Attorney Eric L. Pines and disability advocate Courtney Bolton explained that one of the most frustrating parts of the Social Security Disability Insurance (SSDI) process is how frequently claims are denied. Many applicants are denied for technical reasons before their medical evidence is even considered. For example, workers must generally have at least 10 years of work history, including five of the last 10 years, in order to qualify. If they don’t meet these requirements, they will be denied automatically.
Another common reason for denial is earning too much income while applying. If a person is working and making over the Social Security threshold (currently $1,620 per month), their claim will be rejected outright, regardless of medical need.
How important is medical documentation in SSDI claims?
Courtney emphasized that one of the biggest factors in SSDI approval is the strength of medical records. Social Security looks for records that provide concrete results such as MRIs, X-rays, and blood tests. Applicants who can provide objective medical evidence typically have a higher approval rate than those relying only on subjective reports.
Length of treatment is also important. Social Security expects at least 12 months of consistent treatment records, ideally from specialists rather than only primary care physicians. Mental health conditions can also qualify for SSDI, but they are often harder to prove because they lack the same objective test results as physical conditions. For these cases, detailed documentation and consistent treatment are essential.
How do missed deadlines affect disability applications?
One of the most common reasons people are denied benefits is simply missing deadlines. Social Security imposes strict timelines for submitting reports and medical records. If those deadlines are not met, claims are often denied automatically.
Courtney explained that her team at Pines Federal actively monitors every client file to ensure reports are submitted on time. If a deadline is missed, applicants should immediately contact their Disability Determination Services (DDS) examiner, as some examiners may grant extensions. However, it is always best to submit documents on time to avoid denial.
Why are mental health claims harder to prove than physical claims?
Although mental health conditions are increasingly recognized, they remain harder to prove in disability claims. Unlike physical conditions, which can often be confirmed with medical tests, mental health conditions rely on consistent documentation from treatment providers.
Courtney stressed the importance of advocating for yourself with doctors. Instead of saying “I’m tired,” applicants should be specific, such as, “I am so fatigued that I must nap every hour.” This level of detail ensures medical records reflect the full extent of the condition and can strengthen the case.
What should applicants do after a Social Security Disability denial?
Most applicants are denied at the initial application and reconsideration stages, so a denial should not come as a surprise. Once denied, applicants receive a notice that explains the reason for denial and outlines the 60-day deadline to appeal. Meeting this deadline is crucial, as Social Security does not have to extend the appeals period.
During the appeals process, it is critical to continue medical treatment and provide updated records. At this stage, having an attorney is often essential to ensure that Social Security is reviewing all medical evidence and following proper procedures.
Who is more likely to be approved for SSDI benefits?
Certain categories of applicants have higher approval rates. For example, individuals with terminal illnesses may qualify for expedited processing under the Quick Disability Determination (QDD) process. Veterans who have been rated 100% disabled by the VA also typically experience faster reviews and higher approval rates.
For most applicants, however, approval depends on maintaining detailed, consistent medical documentation and ensuring Social Security requests and reviews all necessary records. Attorneys can hold the agency accountable for conducting a complete review.
What is the top advice for avoiding Social Security Disability denials?
Courtney’s number one piece of advice for avoiding denial is simple: never miss a deadline. Social Security is not looking for reasons to approve claims—it is looking for reasons to deny them. By staying on top of deadlines, maintaining consistent medical care, and working with experienced advocates, applicants can significantly improve their chances of success.