Are you planning to file a disability benefits claim?
You have probably heard that SSDI claims are complex and challenging to win.
That’s not entirely false. After all, about 70% of initial claims face rejection each year.
Although that number can be overwhelming, many cases are denied for similar reasons.
Learning what leads most claims to fail will allow you to build a case that stands better chances of winning.
In this article, Pinyerd Law, a seasoned disability law firm, will disclose the top 6 reasons why disability claims are denied. They’ll also share professional tips to avoid those mistakes and build a case that secures disability benefits.
Insufficient Medical Evidence
Lack of strong medical evidence is the number one reason why disability claims are denied.
Most individuals don’t realize how stringent the disability claim process is.
Expressing you have a disability won’t suffice to grant you financial assistance. Even with a valid diagnosis, having a health impairment is not a straight ticket to disability benefits.
Your condition must prevent you from working to be eligible. And you must support that with medical proof.
Suppose you have arthritis; a claim where you only mention you have this impairment is unlikely to win the case.
You have to showcase how arthritis symptoms make performing work and daily life tasks difficult.
If you fail to prove the disability hinders your ability to work, your claim will be rejected.
How To Avoid It: Gather Strong Medical Proof
From the onset of your disability, start collecting medical records.
The information you submit must be relevant and up-to-date.
Medical evidence you can include:
- Diagnoses
- Test results
- Medication treatments
- Rehabilitation reports
- Residual Functional Capacity (RFC) assessments
- Physicians’ statements
Incomplete or Incorrectly Filed Application
You’d be surprised by the number of applications that get rejected due to technicalities.
Social Security disability claims must be complete and free of errors.
You might have a qualifying disability and enough medical evidence to support it. However, one missed document, a single missed deadline, can immediately disqualify you.
How To Avoid It: Filing a Flawless Claim
Make sure to follow through with every step of the application.
You’ll be asked for personal information, medical records, work history, and more.
Answer every question; don’t leave anything blank. Provide thorough and concise information without exaggerating your condition.
After submitting your claim, maintain regular communication with the SSA. Keep track of important deadlines and always reply to calls or emails promptly.
Not Meeting The SSA’s Definition of Disability
The SSA has a definition of disability which states that your impairment must:
- meet the ones on their Impairment Listing, and
- prevent you from working
Your disability has to reach a severity level where you can no longer perform your work.
No matter if you have several impairments, you won’t qualify for benefits if they don’t meet the SSA’s strict criteria.
How To Fix It: Ask For A Case Review
The first step is confirming your disability meets the SSA’s criteria.
You can check their “Blue Book” of qualifying impairments. Or you can schedule a free consultation with a disability attorney. They’ll review your case and tell you your chances of winning.
The second step relates to the first point from this guide. You must collect solid medical evidence that proves your impairment satisfies the SSA’s benchmarks.
Lack of Work Credits (SSDI)
A core requirement for Social Security Disability Insurance (SSDI) is having enough work credits.
You obtain work credits by paying Social Security taxes through your jobs.
How many you’ll need to qualify will depend on your age. Not having sufficient work credits means you are not eligible for SSDI.
How To Avoid It:
Unfortunately, you cannot do much if you haven’t collected enough work credits through your work history.
On the bright side, the SSA offers another program for individuals who don’t meet the work credits requirement. This program is called Supplemental Security Income (SSI). The application process is the same as SSDI, although some conditions differ.
Income or Resources Exceeding The Cap (SSI)
SSI provides financial and medical assistance to claimants without work credits and/or with low income and resources.
Since this benefit intends to help individuals with scarce resources, there is an income limit you must meet.
As of 2024, the limit is set at $1,971 per month for individuals and $2,915 per month for couples.
The SSA will reject your application if your income or resources (such as money in the bank, savings, stocks, and funds) surpass the SSI cap.
How To Avoid It:
There is not much you can do if you exceed the SSI’s income and resources limit.
You can check the requirements before applying and confirm you are an eligible candidate.
Ability To Perform Other Types of Work
As part of the evaluation process, the SSA will assess your ability to perform a new job.
If, after carefully evaluating your Residual Functional Capacity, you are found able to do a different type of work, you won’t receive disability benefits.
How To Avoid It: Prove You Cannot Do Other Work
Is your disability severe enough and hinders your ability to obtain a new job?
You must provide Social Security enough proof so they can make an accurate decision.
Refrain from facing rejection due to lack of evidence. Medical records, doctors’ letters, and colleagues’ or family members’ statements can help prove the impact of your disability.
Ready To File A Winning Disability Benefits Claim?
Knowing what makes a disability claim weak and prone to rejection will help you build a flawless case.
Substantial medical evidence and a complete application are what you want to focus on.
Do you have more doubts about the process or how to file a claim? We encourage you to contact a disability attorney. Most firms offer a free initial consultation to evaluate your case.
Professional lawyers will build a strong case that smoothly sails through each SSA’s evaluation step and help you win disability benefits.
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