Understanding Why Your Claim Was Denied

The first step after receiving a denial is to understand why the Social Security Administration (SSA) denied your claim. The SSA typically sends a detailed notice explaining the reason for the denial. Common reasons for denial include:

• Lack of medical evidence: The SSA may have determined that you didn’t provide enough medical records or documentation to prove that your condition meets their disability requirements.
• Not meeting the SSA’s work history requirements: For Social Security Disability Insurance (SSDI), you must have worked a certain number of years and paid into Social Security.
• Failure to meet the SSA’s definition of disability: The SSA may decide that your disability is not severe enough to prevent you from working or that you are still able to perform some form of work.
• Financial eligibility issues: For Supplemental Security Income (SSI), the SSA may have determined that you do not meet their income or asset limits.

Knowing the reason for the denial will help you address the issue in the next steps.

What Are Your Options After a Denial?

If you’ve been denied Social Security Disability benefits, you have several options:

Option 1: Request Reconsideration

• After receiving a denial, the first step in the appeals process is to request reconsideration. This means that a different SSA official will review your claim and any additional evidence you provide.
• Timeline: You have 60 days from the date you receive the denial letter to request reconsideration. If you miss this deadline, you may have to start the process from the beginning.
• How to Request: You can request reconsideration online, by phone, or by mailing the necessary forms to the SSA. Be sure to include any new medical records or updated evidence that may strengthen your case.

Option 2: Request a Hearing Before an Administrative Law Judge (ALJ)

• If your reconsideration is denied, you can request a hearing before an Administrative Law Judge (ALJ). This is a more formal review process where you will have the chance to present your case in person.
• Prepare for the Hearing: The ALJ will review your medical records, work history, and other relevant information. If needed, you can present new evidence or testify about how your disability affects your ability to work.
• Representation: While you can represent yourself, it’s strongly recommended to have an experienced disability lawyer help you prepare for the hearing. Legal representation can significantly improve your chances of success.

Option 3: Appeal to the Appeals Council

• If the ALJ denies your claim, the next step is to request a review by the Appeals Council. The council will evaluate whether the ALJ made an error in their decision.
• Possible Outcomes: The Appeals Council can either approve your claim, send it back for a new hearing, or deny the appeal. If your claim is denied at this stage, you can still take it to federal court.

Option 4: File a Lawsuit in Federal Court

• If your claim is denied by the Appeals Council, you can file a lawsuit in federal court. This is the final stage in the appeals process, and you’ll need to work with a disability attorney who can guide you through the legal process.