Common Reasons SSA Denies Disability Claims and How to Fix Them on Appeal

A denial from Social Security can feel personal. In reality, many denials trace back to how the file was documented, how eligibility rules were applied, or whether Social Security believed the evidence supported work-preventing limitations under its framework. Appeals exist because initial decisions are often made on incomplete or unclear records.

Below are common denial reasons and the kinds of issues that can be addressed during an appeal.

1) “Not Enough Medical Evidence”

One of the most common problems is a record that is thin, outdated, or missing key treatment sources. The issue is not always whether you have a real condition. The issue is whether the file shows consistent treatment and supports the severity and duration SSA is evaluating.

How this can be addressed on appeal:

• Making sure SSA has the complete set of records, including primary care and specialists.
• Filling in missing time periods and documenting ongoing symptoms and treatment.
• Submitting updated testing or imaging when it exists and is relevant.

2) “Your Condition Doesn’t Prevent Work”

Social Security disability decisions often turn on function, not labels. A diagnosis is important, but SSA is evaluating what you can still do on a sustained basis. At the hearing level, the ALJ considers your RFC along with vocational factors like age, education, and work experience when evaluating whether work exists you can do. 

How this can be addressed on appeal:

• Reframing the case around concrete functional limitations (for example: sitting, standing, walking, using hands, concentration, pace, and reliability).
• Tying those limitations to treatment notes, objective findings when available, and longitudinal history.

3) “You Can Do Other Work”

Many denials come down to SSA concluding you can adjust to other work that exists in significant numbers. At step 5, SSA looks at RFC, age, education, and work experience, and it may rely on the Medical-Vocational Guidelines (the “grid rules”) as part of that analysis. 

How this can be addressed on appeal:

• Clarifying past job duties and physical demands so past work is classified correctly.
• Challenging assumptions about transferable skills, especially for older claimants.
• Addressing grid rule issues when they apply, using the standards in Appendix 2. 

4) “You Didn’t Follow Treatment or Instructions”

SSA can consider “failure to follow prescribed treatment” in limited circumstances, and the rules focus heavily on whether there was good cause. SSA’s ruling explains that an individual generally has the burden to provide evidence showing good cause for not following prescribed treatment. 

Gaps in care can also be misread. Cost barriers, limited access, side effects, transportation issues, and other real-world constraints sometimes explain why treatment was inconsistent.

How this can be addressed on appeal:

• Documenting why treatment was interrupted, including practical barriers and medical reasons.
• Showing what treatment was attempted and what the response was.
• Making sure the record reflects context instead of leaving the judge to guess.

5) Technical or Non-Medical Denials

Not every denial is medical. SSA’s own reporting notes that one of the most common non-medical reasons for denying a claim is an insufficient number of recent work credits. Other non-medical issues can include income and resource rules (often SSI), earnings issues, or application-level problems.

How this can be addressed on appeal:

• Identifying whether the denial was medical or non-medical, because the fix can be very different.
• Correcting documentation issues and preserving the claim timeline when possible.
• In some situations, determining whether a new filing is required, or whether the denial can be addressed through appeal or other SSA procedures (this depends heavily on the specific reason and timing).

6) No Clear Treating Provider Opinion About Work Limits

A common gap is that the records show diagnoses and visits, but do not clearly address work-related restrictions. Many treating providers do not volunteer opinions unless asked in a focused way.

How this can be addressed on appeal:

• Requesting targeted statements that translate symptoms and clinical findings into functional restrictions.
• Ensuring the opinion addresses the kinds of limitations SSA is evaluating (for example: sitting, standing, lifting, off-task time, pace, attendance).
• Aligning any opinion evidence with the longitudinal treatment record so it is consistent and credible.

Why Appeals Are Where These Problems Get Fixed

Initial claims are often decided quickly, and the record that gets reviewed is not always complete or well-organized. 

Appeals create the opportunity to identify why SSA said “no,” correct gaps in the file, and address vocational assumptions using the rules SSA is required to apply.

 To discuss your situation, call (334) 487-8475 or contact us online for a free consultation.