Top Three Reasons for Social Security Disability Claim Denials

Social Security Benefit Denial

The denial rate for Social Security disability (SSDI) is high. Most initial SSDI applications are denied. Many of those applicants do ultimately receive benefits through the appeals process. However, that can mean a delay in benefits of several months to two years or more.

The best way to maximize your chances of a favorable outcome is to ensure that your application, request for reconsideration or appeal is complete, accurate, and fully supported by evidence. An experienced Social Security disability lawyer can help you avoid the missteps that lead to denial or delay approval.

Why are SSDI Claims Denied?

There are two types of Social Security disability denials: technical denials and medical denials. Technical denials are more common, partly because the technical review comes first. If the application fails for technical reasons, it never reaches medical review. If all technical requirements are met, the assessment moves on to medical eligibility.
Technical Denials

Some common reasons for technical denials include:

  • Insufficient work credits: SSDI is an insurance program, paid for with the FICA contributions deducted from your paycheck. If you haven’t worked enough and contributed enough, you won’t be eligible for Social Security disability.
  • Too much time has passed since you last worked: While Social Security retirement benefits rely on a lifetime total, Social Security disability eligibility also depends on having a minimum number of recent work credits. What that means differs depending on how old you were when you became disabled, but for most people it means having worked at least five of the preceding 10 years.
  • Having too much income: Part of the Social Security Administration’s (SSA’s) definition of disability is that you are unable to engage in substantial gainful activity (SGA). If your income exceeds the SGA cut-off, you are disqualified. In 2026, the SGA cut-off is $1,690/month, or $2,830/month if the applicant is blind.

Unlike medical denials, most of the reasons for technical denials are clear-cut. However, you shouldn’t just assume that the SSA is correct. For instance, if you’ve been denied Social Security disability benefits due to insufficient work credits, check your work record at SSA.gov and make sure they aren’t missing anything.

Medical Denials

The three most common reasons for medical denials are:

  • The SSA determines that the applicant is able to do another type of work
  • The SSA determines that the impairment is not severe
  • The SSA determines that the applicant is able to do work they have done in the past

The exact percentages vary slightly from year to year, but the first two reasons listed above typically combine to account for about 55% of medical denials. In the most recent year reported, 35.3% of medical denials were because the applicant could do another type of work, and 19.5% because the condition wasn’t considered severe. A much smaller percentage–typically 6-7%–are deemed able to perform past work.

Other reasons for medical denials include:

  • Impairment due to active drug or alcohol abuse problems
  • Insufficient medical evidence to support the claim
  • Failure to cooperate with the process
  • Failure to follow prescribed treatment
  • The applicant returned to substantial work

Note that some of these denials are based on issues as seemingly minor as having failed to respond to a request from the SSA, or even having neglected to notify them of an address change. One benefit of working with experienced lawyers for Social Security disability matters is that your attorneys can explain the pitfalls of the process and help ensure that your application stays on track.

How Can Social Security Lawyers Help?

While “insufficient medical evidence” falls into the “other” category, it’s important to note that many denials based on lack of severity of the medical condition or a determination that the applicant can work are actually the result of insufficient medical documentation. Experienced lawyers for Social Security disability understand what type of evidence is required, and can help an SSDI applicant put together a more effective application.

In some cases, that may involve building the record by seeking out additional medical assessment or testing before submitting an application. In other cases, it’s simply a matter of thoroughly understanding what the SSA is looking for.

Our Social Security Lawyers Help with Every Stage of the Process

The best time to consult an experienced Social Security disability lawyer is before you file your application. The further you get into the appeals process, the greater the delay in receiving benefits. So, it’s to your advantage to make sure you submit the most effective possible application right out of the gate.

When you hire a Social Security disability lawyer at Harrell & Harrell before you apply, we’ll work with you to ensure that your application is complete and correct, and that you are providing the type of evidence we know the SSA will be looking for. With a complete, well-documented application, you could begin receiving benefits within months.

If you’ve already received a denial, we can still help.

Contact Our Social Security Lawyers As Soon as Possible after a Denial

After your Social Security disability application is denied, you will have 60 days to request reconsideration. You aren’t required to submit additional evidence with your request for reconsideration. However, new evidence is often necessary to overcome the denial. So, you will want to contact an attorney as soon as possible after you receive your notice of denial. A Jacksonville injury lawyer from our firm will review the reasons for your denial and help you assemble the additional documentation you need.

If you’ve already submitted a request for reconsideration and been denied, the next stage is more complicated. Again, you’ll have 60 days to appeal. At this stage, that means requesting a hearing before an administrative law judge (ALJ).

You will typically have to wait several months for an ALJ hearing, and then a few months longer for a decision. If you’ve navigated the process alone up to this point, this is the time to hire an experienced Social Security disability lawyer. The process is more formal than the earlier stages, and includes an opportunity to question the ALJ’s witnesses and present your own witnesses.

To learn more about how we can help no matter where you are in the process, call us today at (904) 251-1111 or fill out our contact form.