How to Appeal After Your Disability Claim Is Denied
A denial of Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits does not necessarily mean that the claim is over. Social Security provides several levels of review for applicants who disagree with a decision.
The correct next step depends on the stage of the claim and the type of decision received.
Review the Denial Notice
Begin by reading the entire denial notice. It should explain:
- Why the claim was denied
- The date of the decision
- The type of appeal available
- How to request the appeal
- The deadline for responding
Keep the notice and envelope with your disability records. The decision date is important when calculating the appeal deadline.
Do Not Miss the Appeal Deadline
An appeal generally must be requested within 60 days after receiving the decision. Social Security normally assumes that the notice was received five days after the date shown on it unless the applicant can demonstrate otherwise.
If the deadline has passed, contact Social Security promptly. You may submit a written request for additional time and explain why the appeal was late. Social Security decides whether the reason is sufficient to extend the deadline.
The Four Levels of Appeal
1. Reconsideration
Reconsideration is usually the first level of appeal after an initial application is denied. A new reviewer examines the existing claim and any additional evidence. The reviewer was not involved in the original determination.
Additional information may include updated medical records, new test results, recent treatment, medication changes, and clearer descriptions of work-related limitations.
2. Hearing Before an Administrative Law Judge
If reconsideration results in another denial, the applicant may request a hearing before an administrative law judge.
The judge reviews the evidence and may ask questions about:
- Medical conditions and symptoms
- Treatment and medications
- Daily activities
- Previous employment
- Physical and mental limitations
- The ability to perform past or other work
Medical or vocational experts may also testify.
3. Appeals Council Review
If the hearing decision is unfavorable, the applicant may request review by the Appeals Council.
The Council may:
- Deny the request for review
- Dismiss the request
- Issue its own decision
- Return the claim to an administrative law judge for further action
The Appeals Council generally focuses on whether the hearing decision followed applicable law and was supported by the record.
4. Federal Court Review
After the administrative appeal process has been completed, an applicant may be able to file a civil action in federal district court.
Federal court review involves formal legal rules, procedures, filing requirements, and deadlines. Consider obtaining advice from a qualified legal professional before proceeding at this stage.
Update the Medical Evidence
An appeal provides an opportunity to add relevant information that was missing or unavailable during the earlier review.
Possible updates include:
- Recent treatment records
- New diagnoses
- Laboratory or imaging results
- Hospital or emergency-room records
- Medication changes and side effects
- Statements describing functional limitations
- Information about unsuccessful work attempts
Continue receiving appropriate medical care and keep Social Security informed about new treatment providers.
Explain How Your Condition Limits Your Ability to Work
Medical records should document the condition, but the claim should also explain how symptoms affect work-related activities.
Describe limitations involving:
- Sitting, standing, and walking
- Lifting, carrying, and reaching
- Concentrating and remembering
- Following instructions
- Interacting with other people
- Managing workplace stress
- Completing tasks consistently
- Maintaining regular attendance
Use specific and accurate examples rather than general statements.
Keep Records of the Appeal
Save copies of all documents and confirmation records, including:
- Appeal forms
- Medical evidence
- Submission receipts
- Fax confirmations
- Online confirmation pages
- Letters from Social Security
- Notes from telephone conversations
If you submit an appeal online, make sure you complete the final submission step and save the confirmation.
Keep Contact Information Current
Notify Social Security if your mailing address, telephone number, or email address changes. Missing an important letter, examination notice, or hearing notice may affect the claim.
Respond promptly to requests for additional information.
Take the Next Step After a Denial
Disability appeals involve strict deadlines and detailed medical and vocational information. Understanding the reason for the denial and submitting accurate, updated evidence may help Social Security conduct a more complete review.
Contact us to request general information about reconsideration, disability hearings, Appeals Council review, and possible next steps.
