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Common reasons for an SSDI denial

Navigating the Social Security Disability Insurance application process can be complex, Unfortunately, many applicants get a denial after submitting their applications.

Denials may occur for various reasons, but there are some common ones. Understanding these common reasons can allow individuals seeking SSDI benefits to ensure they avoid them.

Insufficient medical evidence

The lack of substantial medical evidence supporting the applicant’s claim is a common denial reason. The Social Security Administration relies heavily on medical records to assess the severity of the applicant’s condition. Inadequate or inconsistent medical documentation may result in a denial.

Failure to follow prescribed treatment

If an applicant fails to follow the prescribed medical treatment without a valid reason, the SSA may deny the claim. The rationale behind this is that the applicant’s condition could potentially improve with proper adherence to medical recommendations.

Lack of work history

SSDI eligibility relies on the applicant’s work history and payment of Social Security taxes. Some individuals may not have accumulated enough work credits to qualify for benefits, which would result in a denial.

Engaging in substantial gainful activity

If the SSA determines that an applicant is engaging in substantial gainful activity, meaning they are working and earning above a certain threshold, it can deny the application. The SSA considers the ability to engage in SGA as an indicator of a person not having a qualifying disability.

Disability duration

To qualify for SSDI benefits, the applicant’s disability must last for at least 12 consecutive months or result in death. If the SSA anticipates that the disability will not meet this duration requirement, they may deny the application.

While these reasons represent common grounds for SSDI denial, each case is unique. The SSA considers a combination of factors, and applicants should carefully review the specific denial notice to understand the basis for the decision.