What Is Errors and Omissions
Errors and omissions in your Social Security disability claim refers to mistakes made by the SSA, your representative, or medical providers that affect your case outcome. These can include missing medical records, incorrect wage calculations, overlooked evidence submitted to the file, procedural violations, or faulty medical assessments by the agency's consulting physicians. An error is something done wrong. An omission is something that should have been done but wasn't.
How Errors Affect Your Claim
The SSA denies approximately 65-70% of initial SSDI and SSI applications. Many denials stem from incomplete medical evidence rather than the strength of your actual condition. When errors and omissions occur, they can be grounds for remand (sending your case back for reconsideration) or reversal of an unfavorable decision.
Common errors in disability cases include:
- The SSA's doctor writing a consultative examination report without reviewing all your medical records, leading to incomplete findings about your functional limitations
- Missing pages from your treatment history that contradict the denial decision
- Incorrect calculation of your Primary Insurance Amount (PIA), which determines your monthly benefit
- The SSA failing to request updated medical evidence before issuing a denial
- An Administrative Law Judge (ALJ) not addressing specific medical evidence you presented at your hearing
- Your representative failing to submit supporting medical records before the hearing date
Errors at Administrative Law Judge Hearings
ALJ hearings reverse roughly 60% of initial denials nationwide, though reversal rates vary by judge and region. When an ALJ makes errors in your hearing, you have grounds for appeal to the Appeals Council. Reviewable errors include an ALJ who fails to properly evaluate medical expert testimony, ignores your statements about pain or functional limitations, or bases a decision on assumptions rather than evidence in the medical record. An ALJ's error can also occur if they apply outdated listings from the SSA's Blue Book (the Listing of Impairments) or misapply the sequential evaluation process required by law.
Omissions and Back Pay
Omissions can directly reduce your back pay award. Back pay is calculated from your date of disability (the date you claim your condition became disabling) to your approval date. If the SSA omits medical records showing you were disabled earlier than they determined, or if your representative fails to argue for an earlier onset date, you lose monthly payments you were entitled to receive. An average SSDI benefit in 2024 is approximately $1,550 per month. A one-year error in back pay dating could cost you $18,600 or more.
What You Can Do
- Keep copies of every medical record you submit to the SSA. Request a copy of your SSA file to compare your submitted records against what the agency actually has on file
- If your claim is denied, request the SSA's case file through an FOIA request to identify what evidence they considered and what they may have missed
- If you worked with a representative and believe they made errors, you can file a complaint with your state's disability advocate office or the SSA's Office of Inspector General
- At an ALJ hearing, have your medical providers send treating records directly to the hearing office before your hearing date in writing
- Ask your representative to request a continuance (delay) if critical medical evidence arrives after your hearing date to ensure the ALJ considers it
Common Questions
- If the SSA made an error on my claim, can I get it fixed? Yes. If the error occurred at the initial or reconsideration stage, you can appeal to an ALJ hearing where the error can be addressed. If the error happened at the ALJ level, you can appeal to the Appeals Council. For errors affecting your back pay amount, you can request an overpayment waiver or correction even after approval.
- How do I prove my representative made an error? Document the specific action or inaction (such as missing the hearing date, failing to submit medical records before the deadline, or misrepresenting your medical condition). Compare what they did to what a qualified representative should have done. You can file a complaint with the SSA and pursue a malpractice claim if you suffered financial harm.
- Can an ALJ's error automatically get my claim approved? Not automatically. An ALJ error is grounds for remand to a new ALJ for reconsideration. The new ALJ will review the case without the error, but approval depends on whether the evidence supports disability under SSA standards, not just that an error occurred.