Why Your Disability Claim May be Rejected or Denied

Posted by on Sep 3, 2017 in Disability | 0 comments

The Social Security Administration (SSA) requires various documentation to prove your disability. The fact is that most cases will be denied, often because there was not enough medical evidence to prove your case. This can force most claimants to go through the disability appeal process. However, if you have a disabling condition, you don’t need to give up on your claim. In these cases, a knowledgeable attorney can advocate for you and assist you through the time-consuming and lengthy process.

There are numerous reasons that your disability claim may be rejected or denied. First, the SSA and Disability Determination Services (DDS) must be able to communicate with you regarding your application. DDS is the agency that determines your medical eligibility for benefits. If SSA cannot find you, your claim can get rejected or denied, so be sure to inform them of any address or phone number changes. If you have a representative assisting you, such as an attorney, to handle your paperwork, it is important to get updates to your attorney.

A second reason you could be denied is that you may earn too much income. There is a term called ‘substantial gainful activity (SGA), and if you are denied due to your income level, this means that your income is above the SGA limit. You can work some when applying for and collecting Social Security Disability Income (SSDI), but not over the SGA limit (which is $1,170 per month in 2017 for nonblind people). This SGA limit amount is adjusted annually, and only work income can be included in this SGA amount.

Third, it may be determined by SSA that your disability won’t last long enough or is not severe enough. To qualify for disability, your impairment needs to last at least 12 months or result in your death. For example, any bone fracture from an acute trauma that may be related to an auto accident may be denied because SSA determined that this injury is not likely to be disabling for twelve months. However, if you have a more severe bone fracture, your case can be reviewed by SSA to determine eligibility for benefits.

Another reason your claim may be rejected or denied may be that you are refusing to cooperate. For example, if you refuse to release your medical records to the SSA, your claim will likely be denied. Or, if you don’t provide the additional information that SSA may be requesting from you, you can get denied as well. In some instance, if medical records are missing or incomplete or if you didn’t have a regular treating physician, the SSA can request that you be examined by an SSA physician. However, if you do have a treating physician, but fail to follow his or her prescribed therapy, you also can be denied disability benefits.

Furthermore, you can get denied disability benefits if a drug addiction or alcoholism is a contributing factor to a disability. Additionally, there are certain conditions that are related to conviction of a crime or imprisonment that can prevent you from getting SSDI benefits.

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