Why Are SSD Claims Denied? 5 Top Reasons and How to Avoid Them

Filing for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) is a complex process, and many first-time applicants face denials. Colorado Disability Determination Services (DDS), which evaluates SSD applications at the state level, follows strict federal criteria to determine eligibility. Many denials result from technical errors, incomplete medical documentation, or not meeting the SSA’s definition of disability.

Our experienced Denver Social Security Disability lawyers have put together this guide to help you understand the most common reasons SSD claims get denied and how to avoid these pitfalls. Understanding the process can improve your chances of getting the benefits you deserve.

Why Do SSD Claims Get Denied in Colorado?

SSD applications are reviewed by Colorado DDS based on federal disability standards. The DDS does not determine benefit amounts or financial eligibility, but it plays a crucial role in whether an applicant is approved. According to Colorado Disability Determination Services, each case is reviewed based on medical records, vocational history, and functional limitations. The SSA will only approve claims where medical evidence clearly supports that an applicant’s condition prevents them from working for at least 12 months or is terminal.

Many denials happen due to missing documentation or errors in the application process. When applying, it’s important to submit detailed medical records and a complete work history. The SSDI application process can be challenging, and many applicants who file without legal assistance struggle to provide the necessary proof of disability.

Top 5 Reasons SSD Claims Are Denied

The Social Security Administration (SSA) approves approximately one in three initial applications, rejecting the rest often for preventable reasons. This high denial rate isn’t just statistics—it represents thousands of people with legitimate disabilities who must navigate a complex appeals process or reapply.

Below, we’ll examine the five most common reasons SSD claims are denied in Colorado and nationwide.

1. Insufficient or Incomplete Medical Evidence

Medical documentation is the most important factor in an SSD application. The SSA reviews medical records to determine if an applicant’s condition meets the legal definition of disability. If records are incomplete, outdated, or do not clearly describe how the condition limits work abilities, the claim may be denied.

Many applicants assume that submitting a diagnosis is enough, but SSA examiners require detailed records that demonstrate the severity of the condition. A key issue in Colorado SSD denials is the failure to provide specialist evaluations or documentation proving an inability to perform work-related tasks.

The SSA’s official rulings emphasize that disability claims must be backed by strong medical evidence, including detailed physician reports, test results, and functional assessments. If medical records do not clearly state why an applicant cannot work full-time, the claim will likely be denied.

To strengthen a claim, applicants should work closely with their doctors to ensure that all records include specific limitations on daily activities, pain levels, and work-related restrictions. SSA decisions are often based on whether a person can perform substantial gainful activity (SGA), so medical documentation must demonstrate that the applicant is unable to engage in any type of work.

2. Failing to Meet the SSA’s Definition of Disability

A medical condition alone is not enough for SSDI approval. The SSA’s definition of disability states that a condition must:

• Prevent an individual from engaging in substantial gainful activity (SGA)
• Last at least 12 months or be expected to result in death

For applicants whose conditions do not meet the SSA’s official Blue Book listing, additional evidence—such as functional capacity evaluations—may be necessary. In cases where an applicant is unable to return to their past work but might be able to transition to another role, vocational expert testimony can be critical in demonstrating the severity of the disability.

3. Application Errors and Missing Information

A simple mistake on an SSD application can result in an immediate denial. The SSA requires complete and accurate information, including medical history, employment records, and a list of all treating physicians. Common errors include:

• Failing to list all medical conditions
• Providing incorrect employment dates
• Missing doctor visits or treatment history

Many applicants overlook the importance of fully documenting daily limitations and side effects from medication. The SSA evaluates whether an individual can perform basic work functions—such as sitting, standing, concentrating, and handling objects—so leaving out details about fatigue, cognitive impairments, or pain can weaken a claim.

Applicants who work with an experienced SSD attorney can avoid these errors and ensure that their application is properly completed. Many claims are denied due to technical mistakes that could have been corrected before submission.

4. Earning Too Much Income While Applying

One of the most common reasons for SSD claim denials is exceeding the SSA’s substantial gainful activity (SGA) limit. The SSA evaluates whether an applicant is earning more than $1,550 per month in 2024. If earnings surpass this threshold, the application will likely be denied, as the SSA assumes the applicant is capable of working.

Even part-time work can affect eligibility if income exceeds the SGA limit. Many applicants unknowingly disqualify themselves by earning too much while waiting for a decision. In some cases, self-employment income or side jobs may also be counted toward SGA, making it critical to monitor all sources of earnings during the application process.

5. Prior Denials Without Proper Appeals

Filing a new application instead of appealing a denial can hurt the chances of approval. SSA reviewers often notice repeated applications and reject them for the same reasons as the initial denial.

The best course of action is to file an appeal within 60 days of receiving the denial notice. There are multiple levels of appeal:

• Request for reconsideration – A new reviewer examines the application and any additional evidence submitted.
• Hearing before an administrative law judge (ALJ) – If the reconsideration is denied, applicants can request a hearing where they can present their case before an independent judge.
• Appeals Council review – If the ALJ denies the claim, the case can be reviewed by the SSA’s Appeals Council.
• Federal court review – The final level of appeal involves taking the case to federal district court.

Many applicants who appeal successfully receive benefits at the hearing level. However, these hearings require strong medical evidence and expert testimony. Working with an SSD attorney can make a significant difference in presenting a compelling case.

The Colorado Disability Determination Services (DDS) office handles initial claims, but appeals go through a separate process. Applicants should submit additional evidence during appeals, including updated medical records and vocational assessments, to strengthen their case.

Those who have already received multiple denials should avoid refiling and instead focus on appealing the decision with legal guidance.

Need Help With Your SSD Case After a Denial? Contact Boesen Law Today

Navigating the SSDI appeals process requires strong medical evidence, a well-prepared case, and knowledge of SSA procedures. Many applicants who were initially denied ultimately receive benefits through the appeals process, but securing approval requires careful preparation.

At Boesen Law, our Denver Social Security Disability attorneys have decades of experience helping clients across Colorado successfully appeal SSDI denials. We understand the complexities of the Colorado DDS review process and the SSA’s strict disability criteria. Our team works to gather the right evidence, prepare appeals, and represent clients at hearings to ensure they receive the benefits they deserve.

Our firm operates on a contingency fee basis, meaning clients pay no upfront fees—we only get paid if the case is won.

If your SSDI claim has been denied, don’t wait. Appeals must be filed within 60 days, and early action can significantly impact the outcome. Contact us today for a consultation with an experienced SSD lawyer.