Social Security Disability Insurance is critical for people whose medical conditions restrict their ability to hold a job and work for a living. SSDI benefits provide monthly payments to individuals and certain family members. However, the process of applying for SSDI benefits is complicated. Many people in Texas have their initial applications denied due to a lack of medical documentation of their disability, an insufficient record of employment, or other eligibility issues.
If you are applying for Social Security Disability benefits or are filing an appeal after a denial, understanding the most common reasons for claim denials can help you understand how to avoid them. By working with an experienced Texas Social Security Disability Insurance lawyer, you can optimize your chances of submitting a successful disability claim.
Some of the Common Reasons for SSD Claim Denials
While people receive denials for their SSD claims for several reasons, the following are the most common:
Lack of Medical Documentation for Your Condition
Insufficient medical evidence documenting the extent of a disability may be the number one reason for SSDI claim denials. The Social Security Administration’s criteria require individuals to provide thorough medical records of the severity and ongoing nature of the person’s condition. To be a qualifying disability, the SSA states, the disabling condition must be expected to last at least a year or eventually result in the person’s death.
A skilled SSD attorney can work with medical professionals to gather medical testimony to supplement the medical record of your disability and develop a persuasive case.
Insufficient Employment Record
Qualifying for SSDI benefits entails having an established employment record and meeting the Social Security Administration’s requirements for having sufficient work credits. Even if you meet the requirements, you might feel confused about what employment records are needed to provide proof of your eligibility. Many claims are rejected because of an incomplete employment history. An attorney can evaluate your work history to determine whether you fulfill the requirements and submit the necessary documentation in your application or appeal.
Eligibility Issues Under SSA’s Disability Criteria
The Social Security Administration has stringent criteria for determining disability. Even if you have a legitimate medical condition, you may still get denied if you do not meet all the criteria. Some common eligibility issues include:
- Your condition is not included on the SSA’s list of qualifying impairments
- Your condition is not considered severe enough to prevent you from working
- You are still able to perform certain types of work, even with limitations
- Your condition is expected to improve with treatment
- Your condition is not expected to last at least 12 months or be a terminal condition
An attorney can present evidence demonstrating why you qualify for disability benefits, even if the SSA initially disagrees. An attorney can also argue that the SSA’s criteria do not correctly evaluate your specific circumstances.
Not Adhering to Prescribed Treatments
To receive disability benefits, you must follow the course of treatment directed by your medical provider. When a person applies for SSDI benefits, the SSA expects that the person will follow all prescribed medical treatments. However, some people do not follow the prescribed treatment without an acceptable reason. In those situations, claims reviewers will deny eligibility for benefits. Working with a skilled lawyer can strengthen your application or appeal by helping you understand how to provide evidence of any qualifying exceptions.
Repeated Applications and Unfollowed Appeals
Many people get denied on their initial SSDI application and then give up. However, approval often requires appealing a denied claim. Persistence is a key. The reasons for denial on subsequent applications include:
- Failing to appeal a denial within the 60-day deadline
- Reapplying without additional evidence of disability
- Failing to follow prescribed treatments as the condition has progressed
- Failing to obtain updated medical records that support worsening health
A knowledgeable Dallas disability attorney can guide you through the disability appeals process and present the strongest case possible at each point in the process.
How Can You Avoid Claim Denials?
Now that you know the most common reasons for SSDI claim denials, how do you avoid them? The best way to avoid common pitfalls and give yourself the best chance of success is to enlist the help of an experienced Social Security Disability lawyer. An attorney who knows how to handle these cases can help you in several key ways:
- Review your medical records thoroughly – Your attorney will determine what additional evidence is needed to prove your disability under SSA criteria.
- Obtain credible medical opinions – Your attorney can work with your doctors to get the necessary medical evidence, including helping your doctors fill out forms and write letters of support.
- Scrutinize your work history – They will gather employment documentation and demonstrate how your work credits qualify you for benefits.
- Complete error-free paperwork – The application process involves extensive paperwork that is easy to fill out incorrectly. Your lawyer will ensure that every form you submit meets SSA standards.
- Navigate appeals and hearings – If your claim gets denied, your attorney will handle the appeal and represent you at an Administrative Law Judge hearing regarding your eligibility for benefits.
- Persist through denials – Your lawyer will continue reapplying and appealing to get benefits for you. They know denial is common at first.
The bottom line is that avoiding common mistakes takes thorough legal knowledge and diligent work. A qualified lawyer can provide you with the help you need.
Seek Guidance from Kraft & Associates, Skilled Social Security Disability Attorneys
Applying for Social Security Disability Insurance benefits can be overwhelming and frustrating. However, you do not need to give up if your claim has been denied. The experienced Texas Social Security Disability attorneys at Kraft & Associates, P.C., understand the stress people face when applying for disability benefits. Every case has its own facts. Our legal team has a proven track record of helping people file successful applications and appeals. We are ready to put our experience to work for you, too.
Call our Dallas, TX, offices today at (214) 999-9999 or contact us online for a free consultation to learn how we can help you.
