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Why Are Social Security Disability Claims Denied So Often?

| Mar 14, 2014 | Social Security Disability Insurance (SSDI) |

     In Tennessee, as well as nationally, the vast majority of people applying for Social Security Disability or SSI benefits are denied upon application. At Reconsideration, or the first appeal, the denial rates only go up. Recent statistics show that over 75% of applications are denied and over 94% of requests for reconsideration are denied. Claimants and lawyers often ask why these percentages are so high.

     There are many reasons for the high denial rate. The reasons for the denials always have something ostensibly to do with the Five Step Sequential Evaluation process used to evaluate the claims or due to the claimant’s lack of quarters of coverage (or income or resources for SSI). Often the Social Security Administration will not obtain or be provided all of the medical evidence or educational evidence available.

     However, even when all treating source information is included in the file, claims are still denied at a high rate. This usually is because the claim has been reviewed by “agency physicians or medical professionals” who invariably say the claimant is in better shape than he or she actually is. Also, the SSA often sends claimants for consultative mental or physical examinations where those health professionals say the claimants can handle work-related tasks sufficiently to work under the guidelines. For instance, for a person under the age of 50, the person must be unable to work at sedentary, unskilled labor to be found disabled (unless that person meets a listing). If an examining physician or non-examining agency physician states that the person could sit for 6 out of 8 hours and lift up to 10 pounds, then the SSA will deny the claim at the application and reconsideration level. An Administrative Law Judge at a hearing will then have to take testimony and review all of the evidence to determine if that claimant can work at unskilled, sedentary labor.



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