By Bethany K. Laurence , Attorney · UC Law San Francisco
Updated by Diana Chaikin , Attorney · Seattle University School of Law
According to Social Security, 64% of people who apply for disability are denied after their initial application for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. Even more people (86%) receive a denial letter after they've requested reconsideration, the first step of the disability appeals process.
So statistically, most applicants get denied for SSDI or SSI two times before they have their best shot at getting benefits with a disability hearing. If you've been denied Social Security disability, read your denial letter closely to figure out the reasons why the agency denied your claim—and find out what type of evidence you'll need to show that your claim shouldn't have been denied.
Denial letters are pretty short—typically two or three pages. You can recognize a denial letter because it will say "Notice of Disapproved Claim" near the top of the first page. Denial letters contain a brief description of your medical impairments, the records that the Social Security Administration (SSA) considered in making the decision, and an explanation for the denial.
Example of a Denial LetterWe've determined that your condition isn't severe enough to keep you from working. We considered the medical information and your age, education, training, and work experience in determining how your condition affects your ability to work.
You said that you're unable to work because of pain and stiffness in your knees and lower back. The medical evidence shows you have osteoarthritis in your lumbar spine and knees that causes you discomfort. We realize that your condition prevents you from doing any of your prior jobs, but it doesn't prevent you from doing other jobs that require less physical effort. Based on your age (53), education (11th grade), and past work experience, you can do other work.
If your condition gets worse and keeps you from working, write, call or visit any Social Security office about filing another application.
Denial notices should also include a "technical rationale" (a full explanation of the medical issues involved in the decision) and a discussion of your residual functional capacity (limitations about what you can and can't do at work). If your denial letter doesn't include the rationale, you should request your file from Social Security so you can review it before you appeal.
Social Security may have denied your claim for many reasons, but the most common is that the agency thinks that you can still work full-time—either because you're still able to do your past work or because you can do other, less demanding work. For example, if Social Security thinks that you can do an easier type of job than you've done before, your denial letter might say something like this:
Your medical conditions, including two bulging discs, chronic knee pain, and neuropathy, cause you some discomfort, and we agree that you cannot return to your prior work. However, there are jobs other than your prior work that you can still do. You do not have limitations that would preclude you from all types of employment.
Other reasons the agency may have denied your claim include:
Social Security can also deny your claim if you don't meet the financial eligibility requirements to receive SSDI or SSI.
Deciphering a denial letter can be tricky. For most applicants, the key to finding out why you were denied lies in the technical rationale (sometimes referred to as the "Disability Determination Rationale").
Here, Social Security will list your severe impairments along with any functional limitations you have as a result. Work-related functional limitations can be exertional—such as limits on how much weight you can lift or how far you can walk—or non-exertional, like restrictions on using your fingers to type or how long you can concentrate on tasks.
The set of work-related functional limitations in your denial letter is known as your residual functional capacity (RFC). Social Security compares your RFC with your past work to see if you could still do those jobs today. If you can't, the agency then needs to determine whether other jobs exist that you could perform, despite the restrictions in your RFC. Social Security will deny your claim if you can return to your past work or perform other jobs.
All limitations in your RFC need to be supported by medical evidence. The evidence used to arrive at your RFC is discussed in the technical rationale (in fairly dry language—the letter will refer to you as "the claimant" rather than your personal name, for instance). Here's an example using excerpts from Nolo's Guide to Social Security Disability:
Example of Technical Rationale With RFC for Light WorkThe claimant has said that he became unable to work as of 06/15/2023 due to a heart condition. He was in the hospital when he applied and was scheduled to have bypass surgery.
The medical evidence documents the presence of coronary artery disease. The claimant was hospitalized on 06/22/2023 due to chest pain with EKG changes suggestive of ischemia. Cardiac catheterization showed 75% obstruction of the left main coronary artery. He was discharged to await bypass surgery. Triple bypass surgery was performed on 07/09/2023. One year after surgery, the treating physician reported that there was no chest pain. No treadmill test had been done and none was planned. The doctor said the claimant should limit lifting to 10-20 pounds.
The evidence documents the presence of a severe cardiovascular impairment; however, the findings do not meet or equal the criteria of any of the listed impairments. While Listing 4.04C1.b was met at the time of the angiogram, the bypass surgery improved the condition and there is no longer any chest pain. The claimant would be restricted from lifting more than 10 pounds frequently or more than 20 pounds occasionally due to his heart condition. There are no other medically imposed limitations or restrictions. The individual is capable of performing light work.
