Most Common Reasons for SSD Denials in Virginia

The Social Security Administration (SSA) approves roughly only 42 percent of Social Security disability applications on initial application in Virginia. This low acceptance rate is frustrating for Virginia residents who are suffering. Not to mention, it adds stress to the already present challenges people living with disabilities have in their day-to-day lives.

If the SSA denies your Social Security disability claim, you are not alone. Many people struggle to receive Supplemental Security Income (SSI) and/or Social Security Disability Insurance (SSDI) benefits and routinely receive denied claims.

On the positive side, if the SSA denies your initial claim, you are not out of options. The knowledgeable legal team at Montagna Law has compiled some of the most common reasons the SSA may deny your application, how to improve your chances of winning your benefits on appeal, and how a skilled Virginia Social Security disability lawyer can help make this complex process easier. Contact our Virginia law firm today at 757-622-8100 to schedule a free consultation.

How Does the Social Security Administration Define Disability?

The SSA defines a disability as the inability to engage in substantial gainful activity (SGA) due to a physical or mental impairment that has lasted, or doctors expect to last, for at least 12 continuous months or will result in death.

The impairment must be severe enough to prevent you from performing your previous work and any other kind of work that exists in significant numbers in the national economy, considering your age, education, and work experience.

The SSA evaluates disability through a strict, multi-step process, including assessing whether you are working at an SGA level, the impairment is severe, the impairment meets or equals a listed impairment, and whether you can perform past or other work.

The definition emphasizes functional limitations and the capacity to work in addition to the medical diagnosis.

What Are the Eligibility Requirements for Social Security Disability?

You must meet both financial and medical criteria to become eligible for Social Security disability benefits. Financially, you need to have worked and paid Social Security taxes long enough to earn sufficient work credits, typically 40 credits, with at least 20 earned in the 10 years prior to the disability beginning.

Younger workers may qualify with fewer credits depending on their age at the onset of disability.

Medically, you must have a severe impairment that prevents you from performing substantial gainful activity, and doctors expect the impairment to last at least 12 months or result in death.

The SSA evaluates the medical condition against its criteria and considers whether you can perform your past work or any other work. Additionally, your earnings must not exceed the SGA threshold, which frequently changes. In 2025, the threshold is $1,620 per month for non-blind individuals to qualify.

Related Article: Am I Eligible for Disability Benefits in Virginia

What Is the Social Security Disability Process in Virginia?

As a Virginia resident, you will need to follow the SSA’s procedures to apply for Social Security disability. This includes filling out the proper paperwork and including supplemental documentation. You can apply online, by phone, in person, or with the help of an experienced and knowledgeable Social Security disability attorney. Generally, the SSA will ask the following:

• To gather information and documents necessary to apply
• Fill out and submit your application
• Wait for the SSA to review and respond to your application
• Wait for the SSA to forward your claim to Virginia’s Disability Determination Services office for a decision

The length of time to obtain a decision will vary from applicant to applicant, but generally takes roughly three to six months for applicants to receive an initial decision. Most people will get a denial, but this doesn’t mean you should give up hope. You can, and should, appeal a denial decision.

Related Article: How to File for Social Security Disability After Age 50

Social Security Disability for Terminal Illnesses

Individuals suffering from a terminal illness will receive expedited status for their SSDI claims by obtaining certification from a doctor. The federal agency defines terminal illnesses as “medical conditions that are untreatable and expected to result in death.” SSA’s Terminal Illness Program (TERI) handles cases of those who are terminally ill.

What Are the Common Reasons The SSA Denies Social Security Disability claims?

While the SSA designed Social Security disability benefits to help people in need, the agency is a structure of denial. Essentially, what this means is the federal agency is not “motivated” to approve claims. Instead, it puts the burden directly upon the claimant to support their disability.

If you have a disability, it is your responsibility to seek treatment with the appropriate specialists. However, the SSA routinely denies even those who do seek proper treatment.

Lack of Medical Evidence

The SSA often denies disability claims due to insufficient or incomplete medical evidence. The agency requires detailed and objective medical records from acceptable medical sources, such as licensed physicians, psychologists, and hospitals, that clearly document the nature, severity, and duration of the impairment.

