David Dopkin, Attorney at Law-Attorney At law

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Why Such A High Percentage Of Initial Claims Are Denied

As a law firm that serves clients needing assistance with federal Social Security disability insurance (SSDI) claims, I frequently receive phone calls and emails wondering why the person's initial claim was denied. Depending upon the regional Social Security Administration (SSA) Disability Determination Services, as high as 65 percent of initial claims are denied, for a variety of reasons.

Fortunately, an experienced SSDI claims lawyer will understand the appeals process and a significant percentage of denied claims will eventually be accepted.

 

 

Top Three Reasons Initial Claims Are Denied

Insufficient Reports And Records

The SSA requires records and reports that specify the exact medical nature of the disability, including the treatment that the claimant has pursued and why the disability is permanent. A large number of initial claimants receive their treatment from doctors who simply don't understand the level of reporting necessary. Gathering the appropriate medical evidence, records and reports is extremely time consuming and frustrating, yet is necessary for a successful claim. Many initial claimants try to handle the process themselves and discover they come up far short of what the SSA requires in order to make a decision. 

The Claimant Continues To Earn An Income

Many people who have suffered a disabling injury or illness continue to earn a reduced amount of money by taking a part time job in another line of work. This is often necessary because people need to find some level of income during the twelve-month waiting period prior to becoming eligible for approval. Unfortunately, SSDI claims will not be approved if the claimant earns an income of more than $1,000 per month at the time of the application.

Not Following Doctor's Orders

For a variety of reasons, people who suffered an injury or disability often stop following their doctor's orders for treatment. For some, the prescribed medication causes serious side-effects. For others, the cost of weekly or monthly doctor visits or supervised physical therapy may be prohibitive. Disability Determination Services will review the record to determine whether the claimant has done everything possible to reach maximum medical recovery, in order to return to work.

Overcoming Denied Claims

The good news is that many people who have their initial claim denied can overcome the initial denial by working with an experienced attorney who can guide them through the process of a successful appeal. If you have been denied, waiting and refiling an initial claim will not necessarily give you an advantage. If your initial claim was denied once, a subsequent 'initial' claim will likely be denied for the same reason. File an appeal, instead. Your claim will actually have a better chance by being carefully taken through the formal appeals process. 

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