Persons suffering from chronic diseases, severe injuries, or serious health conditions can qualify for Social Security Disability Insurance (SSDI). However, if SSDI has denied you, you may think the process is not worth it, but that’s not true. You can still successfully obtain SSDI claims by filing a petition at the reconsideration level.
But what are some possible causes for your claim’s denial? The top reasons most SSDI claims are declined are shown below. Let’s get going.
1. You Earn Too Much Money
According to experts at this recommended site, earnings are a factor the Social Security Administration (SSA) considers in determining whether you’re disabled. After all, the purpose of SSDI benefits is to help persons who aren’t in a position to work.
Therefore, if you earn too much money, there’s a high chance you’ll be denied benefits because you’re not disabled enough to need them. Instead, your earnings must be insignificant to demonstrate that your impairment limits your capacity to earn enough to support yourself.
When considering your claim for disability payments, the SSA considers all sources of income, including money from recent employment and salaries from current ones. The SSA set the cap for blind applicants at USD$2,040 in 2019 and USD$1,220 for disabled applicants. If your income exceeds these limits, your SSDI claim will likely be denied.
2. Lack of Sufficient Medical Evidence
The majority of claims that are initially denied are due to a lack of medical evidence. The SSA cannot establish whether or not your physical or mental condition is severe enough to be designated a handicap without sufficient medical evidence. The following are some of the documents required:
- Physician reports
- Diagnosis and prognosis
- Treatment plans and history
- Laboratory and imaging results
- Physician statements elaborating your limitations
- Hospital records visiting the emergency room or after being admitted
Therefore, if you have been denied and want to re-apply, it’s crucial to gather more medical evidence. Your doctor will need to fill out a form called a ‘medical report’ that describes your impairments and how they affect your daily life. This form will be attached to your appeal application and your record at the SSA.
Better yet, you can have multiple doctors document that you indeed suffer from a medical condition to boost your chances of the SSA approving your claim. You need more medical evidence if your doctors aren’t writing enough about your condition and symptoms.
The SSA will want to see the results of your most recent medical exams and laboratory tests, along with documentation from all your doctors about your medical history. They may require reports from other professionals who have assessed your current health status or made specific assessments about your ability to do certain types of jobs.
3. You Fail To Follow the Prescribed Treatment
Another top reason why SSDI claims can be denied is if you fail to follow the prescribed treatment. If you’re disabled and can’t work, you must get a medical evaluation from a medical professional specializing in disability evaluations. The doctor overseeing your case will want to see that you’re following the steps of your treatment plan. They’ll also want to know that you’re taking an active role in your rehabilitation.
By failing the doctor’s prescribed treatment plan, you’ll no doubt be denied SSDI benefits. However, you can consider some reasons for failing the treatment plan prescribed by your doctor, and these include the following:
- Not having money to pay for your treatment
- Extreme fear of surgery as verified by your doctor
- Serious mental illness
- You require help because of a preexisting condition
- Another doctor differs from your doctor’s prescribed treatment
Besides these exceptions, ignoring the prescribed treatment by your doctor will undoubtedly increase the chances of your claim being denied.
4. You Can’t Be Reached
One of the reasons why your claim might get denied is because the SSA can’t contact you. This means they can’t reach any of the addresses or phone numbers listed in your application or any other contact information given by any other source.
When the SSA can’t contact you to get more information, they’ll send a notice asking for more details. However, if they don’t receive a response within 10 days later, then your claim gets denied.
5. Your Disability Isn’t Serious Enough
If you’re planning to apply for SSDI, you’ll need to show that your condition stops you from working. You’ll have the best chance of success if you can prove that your condition is so severe that it prevents you from performing basic, everyday activities like walking across the room or washing your hair.
SSDI benefits are meant to support those unable to work due to health problems or disabilities that have proven to be long-lasting and severe. If you’re in good health and able to work, even if you’ve been out of work for a year or longer, it’s unlikely that your claim will be approved.
First, make sure you know what kind of disability you’re claiming. You can apply for both SSDI and Supplemental Security Income (SSI), but the two programs have different criteria for determining eligibility and pay out different amounts. And to qualify for SSDI, your condition must be expected to last 12 months or more or result in death. The same conditions will get you SSI, but only if they last six months or more.
Therefore, if your condition isn’t severe enough to be deemed serious under the SSA’s standards, your claim will no doubt be rejected.
6. You’re Uncooperative
If the SSA considers you uncooperative, your SSDI claim may be rejected. This may be the case if you do not provide the SSA with all of the necessary information, such as your medical records. To prove that your disability claim is legitimate, the SSA may have you examined by an accredited physician. They may also request that you attend scheduled meetings to address their issues and queries.
If you fail to cooperate with any of the demands by SSA, your SSDI claim will most likely be denied.
Takeaway
Your SSDI claim being denied can be extremely painful, yet it happens to most applicants, with only 22% of applications being accepted. If you want to lower the odds of this occurring to you, read this in-depth article about the numerous reasons why SSDI claims are denied.
With these insights, you’ll be able to determine the best steps to take to increase the likelihood of your SSDI claim getting approved.