Documentation includes doctors’ notes, test results, treatment history, and statements about how the condition limits work-related activities. Without comprehensive medical documentation, the SSA cannot properly evaluate the claim, leading to denial.

Failure to Meet SSA’s Definition of Disability

Your condition must meet the SSA’s strict definition of disability if you want to qualify for benefits. The impairment must be severe enough to prevent you from performing your past work and any other substantial gainful activity. It may also have lasted, or doctors must expect it to last, at least 12 months or result in death.

If your condition does not meet these criteria, or if you can still perform some type of work, the SSA will deny your claim.

Earning Too Much Income

If you are engaged in substantial gainful activity, earning above the SGA threshold — $1,470 per month in 2024 and $1,620 per month in 2025 — the SSA is going to deem you ineligible for disability benefits since earnings above the threshold suggest that you are capable of working despite your impairment.

Previous Denials and Applications Issues

If the SSA denies a prior application, it can deny a new one if you fail to address the reason for the previous denial(s). Additionally, errors in the initial application, missing documentation, or failure to appeal within deadlines can result in denial. Repeated denials without new or stronger evidence often lead to continued refusals.

Not Following Prescribed Treatment

If you do not follow prescribed medical treatment without a valid reason, such as financial hardship or medical contraindications, the SSA may deny the claim. Compliance with treatment demonstrates a genuine effort to manage the condition, and failure to do so can suggest the impairment is not as disabling as you claim.

Failure to Cooperate With SSA

Denials can occur if you do not cooperate with SSA requests, such as missing medical appointments, failing to provide requested medical records, or not attending consultative exams arranged by the administration. Cooperation is essential for SSA to assess the claim to its fullest potential.

Disability Based on Addiction to Drugs or Alcohol

The SSA generally denies disability claims that are primarily due to drug addiction or alcoholism. The administration excludes impairments caused by substance abuse unless you can prove you would be disabled even without the influence of drugs or alcohol. This policy aims to prevent benefits for disabilities that you can resolve through sobriety.

Other Disqualifying Factors

Filing a fraudulent claim or being imprisoned can disqualify you from receiving benefits. Fraudulent claims include obtaining benefits through fraud on the part of a third party, such as a doctor or someone working for the Social Security Administration.

If the SSA suspects you of fraud, it may conduct a cooperative disability investigation, in which it will ask to observe you. The agency’s report can include discrepancies between what you told SSA and how you complete your daily routine. Investigators can also speak with your neighbors.

The Montagna Law legal team is here to help oversee your application and assemble favorable documentation to increase your chances of approval. In addition to helping clients understand the medical information needed, we assist in collecting and presenting the relevant medical documentation.

How Can I Avoid Being Denied for Disability Benefits?

You can minimize a benefits denial by:

• Understanding SSA’s definition of disability, which requires the condition to prevent substantial gainful activity for at least 12 months or result in death.
• Providing thorough and consistent medical evidence, including detailed doctors’ notes, test results, and specialists’ reports.
• Educating and communicating with your doctors to ensure they accurately document how your condition affects your daily life and ability to work.
• Being honest and detailed in your application, describing all limiting conditions without exaggeration or understatement.
• Maintaining consistent treatment by following prescribed therapies and attending medical appointments regularly.
• Applying at the right time, typically after the condition has lasted or your doctors can document that they expect the condition to last at least 12 months.
• Limiting social media activity to avoid posting anything that could contradict your claimed limitations.

Consider retaining a Social Security attorney to help gather evidence, complete paperwork, and navigate appeals.

How Many Times Can SSA Deny Disability Benefits?

SSA does not place a limit on the number of times it can deny Social Security disability benefits. Applicants can reapply or appeal multiple times if the SSA denies their claims.

Is It Better to Appeal a Social Security Disability Denial or File a New Claim?

Many believe filing a new claim to try to receive Social Security benefits is better than appealing. This is incorrect; do not file a new claim. In some situations, SSA will deny a claim based on a prior denial.

Due to this, it is important for you to go through the appeals process instead. If you opt for a new application, it may result in a loss of entitlement to certain past periods of benefits. Also, the percentage of receiving a favorable decision is higher at the hearing level than it is during the initial stages of a disability benefits claim.

How Many Times Can I Appeal an SSD Denial in Virginia?

