Common Reasons Social Security Disability Claims Are Denied in California
Getting denied for Social Security Disability benefits can be frustrating and confusing, especially when your health prevents you from working. In California, including Sacramento, about 65-70% of initial SSDI (Social Security Disability Insurance) and SSI (Supplemental Security Income) claims are denied. Understanding the most common reasons can help you avoid mistakes and strengthen your application or appeal.
This guide covers the top reasons claims are denied in California, with local insights for Sacramento applicants, and practical tips to improve your chances.
1. Insufficient Medical Evidence
The #1 reason for denials nationwide and in California: Not enough proof that your condition is severe and limiting.
The SSA needs objective medical evidence (tests, exams, imaging) showing your impairment meets their strict criteria. Subjective complaints alone aren't enough.
In Sacramento, claims involving common conditions like back pain, fibromyalgia, or mental health issues are frequently denied for lack of detailed records from providers like UC Davis Health or Sutter.
Tip: Provide records from all treating sources and consider a Residual Functional Capacity (RFC) form from your doctor.
2. Failure to Follow Prescribed Treatment
If you don't follow your doctor's recommendations (medications, therapy, etc.), the SSA may deny your claim, assuming your condition isn't as severe.
Exceptions exist (e.g., can't afford treatment), but you must explain.
California Tip: Mental health claims in Sacramento are often denied here if therapy or meds are skipped without good reason.
3. Earning Too Much Income (Above SGA Levels)
If you're working and earning over the Substantial Gainful Activity (SGA) amount—$1,620 per month in 2025 for non-blind individuals—your claim will be denied, regardless of your condition.
Continuing to work despite pain can trigger a denial if earnings exceed SGA limits.
Many Sacramento applicants try part-time work but unknowingly exceed limits.
Tip: Stop working or keep earnings low before applying.
4. Your Condition Doesn't Meet SSA's Listing or Last Long Enough
The SSA has a "Blue Book" of listings for severe impairments. If yours doesn't match exactly or isn't expected to last 12 months, denial is likely.
Even if not listed, you can qualify if limitations prevent any work—but this requires strong evidence.
Chronic pain or mental conditions common in California often fall short without proving total disability.
5. Technical Denials (Non-Medical Reasons)
For SSI: Too many assets/resources (over $2,000 for individuals).
For SSDI: Insufficient work credits.
Other issues: Incomplete forms or missing deadlines.
Other Frequent Issues in California Claims
- Drug/alcohol abuse as a material factor (strict rules apply).
- Fraud suspicions or inconsistent statements.
- Not cooperating with SSA requests (e.g., missing consultative exams).
Sacramento DDS reviewers are thorough, so small inconsistencies can lead to denials.
How to Avoid These Common Denials in Sacramento
- Be detailed and honest in your application.
- Gather all medical evidence upfront.
- Get help early—many denials are preventable.
If denied, appeal within 60 days—most wins happen at the hearing level.
Get Professional Help to Overcome a Denial
A Sacramento Social Security Disability attorney can review your case, identify denial reasons, gather evidence, and represent you—no upfront fees (contingency only).
Studies show represented claimants have much higher success rates.
If your claim was denied or you're preparing to apply in Sacramento, don't go it alone.
At Disability Sacramento, we help local residents understand denial reasons, fix applications, and win appeals for SSDI, SSI, and Veterans benefits. Contact us for a free case review.
Visit disabilitysacramento.com today.
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