Understand Why Your Claim Was Denied

The first step after a Social Security Disability (SSD) denial is to understand the reasons for it. There are several common reasons claims are denied, including:

• Insufficient medical evidence: If your medical records do not adequately show the severity of your disability or how it affects your ability to work, your claim may be denied.
• Not meeting the SSA’s definition of disability: The Social Security Administration (SSA) has specific criteria for what qualifies as a disability. If your condition does not meet these criteria, your claim could be rejected.
• Failure to follow treatment plans: If the SSA sees that you are not following prescribed treatments or attending regular doctor visits, they may decide that your condition is not severe enough to warrant disability benefits.
• Earnings above the Substantial Gainful Activity (SGA) threshold: If you are working and earning above the SGA threshold (a certain amount of monthly income), the SSA may determine you are not disabled.

The denial letter from the SSA will explain the reason for the rejection. This is critical information for the next steps.

Review Your Denial Letter Carefully

After receiving your denial, review the denial letter thoroughly. This letter will provide you with important information about why your claim was denied, including the specific reasons for rejection. It will also explain your rights and how to proceed with the appeals process.

Request a Reconsideration

If your application was denied, the first step in the appeals process is to request a reconsideration. During this stage, your claim will be reviewed by a different SSA representative who was not involved in the original decision. The reconsideration process allows you to present new or additional information to strengthen your case. To request a reconsideration:

• Submit the appeal within 60 days: You must file for reconsideration within 60 days of receiving your denial letter. Failing to do so may result in your case being dismissed.
• Provide additional evidence: You can submit new medical records, updated treatment history, or letters from doctors that clarify the severity of your condition. This is your chance to strengthen your case.

Step 4: Prepare for a Hearing with an Administrative Law Judge (ALJ)

If your reconsideration is denied, the next step is to request a hearing before an Administrative Law Judge (ALJ). This is where you have the opportunity to present your case in person, with the support of medical professionals, family members, or other relevant witnesses. Here’s what you need to know about preparing for a hearing:

• Gather additional medical evidence: Before your hearing, make sure to collect the most up-to-date medical records that show the impact of your disability on your ability to work.
• Have expert witnesses: If possible, have medical experts testify on your behalf about how your disability affects your ability to function on a daily basis.
• Be prepared to testify: The ALJ will ask you about your disability, its limitations, and how it prevents you from working. Be honest and clear about the severity of your condition.

Consider Getting Legal Help

The disability claims process can be complex, especially if you’ve been denied. Hiring a disability lawyer can significantly improve your chances of success at each stage of the appeal process. A lawyer can:

• Help you understand the SSA’s requirements and ensure that your claim meets those standards.
• Gather and present medical evidence to support your claim.
• Represent you at your ALJ hearing, guiding you through the process and cross-examining any witnesses.
• Assist you with filing the appropriate forms and meeting deadlines.

Follow Up Regularly on Your Appeal

Once you’ve submitted your appeal, keep track of its progress. You can check the status of your case online through the SSA’s portal, or you can call their office for updates. Regular follow-up will ensure that you don’t miss any important deadlines or requests for additional information.

• Create an online account: Having a “my Social Security” account will allow you to monitor the status of your claim and receive updates about your case.
• Respond quickly to any requests: If the SSA requests additional information or documentation, make sure to respond promptly to avoid further delays.

Be Patient During the Appeals Process

The appeals process for Social Security Disability can take a considerable amount of time. It’s important to stay patient and persistent. While waiting for a hearing with an ALJ or a decision on your reconsideration, stay organized and keep all your medical records and supporting documents in one place.

What to Do If Your ALJ Hearing Is Denied

If you are denied after your hearing with the ALJ, don’t give up. You still have options to appeal the decision:

• Request a review from the Appeals Council: If the ALJ denies your claim, you can request a review from the Appeals Council. This is a panel of judges who will review the case to determine if the ALJ made an error.
• File a lawsuit in federal court: If the Appeals Council rejects your case, you can file a lawsuit in federal court to challenge the denial.