You are allowed to appeal a disability denial decision a total of four times. Each step is a little different, and it’s important to follow all federal instructions. The following is an overview of each step of the appeal process.

Request Reconsideration

The first step is to ask the SSA to reconsider its decision. Do this within 60 days of receiving a denial. The probability of a reversal in the federal agency’s decision is very low. Remember, the system often pushes applicants away instead of approving them, but it is a vital step to take.

Request a Hearing

The second level of appeal is to request a hearing with an administrative law judge. You must do this within 60 days of receiving a denial of your request for reconsideration. Approval rates are higher at this level of appeal.

Appeals Council Review

The third level of appeal is to request a review with SSA’s Appeals Council. Make the request online or file Form HA-520 with the SSA. Again, you must make this request within 60 days of the last denial. It is also important to understand that the Appeals Council will not personally review all requests.

File Federal Court Action

The final appeal is to file a federal district court action with the U.S. District Court within 60 days of your most recent denial. The court you file in will depend on where you reside.

The appeals process is tedious, but working with a knowledgeable Virginia disability attorney can greatly relieve this burden.

What Forms Do I Need to Appeal a Social Security Disability Denial in Virginia?

The SSA does not make filing appeals easy, requiring numerous forms that may vary depending upon your circumstances, including your level of substantial gainful activity (SGA), the reason for your denial (e.g., medical or non-medical reasons), and other factors. To determine what forms you need to file an appeal, visit this government website or speak with a knowledgeable Virginia disability attorney.

Tips For Appealing Your SSDI Denial

Fortunately, there are some actions you can take to improve your chances of winning your appeal. Keep in mind that if you receive any paperwork from the Social Security Administration, you must complete it by the designated deadlines. Tips to follow that can help fully support your case include the following:

• Keeping track of your medical treatments, including doctors’ appointments and hospitalizations
• Recording when your healthcare providers refer you for surgery or objective testing
• Listing any current or new medical diagnoses/test results
• Notifying Social Security of any changes in your medical records

Also, consider the fact that anything you put in writing and send to the SSA becomes a part of your permanent record. The agency can use any details you provide against you as a basis for issuing a denial. Working with a lawyer significantly strengthens your chances of being approved for disability benefits.

The skilled attorneys at Montagna Law are here to help you navigate this complex process and complete all the necessary paperwork. We will also help you keep track of your medical treatments and notify the SSA of any changes.

How Can a Social Security Disability Lawyer Help Me With My Appeal?

Filing a disability benefits claim with the SSA on your own reduces your chances of being approved. According to a study by the U.S. Government Accountability Office, you are three times as likely to be granted benefits if an experienced attorney represents you.

Our office has the ability to work on your claim meticulously. We can access Electronic Record Express (ERE), an online platform that allows us to review aspects of your Social Security file. Other things we can do include:

• Regularly review the status of your claim
• See the analyst assigned to your case
• Determine if the SSA requires additional information
• Upload documents with confirmation of filing

This is a platform that is not available to you, only to representatives. Our attorneys understand precisely how to present a case to provide you with the best chances of success. This is a process we have done many times and are well-versed in all of SSA’s processes. To start your appeal, connect with our office for a free consultation.

Frequently Asked Questions About SSD Denials

What Illnesses Automatically Qualify for Disability?

The Social Security Administration considers certain illnesses so severe that they may automatically qualify people with those conditions for disability benefits under SSA’s Compassionate Allowances program. These include specific cancers, advanced neurological disorders such as ALS (Lou Gehrig’s disease), late-stage kidney disease requiring dialysis, and certain rare conditions.

Additionally, terminal illnesses or conditions expected to result in death may also qualify without the usual lengthy review process.

Does My Age Affect My Denial for Social Security Disability in Virginia?

Yes, your age affects the denial of Social Security disability benefits. According to the SSA, age groups are as follows: under age 50, ages 55-59, and over 60. If you are younger than 50, it may be more difficult to obtain disability. Generally speaking, the older you get, the easier it is to be approved.

Can I Receive Social Security Disability Benefits If I Receive VA Disability Benefits?

