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5 Common Reasons your Social Security Disability Claim May be Denied

Reasons your Social Security Disability Claim May be Denied

Social Security Disability is a federally run insurance program put into place to provide a safety net for individuals who are unable to work. This program is meant to help people who are struggling to work due to a physical and/or mental condition. The goal is always to give you some time to recover and then ultimately return to work. It does not always happen that way though.

The application process for disability is not an easy one. In fact, most people are denied several times before their claim is finally approved. It is typical for an individual to be denied twice and then require a hearing before an administrative law judge. While the program is not an easy one, there are certain things that will guarantee a denial and should be avoided throughout the duration of your claim.

The first reason your case may be denied is you are earning too much money. This would be considered a technical denial, meaning there is no option to appeal. For Social Security Disability if you are earning more than substantial gainful activity then you will not be eligible for the program. A person who is earning more than a certain monthly amount is ordinarily considered to be engaging in Substantial Gainful Activity (SGA). This monthly amount changes year by year. In 2017 the SGA amount is $1,170. Keep in mind, these are gross earnings, not net. All this means is if you are working and earning more than $1,170 per month you are deemed technically ineligible for the disability program. If you are earning less than $1,170 per month you can proceed with your disability claim.

The second reason your case may be denied is your condition is not expected to last 12 months. The Social Security Disability program requires an individual to be unable to work for a period of 12 months. This is different from a private disability program where you may obtain short-term disability benefits. Those benefits have a three-month durational requirement. Social Security requires 12 months. For example, if you have a workplace injury that prevents you from working for 6 months but then you are able to return to work on the 7th month you will not be deemed to meet the durational requirement for the program.

The third reason your case may be denied is if you refuse to cooperate with the Social Security Administration. I have worked with SSA long enough to know and understand they are frustrating to deal with. However, if you refuse to deal with them you are sealing your denial fate. For SSA to make a determination about your disability claim they need to contact your medical providers and review your medical records. If you refuse to give SSA access to your records they will ultimately be forced to deny your case. If you are rude, angry, or aggressive with SSA they will likely deny your claim.

Any time you speak with them make sure to be polite, no matter how frustrated you are. Keep in mind it is you who asked SSA to consider your claim for disability. They are not required to approve the case so it is in your best interest to be polite and cooperative with anyone who may contact you from the office. Another piece of advice is to make sure SSA can reach either you or your representative to discuss your case. If SSA cannot contact you they will have no other choice but to deny your case.

The fourth reason your case may be denied is if you fail to follow the recommendations of your doctor. Your refusal to follow your doctor’s medical recommendation could be viewed as you not wanting to make efforts to better your health and it could be held against you. SSA will make some exceptions if you are unable to follow the medical recommendation due to financial constraints or similar reasoning. Some other excuses include religious beliefs, a psychiatric impairment that prevents you from comprehending, or you have an intense fear of surgery. The best practice is to trust your doctor and to follow their medical recommendations.

The fifth reason your case may be denied is based on your age. If you are under the age of 50 your claim is more likely to be denied than someone who is 50+. The general attitude is that if you are 49 or younger you should be capable of doing your past work or being retrained to do some other type of work. Without severe medical records and treatment, your case will likely be denied. This is not to say that you will not be approved later on in the process. Don’t give up!

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