Recently on our legal forum a user asked, “I have heard horror stories about SSDI claimants waiting months or years to receive benefits. I am hoping that my SSDI claim is approved the first time I apply. Can you tell me the most common reasons that a SSDI claim would be denied?”
SSDI claim overview
Every year millions of SSDI applicants have their SSDI claim denied. Winning SSDI benefits can be tough, and many claimants apply with little understanding or knowledge about what they need to do to win benefits. To improve your chance of winning benefits there are several steps you can take and several pitfalls to avoid. Let’s take a look at the five most common reasons a SSDI claim is denied.
- Claimants fail to provide enough medical evidence to prove they are disabled.
The Social Security Administration makes their disability decision almost entirely based on your medical records. With this in mind, you will need sufficient medical evidence to prove that your condition is so severe you cannot work.
Go to the doctor. Have them clearly document what symptoms and conditions eliminate your ability to work. Do not rely on the consultative examiner’s examination. These visits rarely provide enough information or evidence that you are disabled.
- Claimants lack sufficient work credits to be insured for SSDI benefits.
The second reason a SSDI claim may be denied is that the claimant has not worked and paid sufficient employment taxes to be insured for SSDI. If you have not worked and paid taxes, you will be denied SSDI benefits regardless of the severity of your health condition. Talk to the SSA if you have questions about your work credits. Unfortunately, work credits cannot be bought or borrowed from your spouse. They must be earned on your own work record.
- Claimants are working or making too much money when they apply for SSDI.
Claimants may also be denied SSDI benefits if they are working and making too much money when they apply. Many claimants ask how they can quit work to apply for SSDI benefits. The SSA would claim that if you can work and you make too much money then you are not really disabled. The amount you are allowed to earn each month changes each year. For example, in 2017, claimants may earn $1170 per month.
- Claimants do not follow their treatment plan.
Although there are some valid reasons for not following your doctor’s treatment plan, generally speaking, if you fail to follow your doctor’s treatment plan the SSA will determine you are not disable.
Their argument will be that if you were to follow your doctor’s treatment plan there is a good chance that your health would be sufficient to perform substantial gainful activity.
- Claimants do not respond to the SSA.
The SSA will deny your case if they determine that you are not fully cooperating with the SSDI process. For example, if you fail to return phone calls, do not show up for examinations, or you do not return the forms they have requested, they will deny your case. They have millions of claimants applying for benefits and they will not waste their time on claimants who do not want to help with the process.
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