Published On: Tue, Jan 22nd, 2019

It’s Never Personal: 5 Most Common Reasons Why a Disability Claim May Get Denied

Disability is intended to financially assist those who have medical conditions that prevent them from working. To qualify for social security disability through the SSA (Social Security Administration), the person must have a medical condition that prevents them from being able to work for more than a year. Many times, the initial claim for benefits is denied. Some of the reasons for this include the following.

Photo/Nodar Kherkheulidze via wikimedia commons

Lack of Medical Evidence

Medical evidence is required to show the SSA that the claimant has a medical condition that prevents them from working, that they will not be able to work for at least a year, and that they otherwise qualify for disability benefits. Without sufficient medical evidence, the claim will be denied because the SSA cannot determine whether the person qualifies for disability. It’s always better to submit as much medical evidence as possible to avoid this.

Claims Forms Not Filled Out Properly

Many different forms need to be filled out by anyone who wants to submit a claim for disability benefits. Every form needs to be filled out properly and even small mistakes can lead to the claim being denied. Someone who wants to apply for disability will want to make sure they fill out all forms carefully to improve their chances of approval. If their claim is not approved because of mistakes with the forms, it’s possible to get help with a denied claim and begin the appeals process.

Failure to Follow Treatment Plan

Medical evidence provided as part of a disability claim will likely include information on the claimant’s doctor’s treatment plan. If the claimant does not follow their doctor’s treatment plan, it could be a reason the claim is denied. When someone doesn’t follow the treatment plan, the SSA believes the person is unwilling to help themselves, which means they might be on disability much longer than someone who works toward recovering. They will deny the claim as it’s possible the person will not recover from a condition they could recover from if they followed the treatment plan.

Medical Condition Doesn’t Qualify

A huge number of medical conditions qualify for disability benefits. However, not all do. If they will recover fully from the medical condition in less than a year or the condition isn’t serious enough to keep them from working will likely not qualify them for disability benefits. According to DisabilityGuide.com, the claimant can also be denied if the medical condition stops them from doing some work, but there are types of work they can still do with their condition.

Failure to Work With the SSA

While the idea is that a claimant will submit their claim for benefits and wait to see if they’re approved, that’s not always what happens. In some cases, the SSA will have the claimant attend a consultative exam. This is done by a third-party medical expert to clarify the medical condition or the person’s ability to work despite the medical condition. According to DisabilityBenefitsCenter.org, someone who doesn’t attend this exam or who don’t appear for their appointment will likely have their claim denied.

While you can fill out a disability benefits claim whenever you feel the help is needed, be aware that there is a high chance of the claim being denied. If your claim is denied because of one of the above reasons or for any other reason, you do have the chance to file an appeal to have your claim reconsidered.

Author: Laura Brown

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