Why Social Security Disability Claims Are Denied

Social Security Disability claims can be denied by the Social Security Administration (SSA) for several reasons. Additionally, other factors can play a role in your claim getting denied.

Our team of Social Security Disability lawyers in Greenville, SC, will walk you through the common reasons your Social Security Disability claim might be denied. At Pilzer Klein, you’re not just another case; we treat you with the respect you deserve. When you meet with our team, we can give you a free case evaluation.

Common Types of Technical Denials and Medical Denials

When applying for Social Security disability benefits, it is essential to understand the distinction between technical denials and medical denials. Here’s an overview of these two types of denials:

Technical Denials

Technical denials occur when the SSA determines that you don’t meet the non-medical eligibility requirements for disability benefits. These denials are typically based on factors unrelated to your medical condition. Here are some common reasons for technical denials:

Insufficient work credits: To qualify for Social Security Disability Insurance (SSDI), you must have earned sufficient work credits through previous employment. If an applicant lacks the required work historyor has not earned enough credits, their claim may be technically denied.
Lack of recent work activity: To qualify for disability benefits, you must have worked recently. Your claim may be denied if you have not engaged in substantial gainful activity (SGA) in a specific period.
Failure to cooperate: You are required to provide the necessary documentation and information during the application process. If you fail to cooperate or provide requested documents, it can result in a technical denial.

If you’ve been denied for any of these reasons our team at Pilzer Klein can help you understand your denial and work to get the Disability benefits you need.

Medical Denials

Medical denials occur when the SSA determines that your medical condition does not meet the criteria for disability benefits. These denials are based on assessing an applicant’s impairments and their impact on their ability to work. Here are some common reasons for medical denials:

Lack of medical evidence: Insufficient or inadequate medical evidence supporting the severity and limitations of your condition can lead to a medical denial.
Failure to meet the disability listing: The SSA maintains a Listing of Impairmentsthat outlines specific medical conditions and criteria for determining disability. If your impairments do not meet or equal the severity described in the listing, your claim may be denied.
Ability to work: The SSA assesses your ability to work. Your claim may be denied if the SSA determines that you can engage in substantial gainful activity (SGA) despite your impairments.
Failure to follow prescribed treatment: If you don’t follow prescribed medical treatment without a valid reason, it may negatively impact your claim. Non-compliance with treatment plans can raise doubts about the severity of your impairments.

For a free legal consultation, call 864-235-0234

Why Is Medical Evidence Important for Your Claim?

Medical evidenceis one of the most important keys to success when filing a Greenville, SC, Social Security Disability claim. Medical evidence proves that you have the disabilities you say you do.

Medical evidence also provides additional information about your injuries that can strengthen your case. For example, a test result could show the stage of your medical condition or injury, increasing the amount of Social Security Disability you could receive. Having clear and strong medical evidence, you have a higher chance of obtaining the benefits you need.

Steps You Can Take To Increase Your Chances of Being Approved for Benefits?

When applying for Social Security Disability benefits, there are proactive steps you can take to enhance your chances of a successful claim. By following these steps, you can strengthen your case and provide the necessary evidence to support your eligibility. Here are three steps to consider:

Gather Comprehensive Medical Documentation

To increase your chances of approval, gathering thorough medical documentation is essential. This documentation should include:

Medical records: Obtain copies of your medical records from all healthcare providers involved in your treatment. This includes doctors, specialists, hospitals, clinics, therapists, and other relevant healthcare professionals.
Diagnostic test results: Collect any diagnostic test results, such as X-rays, MRIs, CT scans, or laboratory reports, that support your medical condition and provide objective evidence of your impairments.
Treatment history: Compile a detailed history of the treatments you have undergone, including medications, therapies, surgeries, and any other medical interventions related to your condition.
Statements from healthcare providers: Request written statements from your treating physicians, specialists, or therapists that outline your medical condition, its severity, and its impact on your ability to work.

Maintain Consistent Medical Treatment

Continuing to receive regular medical treatment and following prescribed treatment plans is vital for your disability claim. You should maintain a regular schedule of medical appointments and consistently attend them.

This demonstrates your commitment to managing your condition and provides ongoing documentation of your impairments. Also, you should follow your healthcare provider’s prescribed treatment plan, including taking medications as directed, attending therapy sessions, or undergoing recommended procedures.

Seek Professional Assistance

Handling the Social Security Disability process can be overwhelming. Hiring an experienced Social Security Disability lawyer from our firm can significantly enhance your claim. We can guide you through the application process and make sure that you’ve submitted all required documentation.

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If Your Claim Was Denied, We Can Help You File an Appeal

If your claim has already been denied, we understand your frustration. Luckily, there is an appeal process you can go through to resubmit your claim and possibly get your claim approved. Here’s how it works:

Initial decision: A Disability Determination Services (DDS) examiner reviews your disability claim and makes an initial decision. You can file an appeal within 60 days of your denial.
Reconsideration: You can request a reconsideration if your claim is denied at the initial decision stage. A different DDS examiner, not involved in the initial decision, reviews your case. You can submit additional evidence during this stage.
Hearing: If your claim is denied at the reconsideration stage, you can request a hearingbefore an administrative law judge (ALJ). You, your lawyer, and witnesses can present evidence and testify during the hearing. The ALJ reviews the evidence and decides on your case.
Appeal Council: If the ALJ denies your claim, you can appeal to the Appeals Council. The Appeals Council reviews your case to determine if the ALJ’s decision was correct. They may deny your request or decide to review your case and issue their own decision.

Our Greenville, SC, Social Security Disability lawyers will help you through this process. We’ll work together to build a strong case so you can receive the benefits you need.

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Contact Us to Learn More About Why Your Claim May Have Been Denied

At Pilzer Klein, our team of Social Security Disability lawyers is ready to help you figure out why your claim was denied for benefits. We’re ready to help however we can so you can live comfortably.

Call or text 864-235-0234 or complete a Free Case Evaluation form