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Medical reasons for SSD benefits claim denial

On Behalf of | Jun 7, 2018 | Firm News, Social Security Disability

Colorado residents who are about to apply for Social Security Disability benefits may have heard an alarming figure thrown around: approximately two-thirds of all initial claims for SSD benefits are denied by the Social Security Administration. This may seem frustrating to applicants, as a portion of one’s paycheck is contributing towards the very benefits that one is applying for, but rather than give up hope, one should understand the reason why their application has been denied so that additional next steps can be taken in hopes of remedying the matter.

When the Social Security Administration sends a denial notice to applicants it includes a description of the reason for denial and the records and evidence considered to make the decision. Oftentimes denials are issued due to a lack of medical evidence

A lack of medical evidence could arise for a number of reasons. For example, an applicant may not see their doctor frequently. Without frequent visits to medical professionals, there will be less evidence that the disability examiner can review to adjudicate the claim in a disabled individual’s favor. In situations such as this, the SSA might end up hiring a medical professional of their own to conduct a medical exam, but these exams are often brief and do not bode well for the applicant.

There are other factors that can lead to a lack of persuasive medical evidence. Medical evidence must prove the condition will last at least 12 months and if this is lacking, the claim may be denied. Also, if the applicant is not following through with prescribed therapy or brought their condition upon themselves through a drug or alcohol condition, then their application is likely to get rejected.

These are some of the medical reasons why an application may be denied on the first blush, but applicants should not give up hope if they don’t succeed on their first attempt. A denial does not mean one does not have the medical condition they claim to have. Instead, it usually means the supporting evidence was not complete. Rectifying the mistake can be beneficial for the appeals process and may even lead to the recovery of SSD benefits. This is why acquiring the assistance of an experienced professional might be helpful.

Practice Areas


Social Security
Disability (SSD)

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