Top 10 Reasons Disability Claims Are Denied And How To Avoid Them

How to Avoid Being Denied Your Social Security Disability Claim

Social Security Disability Denied

  1. Insufficient treatment. If you are applying for disability benefits, you need to treat
    enough to establish your diagnoses and the severity of your conditions. Your
    medical records are what Social Security uses to determine whether
    you are disabled, so it is a good idea to make sure your doctors are documenting
    what you deal with on a day to day basis.
  2. Poor medical care. Poor medical treatment will typically repeat the same
    phrases for each appointment and lack corroborating examination detail. Your
    providers should be completing full examinations, to prove the extent of your
    medical conditions. At times, you may need to investigate better care if you feel
    that your providers are not listening to you or providing you with the best care.
  3. Lack of medical testing. A classic cause for denials is a lack of MRI’s, with x-
    rays revealing limited findings. Depending on the conditions, objective medical
    testing can make or break a claim. Certain tests may prove certain medical
    conditions to satisfy Social Security’s standards, such as an EMG for neuropathy.
    You can inquire whether such tests are appropriate at your medical appointments.
  4. Uncomplaining claimant. Some people simply do not complain, neither to their
    loved ones nor their doctors. While this stoic approach may seem brave, it can
    significantly hamper medical treatment and strip the medical record of subjective
    symptoms. You should cooperate with your providers to allow them to do their
    jobs. Then, the medical treatment notes may better prove the extent of your
  5. Overthinking claimant. Some claimants engage in a strategy of proving their
    disabilities rather than letting their providers do the doctoring. This classically
    occurs for some conditions that have strong subjective bases and require extensive
    testing to prove, such as fibromyalgia, connective tissue disorders, and
    somatoform disorders. If you are forcing treatment decisions on your providers,
    your providers may believe you are exaggerating. You should do research but
    learn to trust your treatment providers’ decisions about care.
  6. Drug-abuse. Drug and/or alcohol abuse tends to make Social Security ignore
    mental health issues due to “materiality.” If you have an issue with this, you
    should get help to get and remain clean and sober if you wish to have a better
    chance at an approval for benefits. Attorneys may condition their continued
    representation on this factor. For example, if you cannot get or remain clean and
    sober, an attorney may choose to withdraw their representation.
  7. Remote DLI. The date last insured, or the date by which we must prove you are
    disabled, will dictate what evidence can be used to prove your disability. For
    clients with a DLI in the remote past (over three or so years ago), we must take
    great care to get any and all records that document medical conditions, including
    one-time ER visits, ambulance notes, letters from neighbors, prescriptions for
    canes, etc. If you have a remote date by which we must prove you are disabled,
    we will try to help you think of significant events on or before this date to jog
    your memories as to your limitations near that time period.
  8. Missing client. A major obstacle to winning a hearing can be that a client moves
    without letting us know how to contact them. Social Security’s long timelines
    cause people to lose their homes and move while they await hearings. Make sure
    you always keep your attorney informed as to how to get in touch with you. Most
    judges will not allow hearings to occur without a client present, and even if they
    do, they will not be able to pay you benefits without knowing your whereabouts.
  9. Work. If you want to work or plan to work while you apply for disability benefits,
    there is a limit as to how much you can earn and still receive benefits. This
    amount changes from year to year. You should also clear any work activity with
    your physicians and/or other providers. You should also inform your attorney and
    the social security administration of any earnings that you have.
  10. Duration/Medical improvement. In these cases, disability must last a continuous
    12 months or more. If you improve medically and can return to substantial
    gainful work, make sure, again, that you are discussing your return to work with
    your providers. That way, the medical records document the medical
    improvement that allows the return to work. If a return to SGA work occurs
    under 12 months from the AOD (alleged onset of disability), a withdrawal may be
    in order before a hearing is held.

-Tracy Kinney, Esq.

Written by Tracy Kinney

Tracy is an associate attorney at Hoglund, Chwialkowski & Mrozik. She practices exclusively in the area of Social Security Disability law.

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