Why Are SSDI Claims Denied?

Your denial letter from the Social Security Administration (SSA) will explain the reason for your denial. Common reasons include:

• Lack of sufficient medical evidence proving disability
• The SSA believes you can do your past work or adjust to other work
• Your condition is not considered severe enough to prevent substantial gainful activity (SGA)

Understanding the specific reason for your denial is crucial for addressing weaknesses in your appeal.

When Should You Appeal?

You must file your appeal within 60 days of receiving your denial notice. Missing this deadline could require you to start a new application, delaying your benefits significantly.

The Four Levels of SSDI Appeals

1. Reconsideration

• What it is: A different SSA examiner reviews your entire claim and any new evidence you submit.
• How to request: You can request reconsideration online at www.ssa.gov, by phone at 1-800-772-1213, or at your local Social Security office.
• What to submit: Include new and updated medical records, test results, and detailed doctor statements explaining your limitations.

2. Hearing Before an Administrative Law Judge (ALJ)

• What it is: If reconsideration is denied, you can request a hearing before an ALJ.
• Why it matters: This is a critical stage where you can present your case in person or via video, provide testimony, and bring witnesses such as doctors or vocational experts.
• Preparation: Be prepared to explain how your disability prevents you from working and provide additional medical evidence supporting your claim.

3. Appeals Council Review

• What it is: If the ALJ denies your claim, you can request the Appeals Council to review the decision.
• Outcome options: The Appeals Council can uphold the decision, send it back for a new hearing, or reverse the decision.

4. Federal Court Review

• What it is: If the Appeals Council denies your request or upholds the ALJ decision, your final option is to file a lawsuit in federal district court.
• Note: This stage is complex and usually requires representation by an experienced disability attorney.

How to Strengthen Your Appeal

To improve your chances of approval:

• Continue medical treatment and obtain updated records
• Request detailed statements from your treating physicians about your limitations
• Document how your disability affects your daily life, work tasks, and functional abilities
• Submit all new evidence promptly with your appeal

Follow Up Regularly

After submitting your appeal:

• Monitor your appeal status through your my Social Security account
• Respond quickly to SSA requests for additional documents or information
• Keep copies of all forms, medical records, and correspondence for your records