Reasons Social Security Disability Claim May Be Denied & What To Do About It

Navigating the world of Social Security Disability benefits can be a daunting task. You may find yourself in a situation where you believe you’re eligible for these crucial benefits, only to face the disappointment of a denial. But don’t lose hope! In this blog post, we’ll explore some common reasons why Social Security Disability claims get denied and, more importantly, provide you with practical steps on what to do if you find yourself in this challenging situation.

  1. Insufficient Medical Evidence

One of the primary reasons Social Security Disability claims are denied is insufficient medical evidence. To have a successful claim, you must prove that your medical condition significantly impairs your ability to work. Here’s what you can do:

  • Take Your Medical Records Seriously: Ensure your medical records are complete and up-to-date. This includes reports, test results, and doctor’s notes detailing the severity and impact of your condition on your daily life.
  • Regularly Visit Your Healthcare Provider: Consistent medical treatment shows that you’re actively trying to manage your condition. Attend all scheduled appointments and follow your doctor’s advice.
  • Consult a Disability Attorney: Consider seeking legal representation to help gather the necessary medical evidence and ensure your case is presented effectively. This resource, https://www.protectyourlegalrights.com/wilmington-social-security-disability-lawyer/, is a great starting point.
  1. Failure to Meet the Eligibility Criteria

Social Security Disability benefits have specific eligibility criteria that you must meet. Failure to do so is a common cause of denial. Here’s what you can do:

  • Understand the Eligibility Requirements: Familiarize yourself with the Social Security Administration’s (SSA) criteria for disability benefits. These include having a medically determinable impairment that lasts at least 12 months or is expected to result in death.
  • Consult an Expert: Speak with a disability attorney or advocate who can assess your case and help you understand whether you meet the eligibility criteria. They can also guide you on what steps to take if you don’t meet them yet.
  1. Inadequate Work Credits

Social Security Disability Insurance (SSDI) is based on your work history and the number of work credits you’ve earned. If you don’t have enough work credits, your claim may be denied. Here’s what you can do:

  • Review Your Work History: Request a copy of your Social Security Statement to check your work history and credit count. You can do this online through the SSA’s official website.
  • Consider Other Assistance Programs: If you lack the required work credits for SSDI, explore other assistance programs like Supplemental Security Income (SSI) that are based on financial need rather than work history.
  1. Engaging in Substantial Gainful Activity (SGA)

The SSA defines “Substantial Gainful Activity” as work that earns you a substantial income. If you engage in SGA, your disability claim is likely to be denied. Here’s what you can do:

  • Understand SGA Limits: Familiarize yourself with the income limits set by the SSA for SGA.
  • Be Honest About Your Work: Be transparent about any work you’re doing. The SSA allows for a trial work period, during which you can test your ability to work without losing your benefits.
  1. Incomplete or Inaccurate Application

Sometimes, claim denials happen simply because of incomplete or inaccurate applications. Here’s what you can do:

  • Seek Assistance: Reach out to a disability attorney or advocate to help you complete your application correctly. They can ensure all necessary information is included and accurate.
  • Double-Check Your Information: Before submitting your application, review it thoroughly to confirm that all details, including your medical history and work history, are accurate and complete.
  1. Non-Compliance with SSA Requests

The SSA may request additional information or documentation to support your claim. Failing to provide this information can lead to a denial. Here’s what you can do:

  • Promptly Respond to SSA Requests: Stay in close communication with the SSA and provide any requested information promptly. Delays in response can negatively affect your case.
  • Keep Copies of All Correspondence: Make copies of all correspondence with the SSA and keep them organized. This will help you stay on top of your case and provide evidence of your cooperation.
  1. Lack of Follow-Up

Once you’ve submitted your initial claim, it’s essential to stay involved in the process. Some claims are denied simply because applicants fail to follow up or appeal denials. Here’s what you can do:

  • Stay Informed: Keep track of your case’s progress, including key dates and deadlines. Stay informed about the status of your claim by regularly checking the SSA’s online portal or contacting your disability attorney.
  • Don’t Be Afraid to Appeal: If your claim is denied, don’t give up. You have the right to appeal the decision, and the appeal process can often lead to a successful outcome with the right representation.
  1. Inconsistent Information

Inconsistencies in your statements, medical records, or work history can raise red flags and lead to a denial. Here’s what you can do:

  • Be Honest and Consistent: Ensure that all information you provide is accurate and consistent throughout your application and interviews with the SSA. Any discrepancies can harm your credibility.
  • Clarify Discrepancies: If you notice any inconsistencies in your records or statements, address them immediately with your disability attorney. They can help you explain any discrepancies to the SSA.
  1. Failure to Comply with Prescribed Treatment

If you’re not following your prescribed medical treatment plan, the SSA may question the severity of your condition. Here’s what you can do:

  • Follow Doctor’s Orders: Adhere to your healthcare provider’s recommended treatment plan and take prescribed medications as directed. Failure to do so can be seen as non-compliance.
  • Document Treatment: Keep records of all medical treatments, including appointments, medications, and any side effects you experience. This documentation can strengthen your case.

Conclusion

Facing a denial of your Social Security Disability claim can be disheartening, but it’s not the end of the road. By understanding the common reasons for denials and taking proactive steps to address them, you can increase your chances of a successful outcome. Remember, seeking professional assistance from a disability attorney or advocate can be invaluable in navigating this complex process. Stay persistent, and don’t give up on the benefits you rightfully deserve. With determination and the right support, you can overcome these challenges and secure the assistance you need to lead a better life.

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