SSDI Denials

If your SSDI claim has been denied, we understand your frustration and confusion. Most people count on the fact that their SSDI application is going to get approved, granting them the coverage they need. In the past, we have seen reoccurring reasons for denials, so our advocates have compiled a list to explain why some people have been denied SSDI benefits: 

1. You Earn Too Much Income

For SSDI, many people are denied simply because they are working above “substantial gainful activity” (SGA). This means you earn too much money to be considered disabled. If you make over $1,130 per month the SSA will consider you to be working and automatically deny you benefits. The figure is adjusted annually. Income from investments does not count toward the SGA—only work income counts, as it shows your ability to work.

For SSI, which is the disability benefit for low-income people or people who have not worked long enough, when you apply for SSI, you cannot be making over the substantial gainful activity level. Additionally, you are unable to have over $2,000 in resources for a single person or $3,000 in resources for a couple.

2. Your Disability is not projected to last more than 12 months or is not severe enough

To qualify for SSDI or SSI benefits, you must prove that your impairment is severe enough to last at least 12 months or result in your death. Many claims are denied because Social Security believes that you will improve in the next 12 months.

In addition, your medical condition must cause you severe limitations to qualify for SSDI or SSI. Impairments are considered severe if they interfere with your daily activities and/or ability to do work-related duties like sitting, standing, walking, bending, lifting, etc. Most claims are denied simply because the applicant’s impairment was not severe enough.

3. The Social Security Agency cannot find you

The SSA and Disability Determination Services (DDS)—the agency that determines your medical eligibility for benefits—must be able to communicate with you concerning your application. If these agencies cannot reach you to schedule examinations or communicate with you about critical matters, your benefits may be denied. If you name a representative (such as a DAWA DISABILITY ADVOCATE) to handle your paperwork, you may not need to get in touch with the SSA, but be sure to stay in touch with your representative. If you move while your application is being considered, make sure the SSA knows how to contact you. Claimants are denied every day because the SSA cannot find them.

4. You Refuse to Cooperate

Your medical records are critical to your claim and your ability to collect disability benefits. Medical records provide the SSA with a basis for granting your disability. If you refuse to release those records to the SSA, your claim will likely be denied. Similarly, the SSA may need additional information about your impairments, either because your treating doctor’s medical records are incomplete or because you have no regular treating doctor. The SSA will also need the ability to inform you about your Consultative Examination (CE) with an SSA doctor. These CE’s are paid for by the government and are required to be done in almost every adult claim. In some cases, the SSA will require you to attend more than one CE. If you refuse to attend or request that the SSA makes a determination based on the medical records already in your file, you may be denied disability because of inadequate medical information or failure to attend the CE.

5. Your Disability Is Based on Drug Addiction or Alcoholism

The SSA will deny benefits to someone whose drug addiction or alcoholism (DAA) is a material factor to his or her disability. For example, if you stopped using drugs and/or alcohol, you would be able to return to the workforce.

Before being served with an SSDI denial, there are several things you can do to improve your chances of obtaining SSD/SSI benefits from the Social Security Administration. Here are some examples:

  1. Obtain all available medical records pertaining to your alleged impairment(s). If the SSA does not have your treatment records they will not be able to assess the severity of your condition(s).
  2. Fully cooperate with your disability examiner and consultative examiner. The SSA will require you to complete forms, attend examinations, and answer questions over the phone from time to time. Completing these tasks immediately will shorten the wait time for a decision and build a positive relationship with the SSA.
  3. Stay informed and do not miss deadlines. The Social Security Administration will send several forms and have several deadlines that you have to meet. If you do not stay on top of these deadlines it could mean the difference between winning and losing benefits. If you miss certain deadlines it will result in an automatic denial or dismissal.
  4. Improve your chances of winning by more than 50% by hiring a DAWA DISABILITY ADVOCATE to do all of the above tasks for you! 1-888-200-6929.

DAWA Disability Advocates are trained experts in helping Claimants obtain SSD/SSI benefits. Contact our team for highly informed guidance by calling 1-888-200-6929. We have a strong track record of helping people just like you get the benefits that they need. Let us help you today!

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