Understand the Reasons for Denial

The first step after being denied disability benefits is to carefully review the denial notice you received from the Social Security Administration (SSA). The notice will explain the specific reason(s) your claim was denied. Common reasons for denial include:

• Insufficient Medical Evidence: Your medical records might not have provided enough evidence to prove your disability.
• Earning Above Substantial Gainful Activity (SGA): If you are working and earning above a certain income threshold, the SSA may decide you are not disabled.
• Failure to Meet SSA’s Definition of Disability: The SSA has specific criteria for determining disability, and you may not meet these criteria.

Understanding the reasons for your denial will help guide your next steps and ensure you address the issues raised in your claim.

File a Request for Reconsideration

If your disability claim is denied, your next step is to request a reconsideration. A reconsideration is the first level of appeal, where the SSA will review your claim again, considering any new evidence or information you provide.

• Time Frame: You must file for reconsideration within 60 days of receiving your denial notice. Failing to do so may result in the loss of your right to appeal.
• New Evidence: If you have additional medical records or other supporting documents that were not included in your original application, now is the time to submit them.

During reconsideration, an SSA representative will review your claim, medical evidence, and any new information you provide. They may approve your claim, or it may be sent to the next level if still denied.

Request a Hearing Before an Administrative Law Judge (ALJ)

If your claim is denied during reconsideration, you have the right to request a hearing before an Administrative Law Judge (ALJ). This is an essential step, as it gives you the opportunity to present your case in person.

• Hearing Request: You can request a hearing within 60 days of receiving the reconsideration denial.
• In-person Hearing: During the hearing, you will be able to testify about your condition, present additional evidence, and have a lawyer or representative present to support your case.

At the hearing, the ALJ will evaluate your medical records, testimony, and any new evidence to determine whether you meet the SSA’s disability criteria. It’s important to be fully prepared for the hearing to maximize your chances of success.

Appeal to the Appeals Council

If your hearing before the ALJ results in a denial, you can appeal the decision to the Appeals Council. The Appeals Council reviews the ALJ’s decision to determine if there were any errors in the process or if the decision was not supported by the evidence.

• Request: You must request an Appeals Council  review within 60 days of receiving the ALJ’s decision.
• Review Process: The Appeals Council may either uphold the ALJ’s decision, send the case back for further review, or, in rare cases, reverse the decision.

If the Appeals Council denies your case or does not agree to review your claim, you can take your case to the final level of appeal.

Take Your Case to Federal Court

If the Appeals Council denies your claim or refuses to review your case, the final option is to take your case to federal court. You will need to file a lawsuit in a federal district court, where a judge will decide whether the SSA’s decision to deny your claim was legally correct.

• Time Frame: You must file the federal court appeal within 60 days of receiving the Appeals Council’s decision.
• Legal Representation: This stage of the process can be complex, and it is highly recommended that you seek assistance from a qualified disability lawyer who is experienced in federal court appeals.