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Appealing a Social Security Disability Insurance claim denial

Oct 27, 2023 |

If you apply for Social Security Disability Insurance (SSDI) and your claim is denied, you have several options available to address it.

Reasons for denial

Your claim may be denied for several reasons. One of the most common reasons a claim is denied is for lack of medical evidence, specifically medical records to support that you have a disability and its impact on your ability to work.

Also, if you are evaluated by a physician who gives you a treatment plan to follow and you fail to do so, SSDI may deny your claim. This is because SSDI may conclude that if you had proper treatment, you may recover and not need benefits.

SSDI will also consider whether your disability is expected to be long term. If SSDI finds that your disability will last less than 12 months, it may deny your claim because benefits are intended for claimants with permanent disabilities.

Your claim may also be denied if your application is incomplete, if you exceed certain income and asset limits, or if SSDI makes an administrative error.

SSDI appeals process

If your claim is denied, you can request a reconsideration by a representative at the Social Security Administration who did not make the initial decision. This representative may ask you to submit additional documentation to help their review.

If the reconsideration is not successful, you can request a hearing with an Administrative Law Judge (ALJ). The ALJ will hold a hearing where you can present evidence. The ALJ will review your case and decide whether to overturn the denial.

If you need to escalate the claim further, you may request a review by an Appeals Council who will review the ALJ’s decision and finally, if that is not successful, you can go to court.