Steps to Take When Social Security Denies Your Claim

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

The first thing to do when you receive a denial letter is to understand the reasons behind it. The Social Security Administration (SSA) will provide a detailed explanation of why your claim was denied. Common reasons for denial include:

• Insufficient Medical Evidence: The SSA may find that you didn’t provide enough medical documentation to prove the severity of your condition.
• Failure to Meet the Eligibility Requirements: If your condition doesn’t meet SSA’s definition of disability, or you haven’t worked enough to qualify for SSDI, your claim may be denied.
• Earnings Exceeding Substantial Gainful Activity (SGA): If you are earning above a certain threshold, the SSA may determine you are not disabled based on income.

Step 2: Review Your Denial Letter Carefully

The denial letter from the SSA will include important information about your case, including:

• The reason for the denial: Understand exactly why your claim was rejected.
• The deadline to file an appeal: You usually have 60 days from the date of the denial to file an appeal. Missing this deadline could result in your case being closed.

Step 3: File a Request for Reconsideration

If your claim is denied, you can start the appeals process by requesting a Reconsideration. This is the first level of appeal where a new examiner will review your case. Here’s how to proceed:

• Submit your Request for Reconsideration: Complete the necessary paperwork and submit it to the SSA within 60 days of receiving the denial letter.
• Provide Additional Evidence: You may be able to strengthen your case by submitting new or additional medical records, doctor’s statements, or other evidence that wasn’t included in your initial application.

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). This is an important step, as it allows you to present your case in person and potentially turn things around. During this hearing:

• You can testify about your condition: You’ll have the opportunity to explain your symptoms, limitations, and how your condition affects your daily life.
• Witnesses can testify: You can also bring witnesses, such as family members or medical professionals, to support your case.

Step 5: Gather Strong Medical Evidence

To increase your chances of success at the hearing, it’s essential to provide thorough medical documentation. This could include:

• Doctor’s Reports: Detailed notes from your treating physician explaining how your condition prevents you from working.
• Medical Test Results: X-rays, MRIs, blood tests, and other diagnostic results that show the severity of your condition.
• Statements from Specialists: If you see specialists, their reports can further support your claim.
  

Step 6: Consider Working with a Disability Lawyer

While you can navigate the appeals process on your own, many individuals choose to work with a disability lawyer, especially during the hearing stage. A lawyer can:

• Help gather medical evidence: Ensure that you have all necessary documentation to support your case.
• Prepare you for the hearing: Advise you on what to expect and help you present your case effectively.
• Represent you at the hearing: Provide legal expertise and advocate on your behalf during the hearing.

Step 7: Be Patient and Persistent

The appeals process can take time, so it’s essential to be patient. It’s common for cases to take months or even years to be resolved. While waiting, continue to gather evidence, stay organized, and respond to any SSA requests promptly.