I’ve Been Sick My Whole Life. How Could Social Security Deny My Claim?

We’ve said it many times, but it still bears repeating: the road to winning Social Security Disability benefits is long and difficult to navigate.

In Illinois, the denial rate for initial disability claims hovers between 60% to 70%. It is especially discouraging to be denied disability benefits when you have been dealing with an illness for your entire life.

A denial does not mean your impairment isn’t severe or real. There are several common reasons the Social Security Administration (SSA) denies a disability claim.

• Your Disability Doesn’t Meet SSA Rules. To be awarded benefits you must prove that your impairment prevents you from engaging in substantial gainful activity (SGA). SGA describes a level of work activity and earnings. In general, if you are working and earning more than $1620 gross per month (in 2025), you are engaging in SGA. Our disability lawyers in Chicago are often asked how Social Security could deny a case if a person has been sick their whole life and their own doctor states that they are “unable to work” or “disabled.” The reason is that the word “disabled” can mean different things to different people and even to different parts of the government. But the only definition that counts for qualifying for disability benefits is the one applied by the Social Security Administration: the inability to engage in SGA due to a mental or physical impairment which has lasted or is expected to last 12 months or more.
• Insufficient Medical Evidence. The secret to winning your disability case is strong medical evidence documenting your disability and how it prevents you from working. Medical evidence takes many forms, including bloodwork panels; imaging studies like MRIs, CAT scans, and X-rays; physician examination and treatment notes; and mental health records. Also, just having historical evidence often isn’t enough, as Social Security will not assume your problems are ongoing. You will need up-to-date medical records to show the current state of your condition, and you will also need a history of how the condition has progressed. Your doctor should also explain how your medical conditions limit your ability to work. This is usually done using a form called the “Residual Functional Capacity” (RFC) form. The RFC form is separate from the medical records and helps your doctor explain your limitations. To decide whether you qualify for Social Security Disability benefits, the SSA will consider the RFC form along with other medical evidence.
• Failure to Follow Prescribed Treatment. One of the most common reasons for denial is when claimants do not regularly see medical professionals for their disabling conditions, or when they do not follow all prescribed treatments. This kind of denial is often completely avoidable.
• Potential for Other Work.  If the SSA believes you can perform work other than your previous occupation, despite your lifelong illness, they will likely deny your claim. “Other work” in the context of Social Security Disability refers to any job in the national economy that a claimant for disability benefits may be able to perform, considering their age, education, work experience, and their residual functional capacity—meaning their remaining ability to work despite their health limitations.
• Failure to Respond to SSA Requests. The SSA may deny your claim if you don’t respond or if you miss deadlines regarding requests for additional information, if you don’t attend medical examinations they schedule for you, or if you don’t provide necessary releases for medical records.
• Insufficient Work Credits. To be eligible for Social Security Disability Insurance (SSDI) you need a certain number of work credits earned through taxes paid on your wages. If you haven’t worked long enough or recently enough, your claim may be denied. However, if you have limited income and resources, you may still be eligible for Supplemental Security Income (SSI). 

If your claim has been denied, don’t be discouraged. You have the right to appeal the decision. Consider working with a disability attorney  to represent you in the application or appeals process.

Statistics show that if you have a Social Security Disability lawyer, you are more likely to win your disability case. Chose a lawyer who focuses exclusively on Social Security Disability benefits.

Winning disability benefits takes a smart, tough and persistent team. For a free evaluation of your case contact us at Nash Disability Law in Chicago.