Why was my disability claim denied? Medical Records.

Why was my disability claim denied? Medical Records.

Social Security denies around 70% of initial applications for disability benefits. Often those whose applications are denied are left wondering why. One of the most common practical reasons why a disability claim is denied is because of the lack of sufficient or compelling medical records.

Going to Doctor is Key.

Social Security looks at your application, and your description of how your disability affects your daily life. But it relies on medical records to award benefits. Therefore, going to the doctor and documenting your diagnosis, condition, symptoms, and treatment is key.

Don’t be Shy.

When you meet with your doctor or a specialist do not be shy about telling them how your condition is affecting your daily life. Most people with medical conditions have good days and bad days. If you happen to visit your doctor on a good day, tell them it’s a good day but also describe what life is like on the bad days and how your condition affects you.

Also, if there was a medical issue you discussed on the last visit that is still causing problems, be sure to bring it up - even if it’s not the main purpose of your visit.

It’s OK to Get a Second Opinion

Going to the doctor can be intimidating. Doctors are busy and it might not always feel like they’re listening to you even when they’re doing their best. If you don’t think your doctor is responding to your concerns it’s OK to go and get a second opinion.


Don’t miss doctor’s visits.

Follow through on your doctor’s treatment recommendations.

What if you can’t afford a doctor visit?

Getting strong documentation of your medical condition is key to proving your Social Security disability case.  So what do those people do who can’t afford a doctor’s visit?

  1. The first thing to do is to see what low cost or sliding scale health providers there are in your area. Try to make an appointment with them.
  2. If you think your health can’t wait - if you’ve had a heart attack, stroke, or other imminent condition - go to the emergency room where they have to provide you life saving care.
  3. Try to get help, even if the doctor’s office eventually refuses your appointment or procedure because of lack of payment.
  4. Talk to your Social Security lawyer about your inability to go to the doctor because you can’t afford it. If your lack of income is a barrier to getting the health care you need, that’s something a Social Security judge is supposed to take into consideration when deciding your case. If you get to a hearing, tell the administrative law judge how you tried to get treatment but couldn’t afford it.
  5. Request a Consultative Examination. If your medical records are lacking Social Security can ask a doctor to examine you on their behalf.

Where to learn more:

  1. Learn how to authorize Social Security to obtain your existing medical records;
  2. Read U.S. government guidance from Health & Human Services about how and when your medical records can be requested by you or your representative;
  3. Use Disability Alabama’s disability calculator for an estimate of your benefit. While you do not need any special information to complete the calculation you may want to take a moment to think about your average yearly income and current household income before using the disability calculator; and
  4. Contact Disability Alabama about your Social Security claim, denial, or appeal.