These paragraphs of the rationale discuss the evidence that Social Security used to arrive at an RFC for light work. Note that the agency considered the objective imaging (EKG), surgical records, and the doctor's opinion before concluding that, while the claimant didn't automatically qualify for disability by meeting a listing, the claimant shouldn't perform any work that requires lifting more than 20 pounds occasionally.
If you think that Social Security didn't consider medical evidence that shows you're more limited than what your RFC says, you should submit those records with your appeal. In the above example, if the claimant did, in fact, have a treadmill test showing severe dyspnea (shortness of breath) on exertion, the agency likely should have included additional restrictions in the RFC.
Most applicants are denied because Social Security thinks they can still work full-time. The agency will state what types of jobs they think you can do in the denial letter and explain how they arrived at that conclusion. Using the work history and RFC from the example claimant above, here's how the technical rationale might look:
Example of Technical Rationale With Inability to Do Past WorkAfter a military career that ended in 2020, the claimant was employed as a winery worker at a vineyard. This was full-time work at substantial gainful activity levels until he was hospitalized on 06/15/2023, his alleged onset date. The period from 2020-2023 lies within the relevant five-year period and was of sufficient duration for him to gain the job experience necessary for average job performance. Therefore, his job as a winery worker has current relevance.
The demands of the job included lifting bulk grapes onto a conveyor belt, connecting pumps between vats, agitating the fermentation solution, tending the grape press, and sterilizing the tanks. These duties entailed the abilities to lift up to 50 pounds occasionally and up to 20 pounds frequently, to stand and walk for 6 hours out of an 8-hour day, and to sit, see, talk, reach, handle, finger, and feel. The job is classified at the medium exertional level.
With the exertional capacity to do light work, and, in the absence of any nonexertional limitations, this individual is unable to do his past relevant work as he described it. However, there are other jobs at the light level that the claimant can perform. Examples of representative jobs include cashier, food assembler, and dog bather. Because these jobs exist in significant numbers in the national economy, the claimant is not disabled.
In this section, Social Security established that the claimant had past relevant work (going back five years) as a winery worker and hadn't been earning at the substantial gainful activity level (around $1,500) since the alleged onset date (when the disability began) of June 15, 2023. The agency then compared the demands of the past work with the claimant's current RFC.
The claimant has a current RFC for light work, which rules out the winery worker position (which is classified as medium work because it requires lifting 50 pounds). But because Social Security found other jobs at the light level, such as cashier, the agency denied the claimant's application for benefits.
Read another example of a technical rationale in our article on reviewing your disability file.
This is a question disability attorneys often hear from clients who've already been awarded workers' compensation or veterans benefits—systems that have different standards of disability. Having a doctor write a note saying that you're "totally and permanently disabled" might have significance for those programs, but it doesn't fulfill Social Security's requirements.
Much of the confusion comes from the fact that workers' comp and VA benefits can award disability payments based on a percentage rating (for instance, 65% disabled), which Social Security doesn't do. These benefits are also awarded based on a link between your current disability and your activities at your past job or while in service. So you might qualify for VA benefits or workers' compensation under the standards of those programs, but not yet meet Social Security's definition of disability.
It's also worth noting that Social Security doesn't require you to be comatose or in an iron lung in order to receive benefits. For example, you can still work (up to a certain amount) and receive SSDI or SSI benefits at the same time. And applicants 50 years of age and older may get benefits even if they're able to do some other jobs under the medical-vocational grid rules.
Finally, if you've been out of full-time employment for at least one year but you've since returned to work due to improved health, you might qualify for a closed period of disability.
When reading through your decision letter and technical rationale, consider what you may have done—or didn't do—that led to the denial. Often the reason for a denial is that the application didn't contain enough medical evidence to establish disability. Fortunately, you can fix this when you appeal. The following are some tips to help you hone in on issues on your application.
Requesting an appeal gives you a chance to get more medical evidence, including any imaging or test results that could prove the severity of your condition and, most importantly, a supportive medical statement from your doctor.
The fact that Social Security denied your disability claim doesn't necessarily mean that you aren't disabled. Most cases will be denied, but don't give up on your claim, whether it's for SSI or SSDI. (Social Security denies more applicants for SSI than it does for SSDI, partly because there are more SSI applicants each year.)
The moment you receive your denial letter, you can appeal the denial. And the sooner you appeal, the sooner Social Security can schedule a disability hearing, which gives you the best chance of winning your claim. Before your hearing, you might consider hiring a lawyer or advocate, to make the best use of your time in front of the judge.
If you're denied after a hearing, read our article on unfavorable decisions from judges to understand your next steps—even then, it's not over. You can head to the Appeals Council to try to get your claim heard a fourth time.