Common Errors Made in Denying Social Security Disability Benefits
Receiving a denial of Social Security Disability benefits can be frustrating, especially when you believe your medical condition prevents you from working. A denial, however, does not necessarily mean that your claim cannot ultimately qualify for benefits.
Disability determinations involve medical evidence, work history, functional limitations, and Social Security Administration (SSA) rules. Errors or incomplete evaluations can sometimes affect the outcome of a claim.
Understanding some of the issues that may arise in disability determinations can help you better understand a denial and determine what steps may be available next.
Why Are Social Security Disability Claims Denied?
SSA evaluates disability claims using specific medical and vocational requirements. A claim may be denied because SSA determines that the applicant does not meet its definition of disability, there is insufficient medical evidence, the impairment is not expected to meet the required duration, or the applicant is considered capable of performing past or other work.
In some cases, however, the decision may be based on an incomplete record, a misunderstanding of the evidence, or an incorrect application of SSA’s rules.
Common Errors That May Affect a Disability Denial
1. Failing to Consider All of Your Medical Conditions
Many disability applicants have more than one physical or mental impairment.
SSA generally considers the combined effects of medically determinable impairments when evaluating a disability claim. Looking at each condition separately without adequately considering their combined impact may result in an incomplete assessment of a person’s limitations.
For example, an applicant may experience physical limitations from one condition while also experiencing concentration, memory, or other limitations from another. Together, those limitations may affect the person’s ability to work differently than either condition would by itself.
2. Incorrectly Evaluating Medical Evidence
Medical evidence is a central part of a Social Security Disability claim. Problems can arise when relevant records are missing, evidence is misunderstood, or important findings are not adequately considered.
Relevant evidence may include:
- Treatment records
- Diagnostic test results
- Laboratory findings
- Imaging studies
- Medication history
- Medical source opinions
- Documentation of symptoms and functional limitations
If important medical information was unavailable or not adequately considered, it may affect the disability determination.
3. Improperly Assessing Residual Functional Capacity
Your Residual Functional Capacity (RFC) represents the most you can still do in a work setting despite limitations caused by your medically determinable impairments.
An RFC assessment may address abilities such as sitting, standing, walking, lifting, carrying, reaching, concentrating, following instructions, interacting with others, and adapting to workplace demands.
If significant limitations supported by the evidence are omitted or incorrectly evaluated, the resulting RFC may not accurately reflect your ability to perform work-related activities.
4. Errors When Evaluating Past Relevant Work
At Step 4 of the sequential evaluation process, SSA may consider whether you can perform qualifying work you performed in the past.
Accurately understanding the demands of your previous jobs can be important. An incorrect or incomplete description of a past job—including its physical requirements, responsibilities, skills, or mental demands—may affect the determination of whether you can still perform that work.
Providing detailed and accurate information about previous employment can therefore be an important part of a disability claim.
5. Errors in Determining Whether You Can Perform Other Work
If SSA determines that you cannot perform past relevant work, the evaluation may proceed to Step 5.
At this stage, SSA considers whether you can adjust to other work that exists in significant numbers in the national economy. This determination considers your RFC together with relevant vocational factors such as age, education, and work experience.
Errors in assessing any of these factors may affect the Step 5 determination.
6. Not Properly Considering the Effects of Pain and Other Symptoms
Some medical conditions cause symptoms that cannot be evaluated solely through a laboratory test or imaging result.
Pain, fatigue, shortness of breath, dizziness, weakness, and other symptoms may affect a person’s ability to perform work-related activities.
SSA evaluates symptoms under its rules and considers relevant evidence when determining how those symptoms affect an individual’s ability to function. An incomplete evaluation of supported symptoms may affect the disability determination.
7. Overlooking Mental Health Limitations
Mental impairments can affect a person’s ability to work in many ways, including their ability to concentrate, remember instructions, interact with others, maintain an appropriate pace, or adapt to workplace changes.
When supported by the evidence, these limitations should be considered as part of the disability evaluation.
This can be particularly important when a claimant has both physical and mental impairments.
8. Failing to Fully Develop the Medical Record
SSA generally needs sufficient evidence to evaluate the existence and severity of an applicant’s impairments.
A disability determination made without important medical records or other relevant evidence may not provide a complete picture of the claimant’s condition.
Reviewing a denial can help identify whether important treatment records, test results, or other evidence were missing when the decision was made.
9. Incorrectly Evaluating the Duration of an Impairment
Social Security’s definition of disability includes a duration requirement. Generally, the medically determinable impairment must have lasted or be expected to last for a continuous period of at least 12 months, or be expected to result in death.
A claim may be denied if SSA concludes that the condition will improve before satisfying this requirement.
If medical evidence supports a different expected duration or shows that limitations have persisted longer than initially anticipated, that information may be relevant when challenging a denial.
10. Misinterpreting Daily Activities
SSA may consider information about daily activities when evaluating the effects of an impairment.
However, being able to perform certain everyday activities does not necessarily mean someone can sustain full-time competitive employment. The circumstances in which activities are performed—including frequency, duration, assistance, breaks, and symptoms—can be important.
An incomplete understanding of daily activities may create an inaccurate picture of a claimant’s functional abilities.
What Should You Do After a Social Security Disability Denial?
Start by carefully reviewing your denial notice. The notice should explain the decision and provide information about your options for requesting further review.
Depending on the stage of your claim, the appeals process may include:
- Reconsideration
- A hearing before an Administrative Law Judge
- Appeals Council review
- Federal court review
Not every claim goes through every stage, and specific procedures and deadlines apply.
It is important to pay close attention to the deadline stated in your notice. Missing an appeal deadline can affect your ability to continue pursuing the claim.
A Denial May Not Be the End of Your Claim
A Social Security Disability denial can be discouraging, but eligible claimants may have opportunities to challenge an unfavorable determination.
An appeal can provide an opportunity to address issues with the previous decision, submit appropriate additional evidence, clarify your limitations, or raise concerns about how the evidence and applicable rules were evaluated.
The appropriate next step depends on the circumstances and current stage of your claim.
Disclaimer: Applying for Disability is operated by Optimized Business Solutions LLC, a lead-generation service. We are not a law firm, law practice, or lawyer referral service and do not provide legal advice, representation, or legal services. The information provided on this page is for general informational purposes only and should not be considered legal advice. Social Security rules, procedures, and requirements may change. Consult the Social Security Administration or an appropriate professional for information about your individual circumstances.
