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4 Common Ways Social Security Disability Claims Get Denied When They Could Be Approved – Part 4

Thursday, 28 April 2016 10: 00
Written by Joni B. Bailey
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This final post addresses a simple concept that surprises many claimants:

Claims are often denied because the claimant does not have sufficient evidence to prove his or her impairment.


If everyone who said they could not work because of illness or injury received Social Security Disability benefits, an enormous percentage of the population would file a claim and the system would quickly run out of funds.

Many claimants have dealt with their injury or illness for so long that they think it is obvious that they cannot work.  That is a dangerous mindset.

There must be adequate evidence of the impairments and the functional limitations caused by the symptoms and time lost for seeking treatment.

The claimant has the burden of producing evidence that he or she is blind or disabled.

20 C.F.R. §404.1512 explains that the Social Security Administration’s adjudicator or judge will look at the following evidence:

(1) Objective medical evidence, that is, medical signs and laboratory findings;

(2) Other evidence from medical sources, such as medical history, opinions, and statements about treatment you have received.  This can include the report from a consultative examination of the claimant arranged by the Social Security Administration.

(3) Statements you or others make about your impairment(s), your restrictions, your daily activities, your efforts to work, or any other relevant statements you make to medical sources during the course of examination or treatment, or to the Social Security Administration during interviews, on applications, in letters, and in testimony in Social Security Administration administrative proceedings;

(4) Information from other sources:

  • Nurse-practitioners, physicians' assistants, naturopaths, chiropractors, audiologists, and therapists;
  • Educational personnel (for example, school teachers, counselors, early intervention team members, developmental center workers, and daycare center workers);
  • Public and private social welfare agency personnel;
  • Parents and other caregivers, siblings, other relatives, friends, neighbors, and clergy; and
  • Decisions by any governmental or nongovernmental agency about whether you are disabled or blind. This can include decisions that a claimant qualifies for disability benefits under another disability insurance plan or policy.

Developing the evidence is the key to winning a Social Security Disability Insurance benefits claim.

Many claimants make the mistake of thinking a Social Security Disability claim is a simple process, so they go all the way up to and through the hearing without a Southern Illinois Social Security attorney.  They are shocked when they receive a denial.  At that point, the only options are appealing or starting a new claim. Either choice probably means years of delay. Claimants who are represented by an experienced, knowledgeable Southern Illinois Social Security Disability representative have better chances of winning benefits. For more information about the odds of winning a claim, see this earlier blog article about how many claims get denied at the hearing level.

For more information about common reasons that claims are denied, see the other 3 posts in this 4-part series:

(1)   The claimant’s residual functional capacity (RFC) gets overestimated.

(2)   The judge determines that the claimant’s impairment is “not severe”.

(3)   The claimant’s allegations of pain are not properly evaluated.

Even though it is a “non-adversarial” hearing and the Agency has some responsibility to help develop the record, it is the claimant’s job to build a record that supports a favorable decision.  Most claimants need an experienced, dedicated Southern Illinois Disability Attorney to prove their case.

Joni Beth Bailey is a Southern Illinois Social Security Disability Attorney.


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