Top Reasons for Disability Insurance Claim Denials and How to Avoid Them

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Top Reasons for Disability Insurance Claim Denials and How to Avoid Them

Top Reasons for Disability Insurance Claim Denials and How to Avoid Them

Exploring the top reasons for disability claim denials may help you avoid them yourself. Most disability claims are denied the first time. Knowing ways to strengthen your claim may increase your chances of success when resubmitting your application. You should also talk to a Pennsylvania disability lawyer about your options.

Top Reasons for Denied Disability Claims

The criteria for disability benefits are what lead to the most disability benefit claim denials. Strict eligibility criteria are used by the Social Security Administration (SSA) to separate those who genuinely need disability benefits to live and those who do not. These criteria revolve around determining whether the disability is preventing someone from earning a basic income.

The first round of denials focuses on technical factors that rule out people from being eligible for disability benefits. Some of the most common reasons people are denied benefits at this stage are:

  • Not meeting the definition of a disabilityTop Reasons for Disability Insurance Claim Denials and How to Avoid Them
  • Not meeting work history requirements
  • Making over a certain amount of income

During the second round, the SSA will send your application to the Disability Determination Services (DDS) office in your state. DDS will check for medical and job eligibility requirements. Reasons for denials at this stage include:

  • A lack of medical evidence
  • A lack of non-medical evidence
  • Still being able to work despite the disability

Substantial gainful activity and residual functional capacity evaluations may be given at this stage. If these tests reveal you can still function on certain levels despite your disability, then your claim could be denied. This is more likely when DDS finds that you can work at a different job despite the limitations caused by your disability.

How to Avoid Being Denied Disability Benefits

There are ways to prevent denied disability benefits. Checking the disability benefits eligibility requirements can help you build a stronger disability claim. The first requirement is to meet the definition of a disability.

The SSA defines a disability as a mental or physical impairment that is expected to last at least one year or lead to an early death. This disability must significantly hinder work performance. Disability benefits under the SSA are not provided to those with partial or short-term disabilities.

A disability must be severe enough to negatively impact past work, current work, and future work performance. When applying for Social Security Disability Insurance (SSDI), you will need a certain number of work credits from past jobs that have paid into Social Security. However, if you are applying for Supplemental Security Income (SSI), then you must make under a certain amount of monthly income to qualify.

To increase your chances, submit as much medical evidence and information as you can related to your disability. Try contacting a Pennsylvania disability lawyer to explore other ways to improve your claim.

Call Edelstein & Nelson Today

You do not have to give up if your disability claim keeps being rejected. Start by asking a Pennsylvania disability attorney about your legal options. All you have to do is call Edelstein & Nelson today at (800) 300-0909 for a consultation about your disability claim. Our legal team can help you take steps to obtain the disability benefits you need.