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Understanding the Common Reasons for SSDI Claim Denials in Virginia

Common Reasons for SSDI Claim Denials in Virginia

Navigating the Social Security Disability Insurance (SSDI) claim process poses formidable challenges. However, understanding the common reasons for SSDI claim denials can help you prepare a stronger case, especially when dealing with a disability that has left you unable to work. In Virginia, just like in the rest of the United States, SSDI benefits provide financial support to individuals who can no longer maintain substantial gainful employment due to a disability. Yet, the road to securing these crucial benefits can be paved with obstacles, and one of the most significant hurdles is the possibility of having your claim denied. Roughly 66% of initial SSDI claimants encounter denials, with denial rates escalating during the reconsideration phase. The procedure to successfully appeal a denied claim can be intricately challenging. Thus, having a Social Security Disability (SSD) attorney by your side is crucial.

Kalfus & Nachman proudly holds the distinction of being top-rated SSD attorneys in Virginia. Our expertise, dedication, and proven track record set us apart, ensuring clients receive the highest level of representation when seeking Social Security Disability benefits. In this article, we'll help you explore the SSDI claim process in Virginia and the most common reasons why SSD claims are denied.

Understanding SSDI in Virginia

The Social Security Disability Insurance program falls under federal jurisdiction and is administered and supervised by the Social Security Administration (SSA). Comprehending SSDI in Virginia is crucial for those seeking disability benefits. Virginia follows federal guidelines for SSDI eligibility, offering financial support to individuals unable to engage in substantial gainful activity due to disability. The eligibility criteria and the application process remain consistent across the United States. To be eligible for SSDI benefits in Virginia, you must meet the following criteria:

  • Work Credits: You must have earned sufficient work credits by paying Social Security taxes over a specific period. The number of credits required varies depending on your age at the time of disability onset.
  • Disability: You must have a qualifying disability that renders you incapable of engaging in substantial gainful activity and is anticipated to last for at least 12 months or result in death.
  • Duration of Work: There are specific rules regarding the recent work history of applicants, ensuring that they were actively working and contributing to Social Security before becoming disabled.

10 Common Reasons for SSDI Claim Denials in Virginia

SSDI claim denials in Virginia stem from various factors, often leading to frustration and financial hardship for applicants. Understanding these pitfalls is vital to increasing your chances of a successful SSDI application in the state.

  1. Insufficient Medical Evidence: One of the leading causes of SSDI claim denials is the lack of comprehensive medical evidence to support your disability claim. Maintaining regular medical treatment and thoroughly documenting your condition is essential to strengthen your case. This includes medical records, test results, treatment plans, and statements from medical professionals.
  1. Failure to Meet Duration of Work Requirements: To be eligible for SSDI, you must have a specific work history and have contributed to Social Security through tax payments. Applicants who haven't worked long enough may have their claims denied. It's essential to review your work history and credit requirements before applying.
  1. Engaging in Substantial Gainful Activity: The SSA intends SSDI for individuals who cannot engage in substantial gainful activity (SGA) and may deny your claim if they believe you can work and earn a certain income. Given the complexity of the matter, seeking guidance from a Virginia SSD attorney can assist you in effectively navigating the situation.
  1. Disability Not Severe Enough: The SSA has strict criteria for what constitutes a qualifying disability. If your condition doesn't meet their definition of severe, you may receive a denial. Providing detailed medical records and expert opinions can help establish the severity of your disability
  1. Failure to Follow Prescribed Treatment: If a prescribed treatment plan exists for your condition, failing to follow it without a valid reason may lead to a denial. The SSA may consider whether your disability could have improved if you had followed the recommended treatment.
  1. Income and Resources Exceeding Limits: SSDI benefits are means-tested, which means that individuals with substantial income and resources may not qualify. The SSA may deny your claim if your income and assets exceed their limits.
  1. Incomplete or Inaccurate Application: Correctly filling out the SSDI application is crucial. Any inaccuracies or incomplete information can lead to delays or denials. Seek assistance from an experienced SSDI attorney to ensure your application is error-free.
  1. Lack of Cooperation: Failing to cooperate with the SSA, such as not attending medical evaluations or providing requested documents, can result in a claim denial. It's crucial to be responsive and provide any requested information promptly.
  1. Disability Is Not on the List of Impairments: The SSA lists medical conditions that automatically qualify as disabilities. If your condition isn't on this list, it doesn't mean you can't qualify, but it may require additional evidence and argumentation to prove your disability.
  1. Age and Education Factors: When evaluating your claim, the SSA considers your age, education level, and work experience. Younger individuals with more education and transferable skills may face a higher chance of denial, as the SSA may believe they can adapt to different types of work.

Don't lose hope if your claim gets denied. You have the right to appeal the decision, and seeking legal representation from an experienced SSDI attorney can greatly enhance your chances of success. Remember that SSDI benefits are crucial for individuals with disabilities, and with the right support and determination, you can obtain the financial aid you need to move forward in life despite the challenges you face.

Get Your SSDI Claim Right on Track in VA

Choosing Kalfus & Nachman, Virginia's premier Social Security Disability Lawyers, to represent you in Norfolk, Newport News, Hampton, Virginia Beach, and Roanoke is a decision backed by expertise, compassion, and unwavering commitment. Our SSD experts have a deep understanding of the SSDI system and a proven track record of securing vital client benefits.

We prioritize your well-being, offering personalized guidance through every step of the complex claims process. We're not just legal professionals but advocates who genuinely care about your future. With us, you gain access to the finest legal representation that fights tirelessly for your rights and financial security. Trust our experienced legal team to navigate the challenges, ensuring you receive the benefits you deserve. Contact us at (855) 880-8163 to schedule a free consultation.

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