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5 Reasons Why Social Security Disability Claims Get Denied

December 24, 2020

Millions of Americans send in applications for social security disability benefits yearly, and only about 30% of that number gets approved by the Social Security Administration. The low number has led many to wonder why their claims get denied at the initial level.

The reasons for the denial varies from person to person, and it is best to seek the legal opinion of a social security law attorney if you’ve gotten denied several times. In the meantime, we’ve put together five reasons the SSA would decline your application for social security disability benefits.

1. Absence of Vital Medical Evidence

Medical evidence is vital in proving your disability and convincing the SSA that you fall under the list of those they consider disabled. The absence of substantial medical evidence is one of the common reasons for denying claims.

Asides from proving to the SSA that you are disabled, it is crucial to show that your limitations prevent you from working for one year or more. You must also show that the limitations keep you from doing any work you would otherwise have qualified for.

It means that even if you have been receiving treatment for a condition that keeps you from working, if your physician fails to link it with your inability to work, it will affect your claim. Add doctor’s notes excusing you from work and record how much time you lost due to the disability.

2. Previous Claim Denials

Previous denials of your social security disability benefits claim is usually a red flag even if you prepare a brand new application. The reason is that the chances of the facts leading to the previous denial changing are slim.

It also doesn’t help that the person reviewing your claim might not look beyond the fact of the previous denial to find out why you reapplied. Thus, it is more advisable to appeal the denial than begin a whole new process. The appeal is more likely to get you the benefits than a reapplication.

3. Your Income 

Your income comes into play if you are applying for the Supplemental Security Income (SSI) benefits. It doesn’t matter when applying for Social Security Disability Insurance (SSDI). Some SSI applicants can work part-time and earn money, but their income must be below $910 per month. Any amount above that number would get your application dismissed.

4. Failure to Follow Treatment Plan

If your physician created a treatment plan to help improve the limitations caused by your disability, you have to follow it thoroughly. Failure to do so would get your claim dismissed, as it will not allow the medical examiner to determine if the treatment could have improved your disability fully.

Additionally, it would prevent your physician from proving that your condition prevents you from working. If there’s a reasonable explanation for not completing the treatment, you can include it in the appeal process and get a disability law attorney to help.

5. Failure to Cooperate 

Getting social security disability benefits involves many processes and evaluations, so you need to exercise patience and cooperate with the SSA. Failing to cooperate would jeopardize your application; thus, keep in touch with the person handling your claim, provide the necessary documentation timeously, and show up for scheduled medical examinations.

Denial and Appeal Rates

Applications for social security disability benefits have a 70% denial rate upon initial evaluation. The rate is based on the reasons discussed above, and the silver lining is that you can appeal if your claim gets denied.

The average appeal success rate is 13.8%, but it increases to 62% when you involve an administrative judge and bring witnesses to collaborate and support your claim. If your appeal fails at this point, you can consider the Appeals Council or the Federal Court. The Appeals Council’s approval rate is 13%, and that of the Federal Court is a 40% rate.

You can also use the SSA Blue Book listing the 14 categories of conditions and their related diagnoses, symptoms, and treatment to improve your chances of getting approved. Appealing means you believe you’re qualified to get the benefits and have enough to get the SSA to make an informed decision. So dot your “I’s” and cross your “T’s” before doing so.

Did Your Claim Get Denied? Contact Tabak Law Firm 

At Tabak Law Firm, we have a team of well-equipped attorneys to help you get your claim approved and file an appeal if needed. Our Wisconsin disability lawyers have 45 years of experience helping injured plaintiffs get their claims approved. Contact us to arrange a free case review.

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