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How to file for disability, Filing for SSI
Disability Requirements, Disability Status
How long is the wait?, Disability Application
The Social Security List of Impairments
Qualifying for Disability, Mental Disability
Disability Lawyer Info, Disability Back Pay

What Are The Reasons For Social Security Disability Cases Being Denied?



 
Social Security Disability and SSI cases are primarily denied for one reason: a claimant's medical records will fail to prove that the individual has enough physical or mental limitations that will prevent them from being able to go back to work--either performing one of their past jobs (past relevant work potentially includes any job that was done in the last 15 years) or performing some other type of other work (that Social Security may claim you can do based on your age, education, medical limitations, and skills and training).

When Social Security finds that a person filing for disability benefits is disabled, this means they have determined that they have either A) met the requirements of a listing in the Social Security List of Impairments, or B) that they have successfully passed through the five-step evaluation process known as sequential evaluation.

Now, most individuals will not be approved on the basis of the approval criteria for a listing. This is because many medical condtitions are not included in the listing book. And when they are the criteria for approval is very high. The simple fact is that most of the time a claimant's medical records will not contain the information needed to prove that they qualify for disability under a listing.



When a person is approved it will be because they have gone through all five steps of the sequential evaluation process, meaning that:

1) They are not currently working and earning a substantial and gainful income,

2) They have a severe impairment,

3), They do not meet a listing in the listing book,

4) Their condition or conditions prevent them from being able to do their past work, and finally

5) Their condition or conditions are severe enough that they cannot do any other kind of work, work that, if they were not disabled, they might easily be able to switch to.

We can distill the way the entire disability system works by making this one statement:

Most claims are denied because an SSA adjudicator--a disability adjudicator or a judge--will decide that the person can still do some type of other work, even if they can no longer do their past work.

The trick to winning a disability claim, of course, is proving that your condition is so severe that you cannot do other work, in addition to being unable to do your past work. And we address that topic more in length on this page: How to Prove you are disabled and Win your Disability Benefits

Non Medical Reasons for being denied disability

There are a variety of reasons an individual’s disability claim can be denied that do not involve their alleged disabling condition or conditions.

For instance, disability cases can be denied because they do not meet the non-disability criteria, or eligibility requirements, of Social Security Disability and/or SSI (Supplemental Security Income disability) program. If an individual has not worked, or has not worked in a long time, they may not be insured for Social Security Disability.

Insured status is gained only through work activity and lasts a limited amount of time once an individual stops working. If an individual files a disability claim on the basis of need, their disability claim may be denied because A) the value of their resources is too high (currently, the income resource limit for an individual is two thousand dollars and the couple’s resource limit is three thousand dollars) or B) they have income that is over the income limit. Like all need-based social welfare programs, individuals who file for SSI must meet certain income and resource limits to be eligible for disability benefits.

Disability claims can be denied for other reasons as well. If an individual files a disability claim and they are working, their disability claim can be denied for the performance of substantial gainful activity (SGA) prior to their case being sent to a disability examiner (at disability determination services, the agency that makes case decisions for social security) for a medical decision.

SGA is a monthly earnings amount that the Social Security Administration has determined to be self-supporting. If an individual is earning over the SGA amount, if does not matter what their disabling condition is or how severe it is; their claim will be denied.

Social Security Disability claims can also be denied either in the Social Security office, or at the state agency responsible for making disability determinations, for failure to cooperate. Failure to cooperate denials involve a failure on the part of the disability applicant to provide forms or information needed to process their disability claim.

Often, too, the state disability processing agency denies disability cases because they are unable to get in touch with the disability applicant. This is why it is so important for all disability claimants to provide Social Security with updated addresses and phone numbers if there are any changes during the processing of their disability cases.

The state disability agency (DDS) may also deny a disability case if a disability claimant fails to attend a scheduled consultative examination. If a disability applicant cannot attend their consultative examination for any reason, they should contact the disability examiner responsible for their disability case a reschedule examination rather than miss it.








Essential Questions

What is the Social Security Disability SSI list of impairments?

Can you work while getting or applying for Disability?

How Often Does Social Security Approve Disability The First Time You Apply?

Tips for getting Social Security Disability or SSI benefits approved

What medical conditions will get you approved for disability?

What kind of Mental Problems Qualify for Disability?

Receiving a Disability Award Letter

Conditions Social Security will recognize as a disability

Previously answered questions regarding SSD and SSI

Applying for disability in your state



Most popular topics on SSDRC.com

Social Security Disability SSI Questions

The listings, list of disabling impairments

Can a mental illness qualify you for disability?

Disability Lawyers prevent unnecessary denials

How much Social Security Disability SSI back pay?

How to apply for disability for a child or children

Filing a Social Security Disability SSI application

Filing for disability - when to file

How to apply for disability - where to apply

Qualifications for disability benefits

How to Prove you are disabled and Win your Disability Benefits

Qualifying for Disability - The Process

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Who can help me file for disability?




Related pages:

How long does a Social Security Disability judge have to make a ruling?
Denial by an ALJ at a Disability Hearing
How long does it take a disability judge to make a decision?
If I Get Denied Twice For SSD or SSI Disability, What Do I Do?
What Are The Reasons For Social Security Disability Cases Being Denied?
What happens if you get denied for Social Security Disability three times?
Why Will A Social Security Disability Application Get Denied?
How Many Times Will Social Security Disability Deny You before You Get Approved for Disability?
Can You Avoid Being Denied on a Social Security Disability or SSI Claim?
What happens if a reconsideration for Social Security Disability or SSI is denied?
What should be done if your disability is denied?
How do you appeal if you are denied for Social Security Disability or SSI?
Should you get Help from a Disability Attorney before the Claim has been Denied?
Can you get a quick disability approval in Missouri
How long does it take for a disability decision in missouri?
Will I qualify for disability Benefits in Missouri?



These pages answer some of the most basic questions for individuals who are considering filing a claim.

Can you get temporary Social Security Disability or SSI benefits?

Permanent Social Security Disability

What is the difference between Social Security Disability and SSI?

Who is eligible for SSI disability?

Can I Be Eligible For SSI And Social Security Disability At The Same Time?

What makes a person eligible to receive disability benefits?

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?









For the sake of clarity, SSDRC.com is not the Social Security Administration, nor is it associated or affiliated with SSA. This site is a personal, private website that is published, edited, and maintained by former caseworker and former disability claims examiner, Tim Moore, who was interviewed by the New York Times on the topic of Social Security Disability and SSI benefits in an article entitled "The Disability Mess" and also by the Los Angeles Times on the subject of political attempts to weaken the Social Security Disability system.

The goal of the site is to provide information about how Social Security Disability and SSI work, the idea being that qualified information may help claimants pursue their claims and appeals, potentially avoiding time-consuming mistakes. If you find the information on this site helpful and believe it would be helpful to others, feel free to share links to its homepage or other pages on website resource pages, blogs, or social media. Copying of this material, however, is prohibited.

To learn more about the author, please visit the SSDRC.com homepage and view the "about this site" link near the bottom of the page.