Common Reasons Social Security Claims Are Denied
Filing for Social Security Disability benefits is often a long and stressful process. Many applicants are surprised when their claims are denied, even after carefully submitting all required documents. In Maryland and across the country, the Social Security Administration (SSA) uses a strict process to evaluate claims.
Small mistakes or missing information can lead to denials. It’s important to understand some of the most frequent reasons claims don’t get approved. At Advocates for the Voiceless, our attorney Keli Renee Cochran has the experience to help you with your case. Based in Riverdale Park, Maryland, our firm serves clients throughout the state and across the nation.
If your Social Security claim has been denied, contact us immediately.
Reasons Why SSD Claims Are Typically Denied
Let's explore some reasons why your claim might have been denied. Understanding these factors can help you take the necessary steps to address the issue.
Missing Medical Evidence
One of the most common reasons for a denial is missing or insufficient medical evidence. The SSA needs detailed documentation that shows the severity and duration of your condition. A simple diagnosis often isn’t enough. You’ll need treatment notes, test results, and records from all relevant doctors and specialists.
Your claim may be denied if your file lacks consistent treatment records or if your medical providers fail to clearly explain how your condition impacts your daily life or ability to work.
Social Security law requires that applicants demonstrate a qualifying disability with solid evidence. Without it, the SSA may decide that your condition isn’t severe enough to prevent you from working.
Not Following Prescribed Treatment
If your doctor recommends treatment and you fail to follow it, the SSA may use that as a reason to deny your claim. They may argue that your condition could improve if you followed the prescribed medical care.
There are exceptions. If you have a valid reason for not following treatment, such as severe side effects, religious beliefs, or lack of access due to financial hardship, you may still have a chance. But those reasons must be documented and credible.
Returning to Work Too Soon
Sometimes applicants attempt to return to work before their claim is fully processed. While it's understandable that people need income, going back to work too soon can signal to the SSA that you’re capable of performing substantial gainful activity (SGA).
This can lead to a denial, even if your condition later worsens. If you earn more than the set SGA limit, the SSA will likely find that you’re not disabled under their guidelines.
While limited or part-time work might not always disqualify you, full-time employment or earnings above the SGA threshold can undermine your case. Social Security law has specific income limits, and exceeding them can make a claim invalid.
Failure to Cooperate With the SSA
The SSA might reach out for additional information during the review process. If you don’t respond, miss appointments, or ignore requests for documentation, your claim can be denied for lack of cooperation.
That includes skipping a scheduled consultative exam. These are appointments set up by the SSA when your medical records are missing or unclear. If you miss the exam without a valid reason, the SSA may rule based on the existing evidence, which may not be strong enough.
Communication is critical. Responding quickly and keeping your contact information updated helps avoid this problem. A lack of cooperation is viewed as a refusal to provide the evidence needed under Social Security law.
Too Much Income
As mentioned earlier, exceeding the SSA’s income threshold is another common cause for denial. Social Security Disability benefits are intended for people who are unable to perform substantial work. If you're earning more than what the SSA defines as substantial, your claim will likely be denied regardless of your medical condition.
It doesn’t matter whether you work full-time or part-time. What matters is the monthly income. The SSA updates the SGA limit annually, so staying informed is important.
This rule applies even during the application process. If your earnings go over the limit at any point, it can result in an automatic denial. Social Security law clearly defines income restrictions, and the SSA strictly follows those guidelines.
Lack of a Qualifying Condition
The SSA has a list of impairments that are considered severe enough to qualify for benefits. These are found in the SSA’s “Blue Book.” If your condition isn’t listed or doesn’t meet the criteria, your claim may be denied.
That doesn’t mean you can’t qualify, but it does mean that the bar is higher. You’ll need to prove that your condition is equal in severity to a listed impairment. This often requires detailed medical and functional evidence.
Here are a few conditions that may lead to denials if not documented correctly:
Chronic pain without a clear diagnosis or test results
Mild depression or anxiety without a treatment history
Arthritis without mobility limitations
It’s important to show how your condition affects your ability to perform daily tasks or hold a job. Social Security law requires that impairments must be both medically determinable and disabling for at least 12 months.
Claim Based on Short-Term Conditions
Some applicants file claims based on injuries or illnesses that are serious, but temporary. Unfortunately, temporary conditions usually don’t qualify under the Social Security law.
To be eligible, your condition must either be expected to last at least 12 months or result in death. If the SSA believes you’ll recover within a year, your claim may be denied, even if your symptoms are currently severe.
Examples of short-term issues that often lead to denial include:
Broken bones are expected to heal fully
Post-surgical recovery with no complications
Temporary mental health crises without long-term impact
In these cases, the SSA may ask for follow-up documentation after a few months. But an initial denial is still likely unless there’s strong evidence of long-term limitations.
Prior Denials Without New Evidence
If you’ve been denied in the past and apply again without submitting new or updated information, the SSA may deny your claim again for the same reasons.
Repeat applications without any change in medical condition or treatment history often don’t succeed. The SSA will likely refer to your earlier file and issue another denial unless there’s been a clear worsening of your condition.
Every new claim should be handled with care, taking steps to make it stronger. This might involve:
Gathering recent medical records
Getting written statements from doctors
Submitting new test results or hospital records
Social Security law doesn’t stop you from reapplying, but it does expect additional evidence if you’ve been denied before.
Incomplete Application Forms
Some claims are denied simply because the forms were filled out incorrectly or left incomplete. Missing information, skipped questions, or inconsistent answers can all lead to automatic denials.
The SSA relies on detailed forms, and accuracy matters. Applicants often underestimate how carefully these forms are reviewed. A small error, such as a wrong date or unclear response, can create problems.
It’s also important to keep all addresses and dates current. Any confusion can slow down the process or result in a denial. Social Security law requires full cooperation and truthful disclosure of all relevant information.
Drug or Alcohol Use
If drug or alcohol use is seen as a contributing factor to your disability, your claim may be denied. The SSA must determine whether you’d still be disabled if you stopped using substances.
If your medical condition would improve without drug or alcohol use, the SSA may decide that the use is material to your disability. This can lead to a denial, even if you’ve been diagnosed with a severe condition.
The Disability Isn't Considered Severe Enough
Even if you have a diagnosed medical condition, the SSA may not view it as severe enough to prevent you from working. The severity standard under Social Security law requires that your condition must significantly limit your ability to do basic work activities.
If you can still sit, stand, walk, remember instructions, and communicate with others, the SSA may conclude that you’re able to work, even if not in your prior job. The agency doesn’t just look at your usual work — it looks at whether you can do any work.
Applying Too Late
Timeliness also plays a role. Waiting too long after becoming disabled can hurt your chances. For SSDI (Social Security Disability Insurance), you must have worked recently enough to qualify. If too much time has passed, you may not meet the work credit requirements.
For SSI (Supplemental Security Income), the issue is a bit different. The SSA looks at your financial resources. If your situation changes or your assets exceed the allowed limits, your eligibility can be affected.
Filing as soon as your disability begins gives you a better chance of approval. Social Security law allows claims to be backdated, but only within limits. Waiting can reduce those options.
Reach Out Today
If you have questions about Social Security law, you don’t have to figure it out alone. Denials can happen for many reasons, but you may still have a valid case. With the right approach and help from our experienced attorney, clients in Riverdale Park, Maryland, or anywhere in the state and the nation will receive quality representation. Call us at Advocates for the Voiceless now to schedule a consultation.
