McDonald Pierangeli Macfarlane, PLLC

Top 3 reasons the SSA might deny your claim

On average, roughly two thirds of all Social Security disability claims filed in a year are denied.  Many claims that should be approved are denied, while many other claims are denied because of procedural reasons.

Here are the top three reasons for denial of a Social Security Disability claim:

1. Your income is too high to qualify for SSD

For the purposes of Social Security Disability benefits, your disability must prevent you from working a full-time job. If you are working and earning more than the Social Security Administration’s threshold ($1,220.00 for 2019) which SSA calls substantial gainful activity, they will likely deny your claim.   This is what we call a procedural denial, meaning SSA does not even need to look at your medical records to deny the claim if you are consistently earning more than SGA and sustaining the job.  Exceptions apply to this rule, such as unsuccessful work attempts, so you should consult an experienced Social Security Disability attorney.

2. You failed to follow prescribed treatment or get treatment

In many cases, a doctor will prescribe specific therapy to aid the healing process. If someone makes a disability claim but does not follow their prescribed treatment, the SSA can deny their claim.  Sometimes, a claimant may have a very serious condition that prevents them from working, but they have avoided getting treatment.   Medical records are the primary evidence in social security disability cases.  Social Security hearing offices adjudicate thousands of disability cases every year.  As a practical matter, many claimants are complaining of the same or similar symptoms that prevent them from working.  An ALJ is going to approve a claim supported by medical records over a claim not supported by medical records.

If you intend to apply for Social Security Disability benefits, be sure to seek treatment for your conditions. Ask your physician questions about your treatment options.

3. Your application lacked documentation or other info

Many denials occur because a claimant fails to provide all necessary information to the Social Security Administration.  It is essential to provide the name, address, and phone number for each and every healthcare provider that has treated you during the period you are alleging disability.  This includes primary care doctors, specialists, hospitals, physical therapy, counseling, psychologist, psychiatrists, ophthalmologists, podiatrists, and chiropractors --- anyone you have seen for treatment.  You should also include any treatment leading up to the start of your disability that may be relevant. Working with an attorney at the initial application stage can help claimants avoid this problem.

For guidance on the initial application process as well as appeals, consult with a Social Security Disability attorney.

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