Why SSDI Claims Are Denied

There are several common reasons why SSDI applications are denied on the first attempt:

Insufficient Medical Evidence
The most common reason for a denial is a lack of sufficient medical evidence proving that your condition meets the SSA’s definition of disability. To qualify for SSDI, you must show that your condition is severe enough to prevent you from working and will last for at least 12 months or result in death.

Not Meeting SSA’s Definition of Disability
The SSA uses strict criteria to define disability. Your condition must be severe and prevent you from doing any substantial gainful activity (SGA), which typically means earning more than a set income threshold each month. If the SSA determines you can still work, even at a reduced capacity, your claim may be denied.

Failure to Follow Treatment or Medical Instructions
If you have not followed your doctor’s prescribed treatment or have not attended regular appointments, the SSA may conclude that your condition is not severe enough to meet the disability requirements.

Failure to Provide Complete Information
Not providing complete and accurate information on your application can lead to a denial. Missing documents, incomplete medical records, or unclear descriptions of your work history can all result in an unfavorable decision.

Income and Work-Related Factors
If you are currently working and your earnings exceed the SSA’s limit for substantial gainful activity (SGA), you may be denied. The SGA limit for 2025 is $1,470 per month (or $2,460 if you are blind). If you earn above this amount, it is difficult to prove that your disability is preventing you from working.

How to Improve Your Chances of Approval on the First Try

While the chances of approval on the first try may be low, there are several things you can do to improve your chances of being approved without the need for a long appeals process:

Submit Complete and Detailed Medical Evidence
Your application should include comprehensive medical records that clearly show how your disability impacts your ability to work. This includes:

• Doctor’s Notes: Include statements from your treating physicians about your diagnosis and limitations.
• Test Results: Provide lab results, imaging reports, and any other relevant medical documentation.
• Treatment Records: Show that you are actively following prescribed treatments and attending doctor visits.

Meet the SSA’s Definition of Disability
Make sure you understand the SSA’s requirements and ensure that your condition meets their criteria. Your disability must be severe enough to prevent you from doing any type of work for at least 12 months. If your condition is severe but you are able to work in some capacity, it could result in a denial.

Ensure Your Application Is Complete and Accurate
Double-check your application for completeness. Ensure that all necessary documents are included and that all information provided is accurate and detailed. Avoid any inconsistencies that could lead to delays or denials.

Follow All Medical Advice and Treatments
If your doctor has prescribed a specific treatment plan, follow it closely. Document any treatments, surgeries, or interventions you have undergone and show that you have complied with all medical instructions.

Consult a Professional
While hiring an attorney or disability advocate isn’t required, having professional assistance can greatly improve your chances of success. A disability lawyer or advocate can help ensure that your application is complete, all necessary documents are included, and your case is presented in the best possible light.

What Happens if Your SSDI Claim Is Denied?

If your application is denied, don’t lose hope. You can appeal the decision. The appeals process includes several steps:

Request Reconsideration
If your claim is denied, the first step is to request reconsideration. This is a review of your case by someone who was not involved in the original decision. You’ll need to provide any additional evidence or information that may strengthen your case.

Request a Hearing with an Administrative Law Judge (ALJ)
If your reconsideration is denied, you can request a hearing before an ALJ. This is an opportunity to present your case in person. Many claimants are approved at this stage because they can provide more detailed medical evidence or explain their situation more clearly.

Appeal to the Appeals Council or Federal Court
If the ALJ denies your claim, you have the option to appeal to the SSA’s Appeals Council or, in rare cases, take your case to federal court.