Why Southern California Social Security disability claims are erroneously denied

We strongly encourage Riverside County and San Bernardino County California disability claimants to appeal if their claims are denied. Two-thirds of applications are denied but more than half of the claimants who appeal and have a hearing are found disabled. Why the discrepancy?

One important reason is that initial denials are based on a review of the claimant’s file. The disability examiner and medical consultant at the state agency have no opportunity to hear from the claimant and witnesses in person. Their focus often is on medical records so they may not appreciate the extent to which a claimant’s impairment limits his or her ability to function in the workplace.

Social Security disability hearings, on the other hand, are conducted before an administrative law judge. The claimant and witnesses can tell the judge about the claimant’s impairments and how they limit what the claimant is able to do. And the judge can see the effect of the claimant’s impairments first hand.

Another reason that claims are denied is because evidence is missing from the claimant’s file. Treating doctors may have failed to send medical records, or the records may be inadequate, or illegible, or too old. Treating doctors may have neglected to complete questionnaires sent by the Social Security Administration. The claimant may have forgotten to return a questionnaire or may not have completed it correctly. A disability attorney may be able to fill these gaps in the file before the hearing.

Incomplete files and missing evidence can lead to numerous errors in the disability assessment because the state agency has nothing but the file to go on. And sometimes, the state agency just gets it wrong.

For example, the state agency may have determined that a claimant is capable of medium work. But the claimant is actually capable of nothing more than light work, an RFC that may, depending on the claimant’s age, education, and experience, result in a finding of disabled.

Other common reasons for erroneous denials are:

  • The claimant’s impairment was determined to be “not severe.”
  • The state agency did not gather evidence showing that a claimant’s impairment meets the Listings.
  • The claimant’s allegations of pain were not properly evaluated.
  • The claimant has multiple impairments, but the state agency failed to consider them all.
  • The state agency determined that the claimant was capable of past work but underestimated the exertional level of the past work (e.g., the claimant’s past work was found to be light, but was actually medium).
  • The state agency used the claimant’s years of formal schooling for establishing educational level but testing reveals the claimant’s educational level is considerably lower.

If your claim was denied, your southern California Social Security disability attorney will determine how the state agency came to its conclusion. Your attorney may then find specific issues on which to develop further evidence that you actually are disabled. This evidence can be presented to the judge during your hearing. The judge does not have to accept conclusions of the state agency that are unfavorable to you.

Whatever the reason, do not let the denial of your application for Social Security disability benefits discourage you from appealing. For more information see Advice for appealing a denial of Social Security disability benefits.

Assistance is available

If you are not already represented by a Riverside County or San Bernardino County Social Security disability lawyer and want our evaluation of your case, give us a brief description of your claim using the form to the right. Or contact us at:

Medlegal Disability
Gilbert & Bourke, LLP
Palm Springs Social Security disability attorneys

E-mail us
Phone: 760-327-1285
Fax: 760-327-1160

225 South Civic Drive, Suite 213
Palm Springs, California 92262

Areas Served: We handle Social Security disability claims for claimants from Palm Springs and surrounding areas.