Step 1: Understand Why Your Claim Was Denied

Before you appeal, it’s essential to understand why your Social Security Disability (SSD) or Supplemental Security Income (SSI) claim was denied. The SSA will send you a Notice of Disapproved Claim, which outlines the specific reason for the denial. Common reasons for denial include:

• Failure to meet medical criteria: The SSA determined that your condition doesn’t meet their disability requirements.
• Substantial Gainful Activity (SGA): You may be earning too much income to qualify.
• Lack of sufficient medical evidence: The SSA may have determined there isn’t enough documentation proving your disability.
• Inability to perform past work: The SSA might have found that you’re still capable of doing your previous job.

Once you identify the reason for denial, you can focus on addressing that specific issue during your appeal.

Step 2: Review the SSA’s Appeal Options

The SSA offers several levels of appeal if your disability claim  is denied:

• Reconsideration: This is the first level of appeal. A different SSA reviewer will evaluate your case, reviewing the same evidence you initially submitted, as well as any additional information you provide.
• Hearing before an Administrative Law Judge (ALJ): If your claim is denied during reconsideration, you can request a hearing before an ALJ. This is a more formal process where you can present additional evidence and testify.
• Appeals Council: If the ALJ denies your case, you can request a review by the Appeals Council. The Council will decide whether the ALJ’s decision was correct.
• Federal Court: If your case is denied by the Appeals Council, you can file a lawsuit in federal court.

Step 3: File Your Appeal on Time

To begin the appeal process, you must file your appeal within 60 days from the date you receive your denial notice. The SSA will allow an additional 5 days for mailing time. If you miss this deadline, you may lose the opportunity to appeal and have to start the process over.

To file your appeal:

• Online: You can request Reconsideration or submit your hearing request online via the SSA’s website.
• Phone: You can call the SSA at 1-800-772-1213 to discuss your appeal options.
• Mail: You can also file your appeal by mailing the appropriate forms to your local SSA office.

Step 4: Gather Additional Medical Evidence

One of the most important aspects of an appeal is providing new medical evidence that supports your claim. Here’s what you can do:

• Follow up with your doctor: Ask your doctor to provide updated notes, lab results, and any other medical records that show how your condition has worsened or how it limits your ability to work.
• Get additional tests: If your condition has worsened since your initial application, consider undergoing further tests or evaluations to support your claim.
• Consult a medical expert: A disability attorney can help you obtain opinions from medical experts that may help strengthen your case.

Step 5: Request a Hearing Before an ALJ

If your Reconsideration request is denied, you can request a hearing before an Administrative Law Judge (ALJ). This is an opportunity for you to present your case in person and provide new evidence. Here’s how to prepare:

• Submit Additional Evidence: Bring all new medical records, test results, and documentation to the hearing.
• Prepare Your Testimony: Be ready to explain your condition, how it affects your daily life, and why you can’t work. The judge will ask questions about your condition and how it limits you.
• Consider Representation: Although you can represent yourself, having a disability attorney at your hearing can greatly improve your chances of success. They can help you organize your case, cross-examine witnesses, and make legal arguments on your behalf.

Step 6: Be Prepared for the Appeals Council Review

If you’re denied after your ALJ hearing, you can request a review by the Appeals Council. The Council will determine whether the ALJ made an error in applying the law or whether the decision was reasonable based on the evidence. The review can take several months, and the Appeals Council may:

• Grant the appeal and send your case back for a new hearing.
• Deny the appeal and uphold the ALJ’s decision.
• Send the case back for further review if there are additional issues to be addressed.

Step 7: Take Legal Action in Federal Court

If the Appeals Council denies your case, you have one final option: filing a lawsuit in federal court. At this point, it’s highly recommended that you work with an experienced Social Security Disability attorney to help navigate the complexities of federal law.

Step 8: Seek Legal Help for Your Appeal

While you are allowed to represent yourself during an appeal, many people find that working with a disability lawyer can greatly improve their chances of success. A lawyer can help with:

• Reviewing your denial: A lawyer will go over the details of your denial to identify any weaknesses in the SSA’s reasoning and how to address them.
• Gathering evidence: They will assist in collecting medical records, obtaining expert opinions, and ensuring your case is as strong as possible.
• Preparing you for hearings: If you need to attend a hearing before an ALJ, a lawyer will guide you through the process, help you prepare your testimony, and represent you at the hearing.