SSDI Claim denied

The process of applying for Social Security Disability Insurance (SSDI) can be both stressful and frustrating, especially when faced with a denial. For many individuals who rely on SSDI benefits due to disabilities or medical conditions that prevent them from working, a denial can feel like a setback on their path to financial stability and support. In this blog, we are going to be going over some of the common reasons for SSDI denials and offer guidance on how to navigate this challenging process.

Common Reasons for SSDI Denials

Many people are unaware of the specific criteria the Social Security Administration (SSA) uses to evaluate disability claims. By being made aware of the specific criteria and some of the common SSDI denial reasons, applicants can ensure that they are filling out their applications to the best of their ability in order to secure the benefits they need.

Lack of Sufficient Medical Evidence

Medical evidence makes a huge difference in SSDI claims, providing insight into the extent of an individual’s impairments. Comprehensive medical records, diagnostic tests, treatment histories, and physician assessments serve as tangible proof of the existence and severity of someone’s medical conditions. The lack of detailed medical evidence can weaken the credibility of their allegations and lower their chances of approval.

What Do You Need From Your Doctor to Qualify For SSDI?

 Failure to Meet the SSA’s Definition of Disability

The SSA defines disability as the inability to engage in substantial gainful activity (SGA) due to a medically determinable physical or mental impairment expected to last at least 12 months or result in death. This definition emphasizes the severity and duration of the impairment. To address the challenge of failing to meet the SSA’s definition of disability, applicants must focus on providing comprehensive evidence of their functional limitations and their impact on their ability to work.

Engaging in Substantial Gainful Activity (SGA)

SGA refers to any significant work activity that results in substantial earnings, exceeding a certain threshold set by the SSA. For individuals seeking SSDI benefits, engaging in SGA can signal to the SSA that they have the ability to perform substantial work and as a result be ineligible for disability benefits. Examples include full-time employment, self-employment, freelance work, and entrepreneurial ventures that result in significant earnings exceeding the SSA’s designated threshold.

Incomplete or Inaccurate Application Forms

It is important that SSDI applications are accurate and complete to ensure that the SSA receives all relevant information to evaluate the applicant’s disability claim to the best of their ability. Inaccurate or incomplete information can lead to misunderstandings about the severity of the applicant’s impairments, and even denials of benefits. Some common mistakes when filling out applications are not including relevant medical information or failing to list all treating healthcare providers, providing inconsistent information across different sections of the application, and failing to disclose details about work history, earnings, or activities that may impact disability eligibility.

What Not To Say When Applying For SSDI

Failure to Follow Prescribed Treatment

Doctor and patient

Failure to follow a prescribed treatment is important for SSDI applicants to demonstrate their commitment to managing their medical conditions and maximizing their functional abilities. Following a treatment plan also reflects positively on the applicant’s credibility and cooperation with medical recommendations, factors that the Social Security Administration (SSA) considers when evaluating disability claims. Applicants should make sure they are well-informed about different treatments available for their medical condition by discussing options with a healthcare provider. Following medical recommendations demonstrates proactive management of medical conditions and enhances the chances of a favorable outcome. 

Seeking Professional Guidance

Navigating the application process for your SSDI can be challenging. If you’re unsure whether you meet the eligibility requirements or need help gathering the necessary documentation, seeking professional guidance is a wise choice. An experienced SSDI attorney can assess your individual circumstances, advise you on your options, and guide you through the application or appeals process. Contact us today for a free case review to discuss your options and take the first step toward financial security.

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