Step 1: Don’t Panic—Understand Why You Were Denied

The first step is to carefully review the denial notice you received from the Social Security Administration (SSA). This notice will explain the specific reason for your denial. Common reasons for disability denials include:

• Insufficient medical evidence: The SSA may feel that your medical records don’t fully support the severity of your disability.
• Failure to meet SSA’s definition of disability: Your condition may not be severe enough, or it may not meet the SSA’s criteria for a disability.
• Inability to prove you are unable to work: If you’re still able to perform substantial gainful activity (SGA), you may not qualify for benefits.
• Not meeting the work history or income requirements: For SSDI, you must have worked a certain number of years and paid into Social Security. For SSI, your income and resources must be below certain limits.

Understanding the exact reason for the denial will help you determine the best course of action moving forward.

Step 2: File a Request for Reconsideration

If you’re denied, the next step is to request reconsideration. This is the first level of appeal and allows you to have your case reviewed by a different examiner. You can request reconsideration online, over the phone, or by mail. During this review, the SSA will examine your case again, including any additional information or documentation you provide.

The reconsideration process typically takes around 4 to 6 months. While you’re waiting, you can continue to gather more medical evidence to strengthen your case, such as updated doctor’s notes or additional test results.

Step 3: 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). This is a formal process where you’ll have the opportunity to present your case in person, and the judge will review all the evidence in your file.

• Prepare for the hearing: It’s important to be well-prepared for your hearing. You can submit additional evidence, such as updated medical records or new testimonies from doctors. Your lawyer can help you prepare and ensure your case is as strong as possible.
• Be ready to testify: During the hearing, you will be asked about your condition, how it affects your daily life, and your ability to work. Your testimony, along with medical evidence, will be critical to your case.

A hearing can take several months to schedule, so you’ll need to be patient. The judge will issue a decision after the hearing, and you’ll receive their ruling in writing.

Step 4: Appeal to the Appeals Council

If the ALJ denies your claim, you can request a review from the Appeals Council. The Appeals Council will look at the ALJ’s decision and determine whether any legal errors were made. They can either:

• Approve your claim: If they find that the ALJ made an error, they may approve your benefits.
• Send your case back to the ALJ: If the Appeals Council finds procedural errors, they may send your case back to the ALJ for a new hearing.
• Deny your request: If they uphold the ALJ’s decision, your case will be closed, and you’ll be left with the option to pursue further legal action.

The Appeals Council review can take several months, and not all cases are accepted for review. However, this step is important if you believe the ALJ made a mistake.

Step 5: Take Your Case to Federal Court

If the Appeals Council denies your request, you can file a lawsuit in federal court. This is the final step in the appeals process. You’ll need a lawyer to help you with this step, as it involves complex legal procedures and rules. A federal judge will review the entire record of your case, including the SSA’s decisions, and determine whether the decision was made in error.

A federal court lawsuit can be a lengthy process, but if successful, the court may order the SSA to approve your claim, award benefits, or send the case back to the SSA for further review.

Step 6: Consider Getting Legal Help

While it’s possible to go through the appeals process on your own, it’s highly advisable to get legal help. A disability attorney can:

• Review your case: They’ll help you understand why you were denied and guide you on the best way to proceed.
• Help you gather more evidence: An attorney can assist with obtaining additional medical documentation or expert testimony to strengthen your case.
• Represent you at hearings: A lawyer can represent you at ALJ hearings, ensuring you present your case effectively and make the strongest argument possible.
• Improve your chances of success: Studies show that claimants who have legal representation are more likely to win their cases, especially during the hearing and appeals stages.

Many disability attorneys offer free consultations and work on a contingency basis, meaning you only pay if you win your case.