Seven Common Reasons Social Security Disability Benefits Get Rejected

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If you’ve become disabled, you may be entitled to Social Security Disability (SSD) benefits in the form of Social Security Disability Insurance (SSDI) or Social Security Income (SSI).  We use the term may because SSD benefits aren’t always granted.  Here are seven common reasons why they get rejected:

  1. You Earn Too Much.  According to the Social Security Administration (SSA), to be eligible for disability benefits, a person must be unable to engage in “substantial gainful activity” (SGA).  Those terms are important:
    – Substantial work involves doing significant physical or mental activities or a combination of both.  It does not need to be on a full-time basis.
    – Gainful work activity is work performed for pay or profit or intended for profit, whether or not a profit is realized.
    The SSA determines eligibility by looking at your work and income and has different rules for the blind. The limits for non-blind persons are $1,040 per month in 2013 and will increase to $1,070 per month in 2014.  The monthly SGA amount for statutorily blind individuals is $1,740 per month in 2013 and will increase to $1,800 per month in 2014.  To receive SSI, which is a disability benefit for people with low incomes, you cannot be earning more than the SGA limits above.  SSI also has an additional requirement that an individual must not have more than $2,000 in cash or assets.
  2. Your Disability Won’t Last For 12 Months.  The SSA must believe that your disability will last at least 12 months or result in death.  However, there is an exception to that for blind SSI applicants. Although some impairments may not initially qualify you for disability benefits, the SSA evaluates cases on an individual basis and may re-evaluate your situation if it changes.
  3. You Don’t Follow Doctors’ Orders.  The basic rule is that you must follow doctors’ orders or you will be denied benefits.  However, the SSA will make medical and non-medical exceptions to this rule, as many recipients cannot do so due to financial, physical, mental or other limitations.
  4. You Don’t Cooperate With The SSA.  The SSA will ask you to release your medical records so that it can determine your benefit eligibility.  If you don’t cooperate, your claim will be denied.  In cases where you don’t have medical records, the SSA will generally have you examined by one of its doctors (referred to as a consultative examination or CE).  Again, if you fail to cooperate, your claim will be denied.
  5. You Commit Fraud.  The SSA can terminate your benefits if it finds that you obtained them by committing fraud.  In many cases, it will also prosecute you for fraud.
  6. Your Claim Is Based on Drug Or Alcohol Use.  The SSA will deny benefits to someone whose drug addiction or alcoholism is a contributing factor to a disability claim.  The SSA will look at whether you would still be considered disabled if drug addiction or alcoholism were not a factor.
  7. You Have Been Convicted of a Crime.  Certain conditions pertaining to being convicted of a crime or being incarcerated will generally prevent you from obtaining SSD or SSI.  A person is ineligible to receive SSD or SSI if incarcerated for 30 or more days, being injured while committing a felony or having your impairment become worse while being in prison.

There are certainly other factors that can lead to Social Security Disability denials.  However, it’s important to remember that you may have other options available to you, such as applying for a “Request for Reconsideration.”   Keep in mind that there are strict time limits associated with the process, and it can be very complicated without the assistance of an SSD attorney who understands how the process works.