Overview of Disability
Disability Back Pay
Requirements for Disability
Applications for disability
Tips and Advice for Disability Claims
How long does Disability take?
Winning Disability Benefits
Common Mistakes after a Denial
Mental Disability Benefits
Denials for Disability
Appeals for denied claims
Disability Benefits from SSA
Child Disability Benefits
Qualifications and How to Qualify
Working and Disability
Disability Awards and Notices
Disability Lawyers, Hiring Attorneys
Social Security List of Conditions
What Social Security considers disabling
Medical Evidence and Disability
Filing for Disability Benefits
Eligibility for Disability Benefits
SSD SSI Definitions
SSDRC authored by Tim Moore
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Why Will A Social Security Disability Application Get Denied?
Most Social Security disability, or SSDI, claims are denied because an individual was not found medically disabled under the Social Security disability guidelines (This article focuses on non-medical denial reasons, so for more on this topic: Social Security Disability Denied — The Reasons Why). However, disability claims can be denied for reasons other than medical reasons. When an individual applies for SSDI disability benefits with Social Security, their disability application has a possibility of being denied without the case ever being evaluated by a disability examiner and without ever receiving a medical determination.
For example, individuals who file their disability application while working and earning above the substantial gainful activity amount with no special considerations or subsidy from their employer are denied prior to their case even being sent for a disability medical determination. Translation: if you working and earning too much at the time you apply for disability, your medical records will never be gathered and reviewed and you will very quickly receive a technical denial.
Notes: SGA is an earnings limit that, if exceeded, will make a person no longer eligible for disability benefits. Special considerations or subsidy are special help from employers that help an individual remain employed.
The definition of disability states that an individual has been unable to perform SGA for twelve continuous months, or that they expect to be unable to perform SGA for twelve months due to a medically determinable impairment. So it stands to reason that an individual who is working above the SGA monthly earnings limit would be denied prior to having their case sent to a disability examiner at DDS (disability determination services) for a disability determination.
Truthfully, there are many individuals who suffer from significant medical or mental problems who are working and earning over the SGA monthly earnings amount. But for Social Security purposes, their medical or mental problems must be considered to be significant enough to prevent substantial work activity. It really does not matter what their condition is, or what the severity of their condition is if they are working over the SGA earnings limit.
There other ways, aside from work activity, that can cause a disability claim to be denied without a medical evaluation of the claim being conducted. For example, many individuals who take the time to file an application by phone, or online, are denied because they fail to return their medical release forms (forms that are signed by the applicant that enable Social Security to request medical records). If an individual fails to provide the information needed to process their disability claim, such as medical releases, their disability application will be denied on the bases of failure to cooperate.
In addition to failure to cooperate denials, disability claims can be denied for failure to attend a scheduled consultative examination (these are medical examinations that are scheduled by disability examiners to get needed medical information).
Some of these types of disability denials can be avoided if an individual simply does what is necessary for the processing of their disability claim. If an individual files for disability, they should make sure that Social Security has a valid address and phone number in case the disability examiner handling their claim needs more information. Also, disability applicants should always complete all necessary forms and provide any information requested during the disability claim-processing period.
Lastly, if an individual is scheduled for any medical or mental consultative examinations, they should make sure that they attend the examination or notify the disability examiner prior to the date of the examination that they need to reschedule their examination. Just following these simple instructions can save disability applicants from needless claim denials.
Return to: Social Security Disability Resource Center, or read answers to Questions
How to apply for disability and where to apply Filing an Application for Disability Benefits under SSD or SSI - Step by Step
Tips on how to file for disability
What is the Application Process for Social Security Disability and SSI?
What happens after I file my disability claim with Social Security? What happens after a Social Security Disability or SSI Claim has been taken and is Pending
If you get denied on a disability application do you have to file a new application?
How the Decision on a Disability Application or Appeal Under SSDI or SSI is Made
Information on the following topics can be found here: Social Security Disability Questions and in these subsections:
Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI
These pages answer some of the most basic questions for individuals who are considering filing a claim.
Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
How to Apply for Disability - What medical conditions can you apply and qualify for?
Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
What happens if I file a disability application and it is denied by a disability examiner or Judge?
How to Prove you are disabled and qualify to win disability benefits
How do you prove your disability case if you have a mental condition or impairment?
Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
Social Security Disability SSI - Eligibility Requirements and Qualifications Criteria