You know you can’t work. You pushed yourself to the limits and thought long and hard about filing for Social Security Disability Insurance (SSDI) before you did it, and you have your doctor’s full support – so why on earth did the Social Security Administration deny your claim?
The first thing you should do is look carefully at the denial letter you’ve received from SSA. It should state the reasons for the denial in clear terms. Some frequent causes include:
Insufficient medical evidence
This is probably the number one reason that perfectly valid claims are denied. Medical records are needed to document the existence of a disability and its severity – and hospitals and physician offices can be notoriously bad about responding to the SSA’s request for information. If one or more of your doctors never provided the information that was needed, then your claim was decided on incomplete information.
Failure to cooperate with the agency
SSA often has to reach out to disability applicants for more information about their prior work activity, their education and skill sets, their ongoing treatment and more. The agency may also arrange for one or more consultative exams with independent medical examiners so that it can resolve conflicting information in your records. If you fell out of contact with SSA, didn’t attend a consultation exam or otherwise failed to give SSA what it requested, your claim can easily be denied.
Lack of duration
SSA only considers a condition to be disabling for the purpose of benefits if it is likely to prevent you from working and earning substantial gainful activity for 12 months or longer or when your condition is terminal. If you were only recently diagnosed with a condition, your claim may be denied for this reason.
Wrongful SSDI denials happen all the time, and many people who file for disability only succeed with their claims after they file subsequent appeals. That’s why it’s important not to give up. Obtaining experienced guidance for your claim is more possible than you may realize, since federal law mandates that legal fees only be paid out of any disability back pay upon a successful claim – and even then the amount of fees are capped at 25% of the past-due award (up to $7,200).