Common Reasons for Social Security Disability Claims Being Denied in Pennsylvania
Unfortunately, it is very common for the government to deny Social Security Disability (“SSD”) claims. Nationally, about two-thirds of all applicants are denied benefits after submitting their initial applications. Many disabled people become discouraged after they receive a disability benefits denial notice, but you should know that there is hope and help available. Understanding the common reasons for these denials is the first step toward increasing your chances of approval. Here are some common reasons the Social Security Administration gives for denying disability claims.
1. Insufficient Medical Evidence
One of the most common reasons for denial is a lack of compelling medical evidence to support the claims of disability. The Social Security Administration (SSA) requires concrete documentation, such as medical records, test results, and treatment history, that demonstrate the severity of your condition. If your records show minimal treatment or inconsistencies in your medical history, your claim is likely to be denied.
Tip: Ensure that you provide comprehensive documentation from your healthcare providers. Regular visits, detailed treatment plans, and specialist opinions can significantly strengthen your case.
2. Failure to Follow Treatment Guidelines
The Social Security Administration (“SSA”) expects applicants to follow prescribed medical treatments. If you don’t comply with your doctor's recommendations without a valid reason, the SSA may view this as evidence that your condition is not as severe as claimed. For instance, missing doctor appointments or not taking prescribed medications can lead to skepticism regarding your disability.
Tip: Keep a record of your treatment history and any difficulties you may face in adhering to prescriptions, such as financial constraints or side effects. These can provide valid explanations if questioned about your treatment compliance.
3. Non-Severe Impairments
The SSA categorizes impairments as "severe" only if they significantly limit your ability to perform basic work activities. Claims can be denied if the SSA determines that your condition, while possibly debilitating, does not meet their severity criteria. For example, conditions that can be managed with medication or therapy might not qualify as severe.
Tip: Highlight how your impairments affect your daily life and ability to work. Providing evidence of limitations—even if they do not seem severe at first glance—can create a stronger case.
4. Inconsistencies in Your Work History
A lack of work history or significant gaps in employment can lead to claim denials, especially if the SSA perceives that you haven’t consistently contributed to the Social Security system. Additionally, if there are discrepancies between your reported work capacity and your past employment, this can raise red flags.
Tip: Ensure your work history is accurate and consistent. If you have gaps due to your disability, document the reasons clearly and include any part-time or volunteer work you may have done.
5. Failure to Demonstrate a Condition that Meets the Listing of Impairments
The SSA has a specific "Listing of Impairments," which outlines certain conditions deemed severe enough to qualify for disability automatically. If your condition does not specifically meet the criteria set forth in the Listing, your claim may be denied.
Tip: Review the Listing of Impairments related to your condition. Working with an attorney can help you understand the criteria more thoroughly and prepare a case that either meets or is comparable to these listings.
6. Overestimation of Your Ability to Work
If you submit your application with inconsistencies that suggest you can still perform some work, the SSA may deny your claim. Statements indicating that you can perform daily activities like cooking, cleaning, driving, mowing your lawn, etc. could be indicators that you are not fully disabled and are capable of basic work.
If Your Claim is Denied
If your SSD claim is denied, you have the option of submitting an appeal. You must file your appeal within 60 days of the day you receive your denial notice. It is extremely important that you act quickly if you have received a notice of claim denial. Do not hesitate to contact Fiffik Law Group to set up a free initial consultation with one of our SSD appeals attorneys in Pennsylvania. We have offices in Pittsburgh and Philadelphia and proudly serve clients in these communities, as well as across the state. Statistically, people represented by an attorney have been successful in winning their claims more often than people without attorney representation.