can serve as strong evidence.

File an Appeal Instead of Reapplying

If a claim is denied, some applicants make the mistake of submitting a new application instead of appealing. Filing an appeal allows you to correct errors and provide additional evidence.

Seek Legal Assistance

Working with an employment law attorney can significantly improve your chances of approval. An experienced lawyer can help gather the necessary documentation, complete paperwork accurately, and navigate the appeals process if needed.

Take Action If Your Disability Claim Was Denied

If your disability claim has been denied, don’t give up. Many claims are approved after an appeal with the right legal guidance. Contact PLBH at (800) 435-7542 to discuss your case and ensure you receive the benefits you deserve.