An Honest, Clear Voice In SSI/SSDI Care

What are the top reasons for SSDI denials?

On Behalf of | Sep 27, 2022 | Social Security Disability

It takes a lot of emotional effort to admit that you’re no longer able to keep working, and the application process for Social Security Disability insurance (SSDI) benefits is pretty complicated. 

Plus, you generally have to wait months before you get a decision – which can make it especially disheartening to receive a denial in the mail. While every claim is unique, denials tend to fall into some basic categories:

1. Your disability isn’t expected to last long enough.

The Social Security Administration (SSA) has a very restrictive definition of what qualifies as “disabling.” Among the rules: You must have a condition that has already lasted for 12 months or longer or is expected to do so.

In situations where there might be questions about a disability’s staying power, good documentation from your physicians can help. 

2. You didn’t follow your doctor’s orders or have gaps in your treatment history.

When you’re applying for SSDI, you’re expected to show that you’ve done your best to get better. Gaps in your treatment history or the failure to follow your doctor’s recommended course of treatment can weigh heavily against your claim.

It’s important to note, however, that SSA does recognize some reasons for treatment gaps and noncompliance as valid. For example, you may have been unable to afford treatment due to insurance issues or declined a treatment that was invasive and risky.

3. Your medical records aren’t clear and SSA is unable to contact you.

SSA may reach out to you several times for additional information. They may need additional medical releases or want to schedule you for a consultative exam with an independent physician for more clarification about your condition.

If SSA is unable to reach you, they will make their decision based only on what’s in your file – and that’s unlikely to tilt things in your favor.

4. Your doctors or hospitals haven’t returned the requested medical information.

Every SSDI claim needs medical evidence to support it – but doctors and hospitals can be terrible about responding to records requests or filling out forms.

Often, you can circumvent this problem by providing copies of your medical records when you file or making an appointment with your doctor specifically to get any requested forms completed. 

If your SSDI claim has been denied, don’t give up: Experienced legal guidance can help you obtain the benefits you need and protect your future.