What percentage of SSDI claims are denied? Learn the facts about SSDI denial rates, why claims get denied, and what you can do if your disability claim is not approved.
Filing for Social Security Disability Insurance (SSDI) is often a complex and frustrating process. One of the most common concerns among applicants is, “What percentage of SSDI claims are denied?” The answer may be surprising—and discouraging—without the right preparation or legal help.
According to the Social Security Administration (SSA), nearly 67% of initial SSDI applications are denied nationwide. That means only about one-third of first-time applicants are approved for benefits, leaving the majority to either abandon their claims or pursue the appeals process.
Understanding the reasons behind denied SSDI claims and how the appeals process works can make all the difference in achieving a successful outcome.
Why Are SSDI Claims Denied So Often?
There are many reasons why SSDI denial is so common, but most denials fall into a few key categories:
- Lack of Medical Evidence – The SSA requires clear and consistent medical documentation that clearly shows that your condition prevents you from working. If your file is missing test results, specialist evaluations, or ongoing treatment records, your claim may be denied.
- Not Meeting the Definition of Disability – SSDI has a strict legal definition of disability. You must prove that your condition will last at least one year (or result in death) and that it prevents you from performing substantial gainful activity (SGA). Many applicants are denied because they do not meet this definition, even if their condition is serious.
- Incomplete or Inaccurate Applications – Missing paperwork, conflicting details, or failure to follow instructions can result in immediate denial. Something as simple as not listing all of your healthcare providers or not responding to SSA requests for additional information can hurt your claim.
- Failure to Follow Treatment Plans – If you do not follow prescribed treatment or attend appointments, the SSA may conclude that your condition is not as severe as claimed.
What Happens After a Denial?
If you are part of the two-thirds of applicants who receive a denial, you still have options. The SSDI program includes a structured appeals process that gives you multiple opportunities to prove your eligibility. Many people are ultimately approved at a later stage.
The first step is to file a Request for Reconsideration, followed by a hearing before an administrative law judge (ALJ) if necessary. Approval rates are significantly higher at the hearing level, especially when a qualified SSDI appeal attorney represents the claimant.
How to Improve Your Chances of Approval
While the statistics may sound discouraging, there are ways to reduce the likelihood of a denied SSDI claim:
- Consult a Disability Attorney: Working with a lawyer from the beginning can help ensure that your application is complete, accurate, and supported by strong medical evidence.
- Provide Detailed Medical Records: Do not assume SSA will gather everything. Make sure your file includes updated test results, treatment notes, and provider opinions.
- Explain How Your Condition Impacts Work: Use your application to clearly show how your medical condition prevents you from working in any capacity.
- Appeal Promptly: If you are denied, file an appeal within the deadline. Do not start over unless advised otherwise by a legal professional.
Frequently Asked Questions
What percentage of SSDI claims are denied after appeal?
According to SSA data, approximately 45% of claims are approved after a hearing with an administrative law judge, especially when accompanied by legal representation.
Can I win an SSDI appeal without a lawyer?
It is possible, but your chances are significantly higher with the assistance of an experienced attorney. Lawyers understand how to strengthen weak areas of your case, submit critical evidence, and represent you effectively in front of a judge.
Get Help with Your SSDI Denial
If you are one of the many applicants who has received an SSDI denial, you are not alone, and you are not out of options. At Culbertson, Jacobs & LaBoda, we help individuals across Florida navigate the appeals process, gather the right evidence, and pursue the benefits they deserve.
Do not let a denial stop you from getting the support you need. Contact us today to schedule a free consultation and learn how we can help you navigate your disability claim with confidence.