If you are applying for Social Security Disability Insurance (SSDI) payments, it’s important to be aware of  common reasons SSDI claims are denied.

What Is SSDI?

SSDI is a program administered by the Social Security Administration (SSA). It pays disability benefits to those who are unable to work due to a medical condition that is likely to last at least one year or result in death. SSDI does not give money to people with a partial disability or a short-term disability.

To apply successfully for Social Security disability benefits, a person must meet the SSA’s disability criteria. SSA defines disability as a condition that significantly limits a person’s ability to do basic work-related activities for at least 12 months.

In addition, the applicant (or their spouse or parent) must have worked a certain amount of time within a recent timeframe in a job where they paid into the Social Security system.

Common Reasons for Denial

Although millions of people apply for SSDI yearly, only a small percentage receive approval. For example, in 2022, approximately 3 million people applied, but only 543,445 were approved.

So, why does the SSA deny such a large percentage of claims? Here are five common reasons for denial.

1. Insufficient Medical Evidence

The SSA may disagree that an applicant meets its disability criteria. This is usually because the application lacks adequate medical evidence supporting the person’s claim that their disability leaves them unable to work.

Medical records must show that the disabling condition has interfered with a person’s ability to work. Medical records that do not have a clear diagnosis, are sparse, or do not have any doctor’s notes on how a specific condition has limited work activities will not support a claim for  SSDI.

2. Multiple Applications and Failure to Pursue the Appeal Process

Another common issue is when a person submits another application instead of appealing a denial. If the SSA reviewer sees you were previously denied benefits based on a similar application, you may find yourself being denied once again.

It is better to appeal a denial before submitting a new application. An appeal comprises multiple levels, so you can correct or supplement your application through the process.

3. You Earn Too Much

If you are working and making more than a certain threshold that qualifies as “substantial gainful activity” (SGA), your claim for SSDI may be denied. The SSA typically will not approve an SSDI benefits award if your earnings are more than $1,550 monthly (in 2024).

4. Your Condition Is Not a Qualifying Medical Condition

Even if your condition is severe and limits your ability to work, the SSA may still find that you can do other work and engage in SGA.

The SSA maintains a list of medical conditions that are serious enough that a person cannot engage in SGA. However, an applicant’s medical issue may not neatly fit into one of these impairment categories. In that case, the SSA has to decide if the person’s condition is comparable to one of the conditions on the list. Often, the person evaluating your request will determine your condition is not comparable and your claim will be denied.

5. Your Employment History Is Not Long or Recent Enough to Qualify for SSDI

In addition to qualifying as disabled per SSA guidelines, an applicant must have worked long enough and recently enough to be eligible for SSDI benefits. An applicant needs a certain amount of “work credits,” earned from reported yearly wages or self-employment income (on which they paid taxes). Work credits are earned for each quarter of the year a person works as long as they make a certain amount of income. The dollar amount of earnings that qualify for one work credit varies from year to year.

SSDI Attorneys

Applying for SSDI is a challenging task. The process can be long and arduous. Working with an attorney who understands disability law can significantly improve your odds of approval.

If you would like to speak with an experienced elder law attorney regarding your situation or have questions about something you have read, please do not hesitate to contact our office at 1 (800) 680-1717. We look forward to the opportunity to work with you.