Receiving a denial letter from the Social Security Administration (SSA) can feel like a devastating setback. You know your medical condition prevents you from working, yet a faceless agency has issued a rejection. It’s a frustrating and common experience for many people here in Las Vegas and across Nevada. The reality is that the majority of initial Social Security Disability (SSDI) and Supplemental Security Income (SSI) applications are denied.
Understanding why your claim was rejected is the first step toward building a successful appeal. While every case is unique, denials often happen for a handful of recurring reasons. Let’s explore the most frequent issues we see and what they mean for your path forward.
Insufficient Medical Evidence
This is, by far, the most common reason for a disability denial. To approve your claim, the SSA needs to see objective, detailed medical records that prove your condition is severe and long-lasting. It is not enough to have a diagnosis; you must show how your symptoms limit your ability to perform basic work activities.
The Nevada Bureau of Disability Adjudication, the state agency that makes the initial medical decision for the SSA, looks for:
- Objective Evidence: This includes things like MRI results, X-rays, blood tests, and clinical findings from physical examinations.
- Treatment History: A consistent record of doctor’s visits, therapies, and medications shows the SSA that you are actively trying to manage your condition.
- Statements from Doctors: Notes and opinions from your treating physicians that detail your specific functional limitations are powerful evidence.
A denial for insufficient evidence often means the file lacked the specific proof needed to connect your diagnosis to your inability to work.
Technical Denials: Income and Work History
Sometimes, the SSA denies a claim before your medical condition is even considered. These are called technical denials, and they usually relate to financial or work history requirements.
For Social Security Disability Insurance (SSDI), you must have worked long enough and recently enough to have paid sufficient Social Security taxes. If you do not have enough credits from your work history, the SSA will issue a technical denial, regardless of how severe your disability is.
For Supplemental Security Income (SSI), your income and assets must fall below a strict, low threshold. If you have too much money in the bank, own valuable assets, or have other sources of household income, your claim will be denied on financial grounds.
Failure to Follow Prescribed Treatment
The SSA expects you to follow the treatment plan laid out by your medical providers. If your doctor prescribes medication, physical therapy, or another treatment that could improve your ability to work and you refuse to follow it, the SSA may deny your claim.
There are, of course, valid reasons for not following a doctor’s orders. You might not be able to afford the treatment. Or you might have a religious objection or experience severe side effects. You must communicate a valid reason to the SSA for them to overlook this issue. Simply disagreeing with your doctor without medical cause is not enough.
The SSA Believes You Can Perform Other Work
Even if the SSA agrees that you can no longer do your past job, they will not approve your claim if they believe you can adjust to other, less demanding work. The claims examiner assesses your Residual Functional Capacity (RFC), which is an evaluation of what you can still do despite your limitations.
They consider your age, education, and past work experience to see if any other jobs exist in the national economy that you could perform. For example, if you worked in construction on the Strip but your back injury prevents heavy lifting, the SSA might decide you can still perform a sit-down job like a security monitor. A denial on these grounds means the examiner concluded that other work is available for someone with your specific RFC.
Application Mistakes and Missed Deadlines
The disability application process is complex and full of deadlines. Simple administrative errors can unfortunately lead to a denial. Missing a deadline to submit a form, failing to provide requested information, or not showing up for a consultative examination (a medical appointment scheduled by the SSA) will almost always result in your claim being closed.
Filling out the paperwork incorrectly or providing vague, incomplete answers can also hurt your claim. The forms ask for detailed information about your work history, medical treatment, and daily activities, and any missing pieces can lead the examiner to deny the claim.
A Denial Is Not the End of the Road
Seeing your claim denied is disheartening, but it is not the final word. You have the right to appeal the decision. The first step in the appeals process is called reconsideration, where your file is reviewed by a new examiner. This is your opportunity to strengthen your case by adding new medical evidence and correcting any weaknesses from the initial application.
Navigating the appeals process can be even more complicated than the initial application. At Roeschke Law, LLC, we help Nevadans understand their denial notices and build stronger cases for appeal. We know how the system works and what the SSA needs to see.
If you’ve received a denial letter and aren’t sure what to do next, contact us. We are ready to listen to your story and discuss your options. Hablamos español and are proud to serve our entire community. Call us today for a free consultation at 800-975-1866.