Some 70 percent of initial claims for Social Security Disability Insurance (SSDI) are denied. The appeals process can take many months, and fewer than half are approved. If you want to avoid this situation, learn about some common reasons that the Social Security Administration (SSA) rejects applications so you can avoid problems.
Common Reasons for Claim Denial
- Your Disability Won't Last More Than 11 Months. An injury or illness must be expected to cause disability for at least 12 months or the administration will reject the application. You may believe that your condition will last longer than 11 months, but you must offer evidence of that to the agency. That means your medical care providers must agree that your condition will be ongoing for a year or more, and must document this in your medical records.
- You Don't Release Medical Records. Having details of your disability in your medical records won't help if you won't release the records to the SSA. You may have a strong preference for privacy in these matters, but the agency needs those records to make a decision.
- You Won't Agree to a Consultative Examination. Occasionally the agency wants applicants to have an additional physical exam from an SSA doctor. Although there is no charge for this, some applicants are skeptical because they figure the SSA doctor won't agree about their level of disability. In reality, the agency is simply trying to get more information to decide one way or another. If you refuse the consultative exam, the agency will probably refuse your claim.
- You Don't Follow Doctor's Orders. Your doctor may have recommended a treatment such as surgery that could heal your condition and allow you to go back to work. It's your choice to avoid surgery, but you may not be able to receive disability benefits if you refuse. You'd need to provide a very good reason why you don't want the operation. Examples would be a relatively high failure rate for this operation or elevated risks for a person with your medical conditions.
Consult a Lawyer
Disability laws are complex and difficult for a person without a legal background to decipher. You might want to consult a Social Security attorney for assistance in filing your claim. This will go a long way toward ensuring that your first application is accepted and that you can start collecting benefits quickly. The lawyer not only makes sure all your medical records are complete and available to the SSA, he or she is meticulous about the technical details of the application process that can result in claim denial if not done correctly.
If you have any questions, visit a social security attorney like Horn & Kelley, PC Attorneys at Law.