This is a question that we often hear from clients and prospective clients at our law firm. The answer is that to win disability benefits it is not enough to have medical problems—even if you have severe disabling medical problems, even if you have multiple health issues. It is not even enough to have your doctor say you are disabled.
Winning a disability hearing is not as simple as showing up and explaining your medical problems. To be awarded SSDI or SSI benefits you must prove to the Social Security Administration (SSA) that your medical condition (or combination of conditions) prevents you from working at your previous occupation and you cannot adjust to other work, your skill set cannot be applied to a different, easier job.
Even with significant medical issues, Social Security can deny a disability claim if the agency determines that your conditions—considering your age, education, and work history—do not prevent you from performing "substantial gainful activity" (SGA), meaning working at any job that pays over a set amount ($1,620 a month in 2025.) The SSA will review your medical records to assess the severity of your conditions and whether they meet their specific criteria for disability benefits.
Here are common reasons why Social Security might deny your claim despite serious medical problems:
- Not meeting the "Listing of Impairments":
To determine if you are medically eligible for disability benefits, Social Security has a set of procedures in place. These procedures are published in a handbook known as the “Blue Book,” and it includes a list of various disabling conditions known as listing of impairments that automatically qualify for disability benefits. If your condition doesn't meet the criteria on this list, your claim may be denied even if you have serious health issues.
- Lack of sufficient medical evidence:
If your medical records are incomplete or don't adequately document the severity of your conditions and how they may prevent you from working, your claim could be denied.
- Disparities in medical reports:
If there are inconsistencies between different medical or doctors’ reports about your conditions, it can raise doubts about the severity of your limitations.
- Not following treatment recommendations:
If you are not actively managing your condition by following your doctor's treatment plan, it can be seen as a sign that you may not be as disabled as you claim.
- Ability to perform other work:
If the SSA determines that you can perform any other work in the national economy your claim will likely be denied.
What should you do if your Social Security disability claim been denied?
First, don’t give up. In almost every case you should always appeal a denial. Most disability claims that are denied are not appealed, even though many claims are approved after an appeal and hearing.
But it is critical that you appeal within the time allowed by the Social Security Administration. In most situations you have 60 days from the time you receive notice of denial of your initial claim or your reconsideration.
Delaying your appeal and being forced to file a new application is generally a waste of your time because you will be forced to go through the whole time-consuming process again. Your chances are much better if you appeal the denial of the original claim.
Don’t give up! Consider hiring an attorney to represent you in the appeals process. Statistics show that if you are represented by an attorney, you are more likely to win your benefits case. Choose a lawyer who focuses exclusively on Social Security disability benefits.
If your disability claim is denied, contact the Social Security office as quickly as possible, or contact a lawyer to file an appeal. The sooner you appeal, the sooner Social Security will schedule a hearing, which gives you the best opportunity to explain your work limitations.
Winning disability benefits takes a smart, tough, and persistent team. For a free evaluation of your case contact us at Cuddigan Law. We only get paid when you win your disability benefits case.
