Applying for Social Security Disability Insurance (SSDI) can be a lifeline when a medical condition prevents you from working. Unfortunately, most first-time claims are denied, which can leave individuals frustrated and unsure of what went wrong.
Understanding the most common reasons for denial is a first step toward building a stronger application or preparing for an appeal. Below are five issues that often lead to a denial of SSDI benefits.
1. Medical condition does not qualify
SSDI is only available to individuals with a medical condition that is expected to last at least a year or result in death. If your diagnosis does not meet the Social Security Administration’s (SSA) definition of a qualifying impairment, your claim may be denied. Even if your condition limits your ability to do certain tasks, the SSA may determine that you can adjust to other types of work.
2. Insufficient medical evidence
You must show that your condition keeps you from performing substantial work. If your medical records are incomplete, inconsistent or lack documentation about how your condition affects your daily functioning or job duties, the SSA may deny your claim. Records from regular checkups, treatment notes and functional assessments are often needed to support your application.
3. Too much earned income
SSDI is not available to people who are earning more than a certain monthly amount, referred to as substantial gainful activity. If you continue to work and earn above that threshold, the SSA may find that your condition does not prevent you from working and deny your claim.
4. Not enough work credits
To qualify for SSDI, you must have earned enough work credits based on your work history and age. If you have not worked recently or long enough in jobs that paid into the Social Security system, your application may not meet the eligibility criteria.
5. Failure to follow through with the process
Missing deadlines, skipping appointments with SSA doctors or not responding to SSA requests for information can result in an automatic denial. Staying organized and keeping up with all required steps is crucial.
Seeking legal guidance can help explore your appeal options and strengthen your case after a denial.