Why are SSDI Claims Denied and What Can Applicants Do Next
SSDI claims are commonly denied because Social Security finds insufficient medical evidence, determines that an applicant can still perform substantial work, or concludes that the applicant lacks enough qualifying work history. If your claim is denied, you can generally appeal the decision instead of filing a new application. During this time, it's important to seek a compassionate attorney who can assess the details and fight for what you deserve.
At Leavitt Meunier Law LLC, we help Louisiana applicants determine why their claims were denied and what evidence may strengthen an appeal. If you received an unfavorable decision, contact our firm to discuss the notice and your available next steps. We proudly advise residents in Metairie, Louisiana, and throughout New Orleans, Baton Rouge, Lafayette, Hammond, Alexandria, Shreveport, Monroe, Lake Charles, Northshore, Mandeville, Covington, and Madisonville.
Why Does Social Security Deny SSDI Claims?
Social Security may deny an SSDI claim when the available evidence does not satisfy the program’s medical or nonmedical requirements. Having a serious diagnosis does not automatically establish eligibility. The record must generally show that a medically determinable condition prevents substantial gainful work and has lasted, or is expected to last, at least 12 months or result in death.
Common reasons for denial include:
Insufficient medical evidence: The records may establish a diagnosis without explaining the severity of the condition or how it restricts your ability to work.
Ability to perform previous work: Social Security may decide that you can still meet the physical or mental demands of a job you previously performed.
Ability to adjust to other work: Even if you cannot return to your former job, the agency may conclude that you can perform other work based on your limitations, age, education, and experience.
Failure to meet the duration requirement: The agency may find that the condition has not lasted and is not expected to last long enough.
Work activity or earnings: Employment and earnings above the applicable substantial gainful activity level can affect an initial SSDI claim. The earnings threshold changes periodically, and different considerations may apply to self-employment.
Insufficient work credits: SSDI eligibility depends partly on your history of work covered by Social Security. The number and recency of required credits can vary by age.
Missing information: A denial may result if requested forms, medical authorizations, examinations, or other information are incomplete.
A claim can be denied for more than one reason, so the first step is identifying the exact basis for the decision. Schedule a consultation today to learn more about you rights and options.
Read the Denial Notice Carefully
The denial notice explains Social Security’s decision, identifies the next level of appeal, and provides filing instructions. It may also indicate which medical records and other evidence the agency considered.
When reviewing the notice, look for:
The specific reason for the denial
The evidence listed or discussed
Medical providers or records that appear to be missing
The type of appeal available
The deadline for requesting that appeal
A denial does not necessarily mean that Social Security believes you have no medical condition. It may mean the claim file did not adequately show how the condition prevents sustained employment.
How Long Do You Have to Appeal?
You generally have 60 days after receiving a Social Security decision to request an appeal. Social Security ordinarily presumes that you received the notice five days after the date printed on it unless you can show otherwise. Because individual circumstances can affect how the deadline is calculated, it is safer to begin the appeal promptly.
For many initial medical denials, the first appeal is reconsideration. Another examiner reviews the claim and any new evidence. If the reconsideration decision is also unfavorable, you can ordinarily request a hearing before an administrative law judge. Further review may be available through the Appeals Council and federal court.
Your notice should identify the appropriate next step. Starting a new application instead of appealing the existing denial may delay the process and potentially affect the period for which benefits are considered.
Building a Stronger Medical Record
A stronger appeal connects your medical conditions to specific limitations that interfere with reliable, sustained work. Simply submitting more records may not be enough if those records do not explain what you can and cannot do.
Relevant evidence may include:
Updated treatment notes
Diagnostic test results
Medication lists and documented side effects
Records from specialists, therapists, or mental health providers
Medical opinions addressing specific functional restrictions
Information about changes in your condition since the application
For a physical condition, the evidence may need to address your ability to sit, stand, walk, lift, carry, or use your hands. For a mental health condition, relevant limitations may involve concentration, pace, attendance, social interaction, or the ability to manage workplace stress.
Treatment gaps do not always mean that a condition improved. Financial limitations, lack of insurance, transportation difficulties, side effects, or symptoms of the condition itself may interfere with treatment. Those circumstances should be explained accurately when they apply.
Our Social Security disability representation focuses on presenting the medical evidence together with the work-related limitations Social Security must evaluate.
Correcting Missing or Inaccurate Information
An appeal provides an opportunity to correct mistakes and add information that was absent from the original claim. Applicants sometimes underestimate their limitations, provide incomplete descriptions of past jobs, or discuss daily activities without explaining the assistance or recovery time involved.
Review whether the claim accurately describes:
The duties and physical demands of previous jobs
Every condition contributing to your limitations
Changes in symptoms over time
The frequency of flare-ups or difficult days
Assistance needed with everyday activities
Problems with concentration, attendance, pace, or stamina
Your descriptions should be specific and truthful. Exaggerating symptoms can undermine credibility, while minimizing them can prevent the decision-maker from understanding why maintaining regular employment is difficult.
What Happens at an SSDI Hearing?
At an SSDI hearing, an administrative law judge reviews the evidence and asks questions about your medical conditions, employment history, treatment, daily activities, and functional limitations. A vocational expert may also testify about your past work and whether other jobs could be performed with the limitations the judge accepts.
Preparation involves reviewing the important dates, medical history, former job duties, and practical effects of your symptoms. You should answer questions honestly rather than trying to memorize ideal responses.
Legal representation can help identify weaknesses in the record, obtain relevant evidence, prepare you for likely questions, and explain why the documented limitations meet Social Security’s requirements. Representation does not guarantee approval, but it can help ensure that the appeal presents the relevant facts clearly.
SSDI Attorneys Serving Metairie, Louisiana
e\Every SSDI applicant has a different medical history, employment background, and set of concerns. At Leavitt Meunier Law LLC, we provide personalized attention and work closely with clients to develop claims and appeals based on their individual circumstances.
Our attorneys have successfully helped Louisiana clients obtain SSDI benefits, and we bring that experience to each matter we handle. Because our Social Security law firm is based in Metairie, we also understand the needs of the communities we represent.
We serve clients in Metairie, New Orleans, Baton Rouge, Lafayette, Hammond, Alexandria, Shreveport, Monroe, Lake Charles, the Northshore, Mandeville, Covington, and Madisonville. If your claim was denied, our Metairie SSDI attorneys can review the decision and help you evaluate the next step. Contact us to discuss your claim or appeal.