Social Security Disability Insurance can be a lifeline for those who have disabilities that make them unable to work. However, the application process can be complex, and many applicants have their claims denied.
Understanding the common reasons for SSDI claim denials helps applicants navigate the process effectively and increases their chances of success.
1. Insufficient medical evidence
A common reason for SSDI claim denials is insufficient medical evidence. The Social Security Administration requires detailed medical documentation to support the claimant’s disability. If medical records fail to provide clear evidence of an impairment that meets the SSA’s criteria for disability, the administration may deny the claim. This highlights the importance of thorough documentation from health care providers, including diagnoses, treatment plans and objective medical findings.
2. Failure to meet eligibility criteria
Another common reason for SSDI claim denials is the applicant’s failure to meet eligibility criteria. To qualify for SSDI benefits, people must show that they have a severe impairment expected to last at least 12 months or result in death. Claimants also must have earned sufficient work credits through their employment history to qualify for benefits. Failure to meet these eligibility requirements can lead to claim denial.
3. Engagement in substantial gainful activity
Engaging in substantial gainful activity is another factor that can result in SSDI claim denials. If the SSA determines that an applicant is capable of performing substantial work despite a disability, it may deny the claim. This underscores the importance of accurately reporting income and work activity when applying for SSDI benefits.
According to NerdWallet, the SSA approved 31% of SSDI claims filed between 2010 and 2019. When the SSA denies an initial claim, an applicant looking to file an appeal must do so within 60 days of the denial.