Yes, if you are a veteran, you are also able to receive Social Security disability benefits in conjunction with VA disability benefits. These are two separate types of benefits and must be applied for individually. The two types of benefits are not affected by each other, so what it will come down to is your eligibility for each program.

Are Certain Disabilities Harder to Prove Than Others?

One of the most significant reasons why the SSA denies disability benefits is due to a lack of sufficient medical evidence. Many people assume the SSA will obtain the required medical evidence necessary to approve a claim. This is not true. The SSA does only the bare minimum to get supportive evidence to approve applications.

Certain disabilities are harder to prove than others. These include chronic migraines, back and neck injuries, fibromyalgia, various neurocognitive disorders, depression, eating disorders, and PTSD, to name a few. This list is not exhaustive. Working with an attorney can help with difficult-to-prove cases.

What Are the Signs SSA Will Likely Approve Your Application for Disability?

Signs that the SSA is likely to approve your claim include having enough work credits, a medical condition expected to last at least 12 months or result in death, consistent medical treatment records, and a condition that equals a listing in the SSA’s Blue Book.

Having a physically demanding prior job, inability to perform past work, and hiring a Social Security attorney to assist with the claim can also improve approval chances.

What if My Health Deteriorates After an SSD Claim Denial?

If your health deteriorates after SSA denies your claim, you can appeal the decision by submitting new medical evidence reflecting the worsened condition during the reconsideration stage or at a hearing before an Administrative Law Judge (ALJ). Alternatively, if the condition has significantly worsened since the denial, you may reapply for benefits with updated medical documentation.

What Not to Say in a Disability Interview?

During a disability interview, you should avoid being vague, dishonest, or unprepared. Exaggerating symptoms, downplaying limitations, or omitting relevant medical information can harm credibility.

Being rude, defensive, or uncooperative with the SSA representative can also negatively impact the claim. It is important to provide clear, specific examples of how the disability limits work and daily activities and to be truthful and consistent throughout the interview.

What Makes a Strong Disability Case?

A strong disability case includes comprehensive and up-to-date medical evidence that clearly documents the severity and functional limitations caused by the condition. Consistent treatment history, adherence to prescribed therapies, and detailed physician statements explaining why you cannot work are essential. The case should also demonstrate that the disability meets SSA’s criteria, including lasting at least 12 months or being terminal. Legal representation can help ensure you complete all paperwork and properly pursue appeals.

Why Work With Montagna Law for Your Social Security Disability Claim

Denial letters are common from Social Security, but you can minimize your risk of receiving one. The experienced disability lawyers at Montagna Law can help you overcome claims of insufficient medical evidence and technical denials on first-time filings and appeals.

We Fight For Your Benefits

Living with a disability or impairment presents many day-to-day challenges. Not receiving the SSDI benefits you need to cover your living expenses and medical care adds to this burden. The caring attorneys at Montagna Law are here to help you navigate the complex application process and structure of the SSA. We can also take a look at your past work history and see if you have enough work credits to help provide you with a fuller picture of your options.

To learn more about how we can support you, contact us at 757-622-8100 or fill out our online contact form. Montagna Law proudly serves the entire Hampton Roads area, including Virginia Beach, Norfolk, Chesapeake, Portsmouth, and Suffolk.

What Our Clients Say About Our SSDI & SSD Lawyers

“When I found applying for disability very intimidating with ALL this paperwork, forms, doctors etc. I called and immediately they got everything started immediately! Katie was the most thoughtful, patient and understanding person to handle my case. She has a special way about her. If you ever find yourself worrying about filing for disability, do not hesitate to call. You’ll be in great hands!!!” — Tina C.

“Mr.Montagna was an absolute pleasure on the phone and in person! My friend recommended me to him and I couldn’t have been happier with my decision! Grace was also such a delight to hear from, she always had the best attitude! Mr. Montagna went above and beyond to make sure I would be treated fairly and with that being said if I could give him and Grace 10 stars, I would! Thank you to Montagna law for helping me feel valued!” — Anita C.

Facing an SSD Denial? Contact Our Virginia Social Security Disability Attorneys Today.

You do not have to go through the disability application process yourself, wondering what you might do or say that could cause a denial. Contact Montagna Law at 757-622-8100 to discuss your disability case and filing an initial application or an appeal. You can also schedule a consultation by completing our online contact form.