Being denied Supplemental Security Income (SSI) can feel like hitting a wall, especially when you’re counting on that support to cover basic needs. Unfortunately, many claims are denied every year, often for avoidable reasons.
At Burgess & Christensen, we’ve spent more than 40 years helping people work with the Social Security system. We’ve seen the frustration that comes with a denial, and we’re here to help.
Let’s look at the seven most common reasons SSI claims get denied and what you can do to improve your chances of approval.
1. Lack of Sufficient Medical Evidence
One of the most common reasons for denial is failing to provide enough medical proof to support your claim. The Social Security Administration (SSA) relies heavily on medical records to determine whether your condition qualifies as a disability. If your documentation is incomplete or vague, your claim might not be approved.
What You Need:
- Detailed doctor’s notes explaining your diagnosis, treatment, and prognosis.
- Test results, such as X-rays or MRIs, that confirm your condition.
- Records showing how your disability limits your ability to perform daily tasks, like sitting, standing, or focusing.
Pro Tip:
Ask your healthcare provider to record specific details about how your condition impacts your ability to work. For example, your doctor might note that you can’t stand for more than 10 minutes without significant pain or that your condition causes frequent absences.
2. Failure to Meet the SSA’s Definition of Disability
The SSA has a strict definition of what counts as a disability. Your condition must prevent you from doing any substantial gainful activity (SGA) and be expected to last at least 12 months or result in death. Simply being unable to do your previous job isn’t enough.
Key Points:
- SGA for 2025 is defined as earning more than $1,620 per month for non-blind individuals.
- Your condition must make it impossible for you to adjust to any other type of work that is available in the national economy in significant numbers.
Pro Tip:
Understand the SSA’s criteria for disability and gather evidence that demonstrates how your condition meets their requirements. Include medical records, work history, and statements from medical providers if possible.
3. Incomplete or Inaccurate Application
Filling out the SSI application can be overwhelming. Missing details or making errors in your application can result in a denial, even if you qualify for benefits.
Common Errors:
- Leaving sections blank, especially those about medical history and daily activities.
- Providing inconsistent information between forms and medical records.
Pro Tip:
Before submitting your application, review it thoroughly. Consider having a trusted person or attorney go over it with you to catch any mistakes or gaps.
4. Earning Too Much Income
SSI is a needs-based program, and there are strict income limits. If your income exceeds the allowable amount, your claim will be denied. The SSA counts both earned and unearned income when evaluating eligibility.
Understanding Income Limits:
- Earned income: Wages from a job or self-employment.
- Unearned income: Money from other sources, like Social Security benefits, pensions, or gifts.
- Resource limits: Individuals cannot have more than $2000 in countable assets, and couples cannot have more than $3,000.
Pro Tip:
If you’re unsure whether your income qualifies, check the SSA’s current guidelines or consult an attorney to review your situation.
5. Failing to Follow Prescribed Treatment
If you’re not following your doctor’s prescribed treatment plan, the SSA may interpret this as a lack of seriousness about your condition. However, there are legitimate reasons for not following treatment, such as financial hardship or side effects.
Valid Reasons to Document:
- Inability to afford medication or therapy.
- Lack of access to healthcare facilities.
- Severe side effects from prescribed treatments.
Pro Tip:
Keep records of your efforts to follow the treatment plan, such as appointment confirmations or pharmacy receipts. If you’re unable to follow through, provide a clear explanation to the SSA.
6. Not Cooperating with the SSA
The SSA may ask for additional information or require you to attend medical exams. Failing to respond to these requests or missing appointments can result in a denial.
Tips for Staying Compliant:
- Keep your contact information updated with the SSA.
- Respond promptly to any letters, calls, or emails.
- Attend all scheduled appointments, even if they seem redundant.
Pro Tip:
Set reminders for deadlines and appointments. If you need clarification on a request, contact the SSA or seek legal assistance.
7. Short-Term or Non-Severe Disability
SSI is designed for individuals with severe, long-term disabilities. If your condition is not expected to last at least 12 months or does not significantly impact your daily life, your claim may be denied.
What to Do:
- Provide evidence showing the duration and severity of your condition.
- Include statements from your doctor explaining how your disability impacts your daily activities.
Pro Tip:
Even if your condition doesn’t meet the duration requirement now, document its severity and the steps you’re taking to manage it. This information can be useful if your condition worsens or if you need to apply later.
How to Avoid These Common Pitfalls
Applying for SSI can be complicated, but there are ways to improve your chances of being approved:
- Keep thorough medical records.
- Double-check your application for errors and completeness.
- Stay in regular communication with the SSA.
- Don’t hesitate to seek legal assistance if the process feels overwhelming.
Call to Action: Get Help with Your SSI Claim in Georgia
If you’ve been denied SSI benefits or need help with your claim, the team at Burgess & Christensen is here for you. With decades of experience in Social Security Disability cases, we know how to handle your case and fight for the benefits you deserve.
Contact us today at 770-422-8111 for a free consultation. Let’s work together to secure the financial support you need.