Social Security Disability Insurance
Written by: Bruce L. Weider | 8.02.2023

How To Appeal An SSDI Denial

If you were recently denied Social Security disability benefits, you might be wondering how to appeal an SSDI denial. The appeal to an SSDI denial may progress through several distinct stages, all that have slightly different processes for appealing. An experienced lawyer from Bruce L. Weider, PC can walk you through the process of appealing your SSDI denial. Consider contacting us for a confidential consultation by calling (734) 485-0535.

Common Reasons for SSDI Denial

According to the Social Security Administration (SSA), 78% of initial applications for disability benefits are rejected. Approximately 11% of applications are approved through the appellate process.

There are many reasons why an application for SSDI benefits may initially be rejected, such as:

  • The application was incomplete or missing information necessary to determine eligibility
  • The applicant works full-time or earn more than the substantial gainful activity limit
  • The applicant has failed to cooperate by not providing additional information SSA requested
  • The applicant has not been disabled long enough
  • The application was previously denied, and the applicant has resubmitted the same application
  • The applicant has failed to seek necessary medical treatment
  • The applicant has not followed their medical provider’s directions
  • The application has not submitted sufficient medical evidence to establish a qualifying disability

The letter you received from the SSA should state the reason(s) why your claim was denied. Carefully review this communication. You may also wish to consider consulting with an attorney who specializes in Social Security disability cases and asking them to review your file with you.

Stages of the Appeal Process

There are several stages in the SSDI appeal process. These are sequential, meaning that an applicant cannot move on to the next level of appeal until they have first attempted to have the decision reversed at the previous step(s).

The stages of appeal are:

  • Request for Reconsideration: A request for reconsideration asks the SSA to review the determination made by the initial examiner.
  • Request for Hearing: If you disagree with the reconsideration decision, you can request a hearing in front of an administrative law judge.
  • Appeals Council Review: If you disagree with the administrative law judge’s decision, you can ask for an Appeals Council Review. If this request is granted, a panel will review your file and issue a decision. However, the Appeals Council does not have to agree to hear your case.
  • U.S. District Court case: If the denial was upheld or the Appeals council denied your request for review, you can file a civil suit in the U.S. district court where you reside.

There is typically a 60-day time limit to file any of these appeals, starting from the date you received the letter indicating the denial. The SSA assumes you receive the notice within five days of the date on the letter unless you provide evidence showing you received the letter after that date.

How To Appeal an Adverse Decision

How you appeal an SSDI denial may require requesting an appeal in writing and/or completing a specific form, depending on which stage of the appeal process you are in. An experienced Social Security disability benefits lawyer from Bruce L. Weider, PC may be able to help you navigate any or all of these stages.

Social Security Disability Denied Initial Application

If your initial application was denied, you will need to file a written request for reconsideration. You can complete Form SSA-561 for this purpose. You will also need to submit Form SSA-3441 and SSA-827 to provide information about your appeal and release your private medical information to the SSA.

Social Security Disability Denied at Reconsideration Level

Applicants who are denied Social Security disability benefits at the reconsideration level, will need to submit Form HA-501 to request a hearing by an administrative law judge. This form may be submitted to your local Social Security Office or via a secure online portal the SSA provides for SSDI appeals.

Social Security Disability Denied at Administrative Hearing

Applicants whose SSDI appeal is denied in the administrative law judge’s decision will need to complete Form HA-520. This form may be submitted to the Social Security Appeals Council either by mail or, again, through the SSA‘s online portal.

Social Security Disability Denied by Appeals Council

If the Appeals Council refuses to review the administrative law judge’s decision, or the Appeals Council’s decision is unfavorable, an applicant still can file a civil claim in the federal district court in their district of residence. In this instance, the SSA simply links to the United States Courts’ map of federal circuits, which applicants can use to determine in which district they should file. Applicants can also call the SSA at 1 (800) 772-1213 for questions about the appellate process or to request the necessary forms.

What To Do During Your Appeal

The full appeal process can take years to complete. Fortunately, there are steps you can take to help your claim while you wait for the case to be resolved, such as:

Continuing Your Care

Whether or not you are eventually approved for benefits, your health is the priority. Continue receiving medical care and following your providers’ advice. While it can be difficult to afford care when your ability to work is limited, the SSA will want to see that you sought treatment and followed your doctor’s orders. Research free or low-cost care in your area to try to maintain a continuation of care. See if you qualify for low-cost or free insurance to help ease the financial burden. In some cases, local hospitals, clinics, or doctor’s offices may provide additional financial support. 

Build Your Claim

With additional time, you may be able to obtain additional evidence to support your claim and improve your odds of a successful appeal. Applicants can submit new evidence at the hearing level as long as they provide the SSA with notice of this evidence at least five business days before the hearing.

Potential additional evidence might include:

  • Detailed reports from your primary care physician
  • Medical test results and screening results
  • Notes and new diagnoses from specialists
  • Consultative exam reports
  • Written statements from colleagues, friends, and family members about how your condition affects you

A Social Security disability benefits lawyer may be able to advise you on other types of information that could be useful in supporting your particular claim.

Work With a Social Security Disability Benefits Lawyer

Many people who have been denied Social Security disability benefits prefer to navigate the complex appeals process with the advice and support of an attorney. If you do work with an attorney, stay in contact with this person throughout the process. Update your lawyer with any major changes in your condition or status. Call if you have any questions about the status of your case or next steps.

Get Help With Your SSDI Appeal

If your application for SSDI benefits was recently denied, you might have questions about how to appeal an SSDI denial. Fortunately, you do not have to find the answers to these questions all alone. An experienced lawyer from Bruce L. Weider, PC can review your case with you, including the reasons given for Social Security disability benefits denial, and help you to understand your next steps. Reach out to us today at (734) 485-0535 to schedule a free consultation to discuss your case.

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