Four Reasons Social Security Disability Claims for Mental Illness Get Denied

The top 4 reasons Social Security Disability Claims for Mental Illness get denied are:

1. Poor treatment notes.
2. Lack of mental health treatment.
3. Failure to follow your doctor’s orders.
4. Not satisfying the one-year rule.

Social Security disability attorney Nick Ortiz provides more detail on these issues below.

Common Reasons the SSA Denies Claims for Mental Health

Your Medical Records Are Illegible or Don’t Provide Enough Information

One of the biggest problems we face in a disability claim for a mental illness is the fact that many mental health providers (psychologists, psychiatrists, counselors, etc.) keep relatively poor notes. Sometimes, the notes are too abbreviated to collect helpful information. Some mental health providers still prefer to keep notes by hand. Sometimes, the medical records will be illegible and impossible to read. 

Brief medical evidence is unhelpful for the Social Security Administration (SSA) when evaluating the extent and severity of the underlying mental illness and in trying to determine your eligibility to receive disability benefits. If your medical records provide little detail regarding your impairment and related limitations, it may help to ask your doctor, psychiatrist, or other mental health providers to provide a summary of their notes that you can submit in support of your claim.

You Are Not Receiving Treatment For Your Mental Illness

All too often, we encounter disability claimants who have filed a claim for mental illness, but there is no record of mental health treatment for the condition(s) listed on the disability application. This is especially true in disability claims involving depression. This is most frequently because the claimant’s family care physician has diagnosed depression and prescribed a common antidepressant. The claimant may not have been referred to a mental health specialist such as a psychologist or psychiatrist. In such instances, the claimant will often not have sufficient mental treatment records to support the disability claim.

You Are Not Following Your Doctor’s Recommendations

In some cases, a mental health provider will recommend a course of treatment like counseling sessions or group therapy, and such recommendations are noted in the claimant’s medical records. However, the claimant refused to attend counseling or failed to show up for group therapy.

Later, treatment notes will document that the claimant was “non-compliant” with the recommended treatment plan. Non-compliance with your doctor’s treatment plan increases the chance of the claim being denied.

In other instances, the medical records will show that a claimant has been diagnosed with a specific mental impairment and has been prescribed medication for the illness. Still, records may further note that the claimant has not taken the medication.

This is a massive problem for mental disability claims because the Social Security Administration (SSA) focuses on what a claimant is still able to do despite the limitations of their condition. A claimant’s limitations cannot be accurately measured if they are not taking their medications as prescribed, and the chance of being approved for benefits decreases dramatically.

You Do Not Satisfy the One-Year Rule Due To Episodic Illness

Some Social Security disability claims are denied based on duration. This means that a disability examiner or ALJ has concluded that the applicant’s condition has not lasted at least one year or is not expected to last for one year. This is especially problematic in a disability claim with a medical condition that tends to “cycle,” (where the condition switches between getting better and getting much worse with regularity). This is an issue in both claims based on a mental condition (like bipolar disorder) and in claims involving a physical disorder (such as lupus).

Improve Your Chances of Being Approved by Working with a Social Security Disability Lawyer

Due to the challenges described above, many people hire a disability lawyer to represent them in their Social Security disability claims. If you cannot work, or your doctor has recommended that you file a claim for disability benefits, we can help. Nick A. Ortiz is a Social Security disability attorney representing claimants nationwide. We assist Social Security disability claimants during the trial phase, from the initial application through a hearing before an Administrative Law Judge (ALJ).

We will not only assist you in obtaining all of your medical evidence—we also prepare custom medical source statements that are specific to your mental health condition. If you would like to learn more about how an experienced disability attorney at the Ortiz Law Firm can help with your disability benefits claim, we encourage you to call our office at (888) 321-8131 or complete our contact form to schedule your free case evaluation.