If you applied for Social Security Disability benefits and received a denial, you’re not alone. Most disability claims are denied at the initial level. A denial does not necessarily mean that you are not disabled or that you did something wrong.

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In many cases, claims are denied for reasons that have more to do with how Social Security evaluates evidence than with the severity of a person’s condition. Below are some of the most common reasons disability claims are denied.

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Medical records don’t clearly show work limitations

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Social Security places heavy emphasis on medical records. Even when someone has a serious medical condition, a claim may be denied if the records do not clearly describe how that condition limits the ability to work.

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Common issues include:

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• Gaps in medical treatment

• Records that list diagnoses but don’t describe functional limitations

• Notes that focus on symptoms but not on how those symptoms affect daily activities or work tasks

• Missing records because of incorrect dates or addresses

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Social Security is generally less concerned with the name of a condition and more concerned with what a person can and cannot do on a sustained basis.

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Treatment appears inconsistent or incomplete

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A claim may be denied if the records suggest that recommended treatment was not followed. This might include missed appointments, stopping medication, or not pursuing certain therapies.

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There are often legitimate reasons for this, such as side effects, cost, lack of access to care, or limited improvement with treatment. However, those reasons are not always obvious from the records unless they are documented.

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Work activity affects eligibility

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For Social Security Disability Insurance (SSDI), working and earning above certain limits can lead to a denial. This can happen even when the work is part-time, short-term, or done out of financial necessity.

 

Social Security considers both how much a person earns and whether the work suggests an ability to perform substantial work activity. 

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Social Security believes other work is possible

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In some cases, Social Security agrees that a person cannot return to past work but still denies the claim based on the belief that other work exists that the person could perform.

This determination depends on several factors, including:

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• Age

• Education

• Past work experience

• Physical and mental limitations

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This is often where disability claims become more complex, and specific attention to an individual’s physical and mental limitations is essential.

 

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Procedural or technical issues

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Not all denials are based on medical findings. Some claims are denied due to technical or procedural issues, such as:

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• Missed deadlines

• Incomplete paperwork

• Failure to attend a scheduled consultative examination

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These issues can sometimes be addressed on appeal, but they still require prompt attention.

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What happens after a denial?

 

A denial does not mean the end of the process. Many disability claims are approved at later stages, including after a hearing before an administrative law judge. The appeals process exists for a reason, and denials at early stages are common.Understanding why a claim was denied is an important first step in deciding what to do next.

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