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Common Reasons Why Social Security Disability Claims Are Denied

Understanding the Most Common Reasons Why Social Security Disability Claims Are Denied: Social Security Disability Lawyer in NYC Explains

Individuals who become disabled due to an illness, injury, accident, or other health condition may be entitled to Social Security Disability Insurance (SSDI). This is a state-run and federally-funded program that provides certain benefits for individuals who become disabled and have an eligible work history. However, many disabled individuals with an extensive work history are surprised when their application comes back as denied. This happens all too often. According to the Social Security Administration (SSA), the initial rate of acceptance is roughly 22% and the overall allowance rate is approximately 47%. That means 78% of all initial applications are denied and 53% of total applications are denied. Some of these denials cannot be challenged for several reasons, including failing to timely appeal. This is why individuals applying for SSDI benefits need to hire an experienced Social Security Disability lawyer in NYC like ours.

Here at O’Connor Law, we understand how important it is to file your SSDI correctly—the first time. Although there is no requirement to have legal counsel to submit a disability application, individuals who fail to hire a lawyer make up a large part of that 78% who are denied, while the 22% is largely made up of represented individuals. This is because the application process is more involved than it may appear, and individuals who are suffering from disability causing them physical and emotional pain, debilitation, and other devastating symptoms may have a particularly difficult time successfully navigating the process—as so some inexperienced lawyers. Due to these factors, individuals and their families should contact experienced Social Security Disability lawyers in NYC at O’Connor Law for help.

Common Reasons Why Social Security Disability Claims are Denied

There are many reasons why SSDI applications are denied. The SSA lists “technical denials” for almost 240,000 applications out of the 1.6 million filed—which is an exceedingly high number, highlighting the importance of hiring legal counsel. But there are many other common causes of SSDI denials that individuals must be aware of in order to avoid these traps in their applications, including the following:

  • Incomplete Forms/Application – not fully completing all forms and answering the application questions can be a quick reason why your application gets denied. Do not assume that the SSA has that information or will help you answer it. An examiner will review the application and either return it for questions and re-completion (putting you at the end of the queue again), or outright reject it and move one.
  • Lack of Medical Evidence – the definition of disability by the SSA is very thorough and specific. If you fail to provide adequate medical support to satisfy that determination, you will have your application denied. An examiner may ask for follow-up information or seek additional information from you, including requesting more medical records and opinions of your treating physicians, but that is not guaranteed if there is a large gap in medical evidence. Rather, the application may be outright denied and require you to submit a properly supported application.
  • Income too High – part of SSDI is that individuals must have little or no financial resources or income. An individual who has too high of income may be denied on that basis, notwithstanding the fact that an individual may have a very serious disability.
  • Prior Denials, Especially With a Denied Appeal or No Appeal – prior denials or denied appeals are very difficult to get around in subsequent applications without proving a large change in circumstances. This is because it might appear to an examiner that you are trying to get around an untimely appeal or a denied appeal by filing a new application to cure those defects. That is not a proper thing to do. This is why it is critical to have an experienced Social Security Disability lawyer in NYC represent you the first time for your application to avoid prior denials.
  • Failure to Follow Treatment Advice and Recommendations – SSDI applications can be denied if the SSA believes that an individual is disabled only because he or she is not complying with a doctor’s orders and treatment advice. This can become fatal to an application because it suggests that a person is or has become disabled by noncompliance, not by the actual injuries or disability.
  • Not Cooperating With SSA – the SSA will often send correspondence for additional information or to substantiate proof of your disability or income. If you fail to timely respond to them, it is likely that your claim may be denied for these reasons. It is difficult to appeal these denials, absent a strong medical record for your nonresponse.
  • No Establishing a Work History – SSDI requires a work history. If you do not provide adequate evidence of this, or if you do not timely respond to SSA requests for information on your work history, it can delay your application and result in a denial.

Do You Need Help With Your SSDI Application in New York? Call O’Connor Law

Although it may be tempting to try to file an application without a lawyer, denials to your application or appeals not filed can harm all of your future applications and chances to get approved for SSDI. It is too important to not get benefits to pay for your disability. If you or a loved one are disabled and need to apply for SSDI, call our experienced Social Security Disability lawyer in NYC at O’Connor Law for help. Call to schedule a FREE appointment by dialing (914) 595-4502 or by sending us a private message through our “Contact Us” box available here.