Common Reasons Why Social Security Disability Claims are Denied

A Social Security Disability claims being denied is not a unique situation. Some are turned down for financial reasons. Others are denied because of the claimant’s health status.

In case you have applied and been refused social security disability (SSD) benefits, some are left to wonder why? While there are various reasons for the Social Security Administration (SSA) denying a claim, there are some common reasons this could have happened. Read below to learn about reasons your social security disability would be denied.

You Get Too Much Income

For SSDI, which is the benefit program for workers that have paid into the Social Security system over multiple years, one of the very basic reasons you might be refused benefits is that, when you apply, you are working above the limit where it is considered “substantial gainful activity” (SGA). This implies you get too much money to be considered disabled. You’re allowed to work a little amount when you’re applying for and collecting SSDI, but not over the SGA limit, which is $1,170 per month in 2017 (for nonblind individuals). The figure is adjusted annually. Income from investments doesn’t count toward the SGA-only work income counts, as it shows your capacity to work. For the details, including what counts as SGA for the self-employed.

As to SSI, which is the disability benefit for low-income folks, when you apply for SSI, you can’t be making over the substantial gainful activity level (although after approval you can make more cash than that). But there’s a limitation on all earned and unearned income for SSI, around $1,500 per month, that implements both when you are applying for benefits and when you’re collecting benefits. And anytime your income is over $740-$800, your SSI payment will likely be reduced, by a somewhat complicated formula. Would be reduced to zero; in payment in the event you make about $1,500 or more, your other words, you won’t qualify for SSI.

Failure to Comply with Consultative Exams

You might be requested to attend a special exam performed by a third-party medical pro. In case you neglect to show up for the examination, you’re guaranteed you’ll be denied.

Lack of Hard Medical Evidence

To be able to justify paying a Social Security Benefits to claim out, the SSA requires considerable medical documentation in order to demonstrate you have a medically legitimate reason to avoid working. Officials assess the available evidence to paint a picture of all of your medical circumstances, including records from all medical professionals who have been treating you when determining eligibility. You may be able to work with your doctors to present additional evidence that’ll validate your claim if you are initially refused because of lack of hard medical evidence.

You Do Not Cooperate With the SSA

When working up your Social Security disability claim the disability examiner for the SSA will wish to order medical records from your medical providers and the claimant needs to work by signing medical authorizations enabling the SSA to obtain your medical records that are applicable. Further, the SSA may schedule one or more Consultative Examinations (CE) with a doctor that the SSA pays for to get advice regarding your medical conditions and residual functional restrictions. Your claim might be denied due to inadequate medical documentation, in case you refuse to show up for scheduled CE’s or refuse to submit to a CE.

Short-Term Affliction

Social Security disability benefits are only granted to individuals whose disability or injury will prevent them from working for a significant period of time. Usually, your condition must be expected to continue for at least one year in order for you to qualify for benefits. If your condition probably will improve with last or treatment for significantly less than a year, your claim might be refused.

This concern is most important in claims based on acute injuries, like broken bones, rather than continual medical conditions or mental handicaps.

Make sure that your claim meets the minimum requirements discussed above to reduce the risk of a claim deniable, in the event that you are still preparing your Social Security disability claim.

You Fail to Follow Prescribed Therapy

In the event that you are being treated by a physician, but fail to follow the doctor’s prescribed therapy when you have the capacity to do this, you may be denied disability benefits. However, the SSA recognizes particular valid justifications for failing to follow the physician’s orders (which can be for taking medicine, going to treatment appointments, or undergoing surgery).

Okay, medical excuses. Failure to follow prescribed therapy could be excused for reasons beyond your control. Some examples follow.

  • You are in possession of a mental illness so intense that you cannot comply with prescribed treatment.
  • You own a fear of operation so intense that surgery would not be suitable. Your treating doctor must support the harshness of your fear to the DDS consulting physician.
  • You physically cannot follow prescribed therapy without support for example, because of paralysis of the arms or cataracts brought on by diabetes.

Okay, nonmedical reasons. It is possible that you can’t follow a prescribed treatment for a motive that really has nothing to do with your medical condition. Satisfactory nonmedical explanations for neglecting to follow prescribed therapy follow.

  • You don’t have the money to pay for treatment.
  • Your religious beliefs prohibit you from receiving medical treatment.
  • Your doctor prescribes treatment that another physician disagrees with. 

Moreover, for the SSA to deny your claim for failing to follow therapy, the treatment that you don’t follow must be one that is definitely anticipated to restore your ability to do substantial gainful activity. In case your treating doctor tells the SSA that the prescribed therapy isn’t likely to result in your capability to work, the SSA will not fault you if you do not follow such treatment.

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