After you apply for Social Security disability benefits (SSDI or SSI) a claims examiner who works for your state's Disability Determination Services will request your medical records and make a decision on your application ("claim"). Claims examiners are frequently overworked and underpaid, so it's not unusual for them to make a mistake in determining that you aren't disabled. Below are some of the more common errors that examiners make when evaluating disability applications.
When filing for disability benefits, it's very common for claimants to list multiple medical conditions ("impairments") on their application forms. These impairments aren't always severe enough to be disabling on their own. If the claims examiner doesn't think that any of the medical conditions you listed on your application are severe, you'll receive a denial letter. But if you listed more than one impairment on your application, you should appeal.
Social Security examiners must evaluate the total impact of your medical conditions on your physical and mental functioning. Before denying your claim, the examiner must consider whether you have non-severe impairments that, when combined, have more than a minimal effect on your ability to work. If they do, then the examiner must determine whether all of your conditions taken together are disabling (SSR 86-8).
You can support your appeal by asking your doctor to write a letter that explains how your impairments combine to keep you from working. For more information, see our article on when non-severe impairments can be disabling.
Claims examiners can sometimes be so focused on a main physical impairment in a disability application that they fail to fully evaluate mental impairments such as anxiety or depression. Even if you don't list a mental health disorder on your application, examiners must consider whether you have work-related mental limitations if they find evidence of mental health symptoms anywhere in your file.
For example, a claims examiner reviewing your activities of daily living should note if your responses include symptoms of anxiety, such as being unable to finish basic household chores. Or, if your doctor's progress notes mention clinical terms such as "anhedonia" (lack of interest) or "flat affect" (lack of emotional expression), the examiner should address whether you have limitations from depression that interfere with your ability to work. Mental health symptoms can impact your ability to focus, get along with others, and maintain regular attendance.
If you feel that the claims examiner didn't sufficiently explore your mental health symptoms and limitations, you should bring this up in your appeal—whether you're requesting reconsideration or asking for a hearing before an administrative law judge. To increase your chances of winning on appeal, visit a psychiatrist or psychologist so that you have up-to-date records documenting your mental limitations. Getting your doctor to fill out a mental residual functional capacity assessment will improve your chances even more.
Learn more in our article on how anxiety and depression help a claim for disability.
Any restrictions you have from medically documented symptoms should be included in your residual functional capacity (RFC) assessment. (Your RFC states what you can and can't do in a work environment.) When your medical records contain information about several impairments that cause multiple symptoms, it's not uncommon for a claims examiner to overlook a limitation that on first glance doesn't seem to significantly affect your functioning. But if the examiner didn't consider all of your limitations, your RFC won't be an accurate reflection of your abilities—which means your claim can be denied if your RFC allows for you to work.
Non-exertional limitations—restrictions that aren't strength-related—are most often omitted. For example, if you can't lift more than 20 pounds due to back pain, your RFC might limit you to jobs at the light exertional level. But if you also have carpal tunnel syndrome and your RFC doesn't include restrictions on repetitive finger work such as typing, a claims examiner can erroneously conclude that you have the ability to perform many clerical jobs at the light level.
In your appeal request, you should state which limitations the claims examiner neglected to include in your RFC. Be as specific as you can, using quantities like time, distance, and weight (such as "After 10 minutes of typing, my hands cramp up") to support your restrictions.
A lot of disability claimants skim over the work history section of the application, giving broad descriptions of job duties and estimating employment dates. But if you didn't fully describe the jobs you've held in the last 15 years, the claims examiner may mistakenly decide that you could return to your past work. Even if your RFC includes restrictions on certain job tasks, that won't help you if the claims examiner doesn't know what exact tasks you did at your old job.
For example, if your work history report says you were a receptionist (a job typically performed at the sedentary exertional level) and your RFC restricts you to sit-down work with no heavy lifting, a claims examiner will likely find that you can still work as a receptionist and deny your claim. But if your actual job duties—regardless of the job title—included lifting delivered packages and bringing them across the building several times per day, the examiner should have found that you couldn't do your old job.
When deciding whether you could switch to less physically or mentally demanding work, the claims examiner needs to see if you have any transferable skills—specialized knowledge that you learned at your old jobs that you could use at another job.
Claims examiners use a Department of Labor publication called the Dictionary of Occupational Titles (DOT) to determine whether your past work should be classified as skilled, semi-skilled, or unskilled. But the DOT only tells the examiner how the job should be generally classified—your day-to-day experience of working may vary from the description in the DOT. In that case, the examiner might erroneously identify transferable skills that you don't actually have.
Depending on your age, lacking transferable skills can make or break your disability claim. If you're 50 or older and your claim was denied because the examiner thought you already know how to do another job, you should appeal. At the hearing level, you're able to speak to (and ask questions of) a vocational expert who can better determine whether you acquired transferable skills from your past work.
If none of the above reasons explain why your application was denied, you can learn more in our article about the correct way that Social Security should assess a disability claim. You might also consider getting help from an experienced disability attorney to point out any mistakes that you didn't catch on your own.
Updated December 14, 2023