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Top 10 Reasons Social Security Disability Insurance Benefits Get Denied

  • By: Law Office of Mark B. Morse
  • Published: May 21, 2021

Each year, thousands of Americans apply to receive Social Security Disability Insurance benefits. Out of those thousands, an overwhelming number get denied. Statistics show that over half of the percentage of applicants are initially rejected. Why such terrible odds?

Many speculate that the Social Security Administration (SSA) habitually rejects applicants without a second thought. While it is true that the SSA is known to deny the majority of applications they receive, it is helpful to understand why. The SSA probes each application on their desk with an eagle eye. They are wary of fraud and people trying to take advantage of the system. Unfortunately, even those who have a qualifying disability often get denied benefits they are entitled to collect. As a result, if you are disabled and eligible for benefits, it is vital to submit a complete and accurate claim to improve your chances of approval.

Here are the top 10 reasons a Social Security Disability Insurance claim gets denied:

  1. Lack Of Evidence Or Information
    One of the main reasons an application gets denied is a lack of evidence or information. It is necessary to provide adequate and complete medical evidence and information. The SSA claims representative or examiner working on the case will need undeniable medical proof that the applicant has a severe disability that is preventing them from working for at least 12 months. It is imperative to include all tests, documents, treatments, medical records, and names of doctors working with the applicant. If a Rhode Island Social Security Disability attorney has been hired, they will be able to gather and submit all of the medical evidence and information on behalf of the applicant.
  1. Failure To Follow The Treatment Plan
    An applicant who fails to follow their doctor’s treatment plan risks forfeiting Social Security Disability Insurance benefits. Applicants should be able to show that they are following their doctor’s orders for their condition. A treatment plan helps to show that the person has a severe disability that does not permit them to work. Without a treatment plan, it may be difficult to establish a qualifying disability that prevents the applicant from working. If there is a reason the applicant is unable to follow a treatment, it should be thoroughly explained.
  1. Trying To Correct Inaccurate Information
    Inaccurate information on an application will likely result in a denial. If some information is incorrect on the initial application, it is recommended to clarify or correct it during the appeals process. This is where it is conducive to have a Social Security Disability claims lawyer working on a case. A Social Security Disability claims lawyer can help the applicant with the type of information that is needed to avoid hurdles and issues with the claims process.
  1. Income
    In order to qualify for Social Security Disability Insurance benefits, a person cannot engage in substantial gainful activity (SGA). In other words, a person who is earning over the SGA threshold set by the Social Security Administration will not be able to receive benefits. The SGA is determined by the applicant’s disability and changes every year.
  1. Ignoring Requests
    If the SSA requests information about your disability claim, it is important not to ignore their requests. Doing so can lead to a denial of benefits. When the SSA requests information, they need it to make an informed decision about the case. If you are not able to reply to requests, it is advised to obtain the representation of a Rhode Island Social Security Disability attorney. An attorney will take care of all communication on your behalf and ensure that the SSA receives all requested information and documentation.
  1. Refiling A Claim
    Though it may seem like a good idea to refile a claim after getting denied, it can actually hurt your case. Refiling your claim most likely will not address the issues that caused your denial. It will also take longer since the entire claim will have to be redone from scratch. The claim will end up at the bottom of the queue behind other applicants who submitted their applications first. Instead of starting the headache of refiling a claim, it is better to request a reconsideration or file an appeal. A Social Security Disability claims lawyer can assess your case and determine the best course of action.
  1. Running Out Of Time To Appeal
    When a Social Security Disability Insurance claim gets denied, the SSA sends a notice explaining why the application was rejected. The applicant has a certain amount of time to appeal the denial, which is typically 60 days from the rejection. Failure to appeal on time results in a shut case. If the SSA does not hear from the applicant, they will close the case. If the applicant wishes to reopen the claim, they will need to have a good reason they missed the deadline. In most cases, once the timeframe to submit an appeal has elapsed, the SSA will not reconsider. Consequently, the applicant would have to refile the claim.
  1. Giving Up
    Many applicants give up their fight for SSDI benefits when a rejection notice is received. However, what most do not know is that many applicants are successful at the appeals level. Therefore, it is worth pursuing benefits for the chance of getting approved. Hiring a Rhode Island Social Security Disability attorney increases the odds significantly.
  1. Not Exercising The Right To Appeal
    Not exercising the right to appeal goes along with giving up. If you receive a rejection, you still have a good chance of getting benefits at the appeals level through an administrative law judge (ALJ) hearing. The process can be challenging, but the best way to go about it is to hire a Social Security Disability claims lawyer to assist you from beginning to end.
  1. Representation
    Representation for SSDI benefits can be acquired at any time, even at the appeals level. Of course, it is highly advised to retain counsel from the beginning. A Rhode Island Social Security Disability attorney can help the applicant complete and submit their petition, as well as gather all necessary documentation. They will also handle all communication coming to and from the SSA. Having a Social Security Disability claims lawyer is an invaluable resource that should not be overlooked.
Mark B. Morse, Esq.

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