Signs That You Will Be Denied for Disability SSDI

You may apply for Social Security Disability Insurance (SSDI) if a disabling condition prevents you from earning a living. Monthly SSDI payments can help you pay for food, shelter, and other basics.

Unfortunately, the U.S. Social Security Administration (SSA) denies most initial claims. If you’ve already submitted a claim in New York and haven’t heard back yet, you may want to familiarize yourself with signs that you will be denied for disability. You can appeal the SSA’s decision if they deny your claim, and an experienced lawyer can help you do so.

Common Reasons for Disability Denial

There are many potential reasons the SSA may deny an SSDI claim. Let’s take a closer look at some of the most common.

Insufficient Medical Documentation

 The SSA’s Blue Book lists the conditions that may qualify applicants for SSDI. When applying for SSDI, you must provide substantial medical documentation showing a qualifying condition. You must also provide medical evidence showing your condition prevents you from working. Medical evidence can take many forms, including:

  • General medical records
  • Test results
  • Prescriptions
  • Treatment plans
  • Doctor notes/testimony

Insufficient medical documentation is among the top reasons the SSA denies claims. The SSA may also deny a claim if medical documentation is out-of-date. Ensure yours is as thorough and current as possible to guard against a denial or delay.

Not Enough Work Credits

SSDI isn’t available to everyone. You must have paid into the Social Security system and earned enough “work credits” to qualify for SSDI. 

How many work credits you need to qualify for SSDI depends on your age. You can earn up to four work credits in a year, based on your income. You usually need 40 work credits to qualify for SSDI.

In addition, you must have earned at least 20 of those credits within the 10 years leading up to your illness or injury. That said, there are circumstances when younger applicants may qualify for SSDI with fewer than 40 credits.

Too Much Income

SSDI exists so that individuals who genuinely need financial assistance can access it. You may not qualify for SSDI if your income is too high.

It’s sometimes possible to work and continue earning SSDI benefits. However, you can’t receive SSDI benefits if your income crosses a certain threshold, which the agency updates regularly to adjust for the rising cost of living. 

Additionally, if you’re still earning an income, the SSA might wonder how serious your disability is. If you’re working, the SSA might issue a denial. The fact that you can work might suggest your disability isn’t very serious.

You’re Improving

It’s very important to stick to a treatment plan when seeking SSDI. Naturally, following your doctor’s orders is key to your health. On top of that, the SSA wants to know you’re attempting to get better. They don’t want to provide benefits to someone who is “gaming the system” by remaining disabled and does not have to be.

If you continue treatment, your condition might improve. SSDI is typically only available to people whose conditions will last for at least 12 months or result in their death. You may no longer qualify for SSDI if your condition is improving.

You’ve Had a Previous Denial

Signs That You Will Be Denied for Disability SSDIAgain, you can appeal the SSA’s decision to deny your initial application. It’s very important to understand why the SSI issues a denial when appealing the decision. If you file a new claim without new evidence, odds are the SSA will issue a denial again.

Cooperate throughout the process when the SSA contacts you with requests. You might think such requests are signs of an impending disability denial, but that’s not necessarily the case. The SSA may need more information to make its decision. Providing this information promptly doesn’t guarantee approval, but it can help your odds.

Keep in mind that the SSA is often backlogged, and a long delay does not necessarily mean an impending denial. The SSA often takes six to eight months (or more) to process a claim.

Contact a New York SSDI Lawyer

How hard is it to get disability? The answer varies on a case-by-case basis. That said, navigating the process is often easier with help from a legal professional.

At Fusco, Brandenstein & Rada, P.C., we understand the nuances of the process. A New York SSDI lawyer with our firm can help with such tasks as:

  • Gathering medical documentation
  • Submitting paperwork
  • Corresponding with the SSA
  • Representing you during hearings if you appeal

It’s best to hire an attorney from the start of the process. However, we can help at any stage. Learn more by contacting us online or calling us at 516-496-0400 for a free consultation.

Last Updated : April 19, 2024
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