Step 1: Understand Why Your Claim Was Denied

The first step after a denial is understanding why the SSA denied your claim. Some common reasons for a disability claim denial include:

• Insufficient Medical Evidence: The SSA didn’t have enough medical documentation to prove that you are disabled according to their criteria.
• Failure to Meet Eligibility Criteria: You may not meet the SSA’s work history requirements or income limits for SSI (Supplemental Security Income) or SSDI (Social Security Disability Insurance).
• Not Severe Enough Condition: The SSA may have decided that your medical condition doesn’t meet the severity required to be considered a disability under their rules.
• Earnings Above the Substantial Gainful Activity (SGA) Limit: If you are earning more than a certain amount per month, the SSA may decide you are not disabled because you are able to work.
• Failure to Follow Treatment: If you failed to follow prescribed treatments or medical advice, the SSA may determine that your disability is not severe enough to prevent you from working.

Understanding the reason for the denial will help you determine your next steps.

Step 2: Review Your Denial Letter

When the SSA denies your disability claim, they will send you a denial letter that includes the exact reason your application was rejected. Carefully review the letter to:

• Understand the specific reason(s) for denial.
• Identify any missing documentation or information.
• Note the appeal deadline (typically 60 days from the date of the letter).

If you’re unsure about the details, you can contact the SSA for clarification.

Step 3: File an Appeal (Reconsideration)

If your disability claim is denied, you have the right to appeal the decision. The first step in the appeals process is Requesting Reconsideration, where the SSA will review your case again with new or additional evidence. Here's how to proceed:

Request Reconsideration

• How to Request: You can file for reconsideration online through your mySocialSecurity account or by calling the SSA. You can also visit your local SSA office.
• What to Include: You may need to submit additional medical records, updated information, or any other relevant documentation that could strengthen your case.
• Timeline: It may take 3-5 months for the SSA to complete the reconsideration process.

During reconsideration, the SSA will review all your documentation again to determine whether the original decision was correct.

Step 4: Request a Hearing Before an Administrative Law Judge (ALJ)

If your reconsideration is denied, the next step is to request a hearing before an Administrative Law Judge (ALJ). A hearing provides an opportunity for you to present your case in person. The ALJ will review all evidence and make an independent decision.

How to Request a Hearing

• Requesting the Hearing: You can request a hearing within 60 days from the date of your reconsideration denial. You can request the hearing online or through the SSA.
• Prepare for the Hearing: It’s important to gather additional evidence and organize your case before the hearing. You may also want to hire a disability lawyer to help you prepare.

What Happens at the Hearing

During the hearing, you’ll present any additional evidence, including testimony from medical experts or witnesses. The ALJ will ask questions to better understand your condition and how it impacts your ability to work. The judge will then make a decision, which can take several weeks to a few months.

Step 5: Appeal to the Appeals Council

If the ALJ denies your case, you can further appeal the decision to the Appeals Council. The council will review your case and determine if the ALJ made any errors in the decision-making process.

How to Appeal to the Appeals Council

• Requesting the Appeal: You must request an appeal within 60 days of receiving the ALJ’s decision.
• What to Expect: The Appeals Council will decide whether to review your case and issue a ruling. They can either uphold the ALJ’s decision, return the case for further review, or overturn the decision in your favor.

The Appeals Council may take several months to make a decision, but it is one of the last steps before moving to a federal court.

Step 6: Consider Taking Your Case to Federal Court

If the Appeals Council denies your case, you can file a lawsuit in federal court. This is typically the final step in the appeals process, but it is not common.

How to File a Lawsuit

• Filing in Court: You will need to file a complaint in the federal district court within 60 days of receiving the Appeals Council’s decision.
• Legal Assistance: At this stage, it’s highly recommended that you work with an attorney who specializes in Social Security Disability cases.

The court will review your case to determine if there was an error in the SSA’s decision. If the court rules in your favor, your case will be sent back to the SSA for further review.

Step 7: Seek Help from a Disability Lawyer

If you haven’t already, now is a good time to consult with a disability lawyer. A lawyer can:

• Review your denial letter to help you understand the reason for the denial.
• Help you file your appeal and guide you through the process.
• Represent you at the hearing to present the best possible case.
• Ensure you meet all deadlines and submit the proper documentation.

An attorney can significantly improve your chances of success and help ensure that your case is handled correctly.

Step 8: Be Persistent and Stay Organized

The disability claims process can be lengthy and stressful, but persistence is key. Make sure to:

• Meet all deadlines for appeals and requests.
• Keep copies of all documents you send to the SSA, including medical records, letters, and forms.
• Stay organized by keeping a timeline of the appeals process and tracking any communication from the SSA.