If You've Been Denied Social Security Benefits
There is a good chance the Social Security Administration (SSA) will deny your initial application for Social Security disability benefits. After all, the SSA denies the majority of applications for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). However, it's worth considering an appeal. Many appeals result in a favorable decision granting SSDI benefits or SSI benefits.
Read the guide below for more information on the SSA's time-sensitive appeals process for SSI and SSDI applications. Also, see our main Social Security Disability index for more articles about the SSA's disability benefits programs.
Why Were You Denied Social Security Benefits?
First, take the time to read and understand the SSA's initial denial. If the decision is “unfavorable," this means the Disability Determination Services (DDS), a state agency, did not find that your medical impairment met the definition of disability. The DDS is a state agency funded by the federal government that completes SSA's disability decisions at the initial level. There is another type of decision called a “partially favorable" decision. In this decision, the DDS either finds that you are disabled beginning after you said you were, or that you are no longer disabled after a period of disability. The determinations should explain the specific reasons why the DDS found you not disabled or partially disabled.
Once you know why you were denied benefits, you can develop a plan of action. You may decide to appeal. At that point, you can begin to collect updated or new medical records and other evidence to prove your case. Or you may want to contact an attorney for legal advice before the appeal deadline.
The most common reasons for denial of Social Security disability benefits include:
- You're earning at substantial gainful activity (SGA) levels. This level is $1,470 a month in 2023. If your work history shows you're earning at SGA levels, the SSA will deny disability insurance benefits outright.
- Your disability will not last at least 12 months.
- You did not follow the SSA's requests for information or medical records.
- The SSA can't locate you.
Another reason for the denial of Social Security disability benefits is that you didn't follow the treatment prescribed by your doctor. However, there are approved exceptions. Some exceptions include that you cannot pay for treatment, the prescribed treatment violates your religious beliefs, or your doctor prescribes treatment that is not effective. Another exception is that you have a mental illness that prevents you from following the prescribed treatment.
Once you have an idea why the SSA denied your application for benefits, you'll know how to respond. Don't get technical or confrontational. Rather, simply respond to the reason(s) you were denied with proof that the situation is otherwise. The best forms of evidence come from professionals such as your employer or doctor, not family members or friends. Documentation from your employer or doctor is often the key to changing the SSA's decision.
When to Appeal
In each step of the process, you have 60 days to file for appeal. You also have 60 days to file a lawsuit in federal court once you get a decision from the Appeals Council. If you wait longer than 60 days with any of the appeals, you will have to start the application process over and file a new application. So it may be wise to get started right away on your appeal.
How to Appeal
You have two options to appeal. The first is to request an appeal online. The other option is to request an appeal in writing. To do so, submit the following forms to your local Social Security office.
- Form SSA-3441-BK (Disability Report, Appeal) to appeal the denial of disability benefits
- Form SSA-827 (Authorization to Disclose Information to the Social Security Administration) AND
- Form SSA-561-U2 (Request for Reconsideration) to appeal the denial of an initial Social Security disability claim OR
- Form SSA HA-50 (Request for Hearing By Administrative Law Judge) if you want a hearing before an administrative law judge
The Appeals Process
There are generally four ways to get an adverse disability determination reviewed. Here's a list.
This is the first level of appeal of your disability application. The reconsideration decision is made by the Disability Determination Services, the same state agency that denied your case in the first place. But the reconsideration review is conducted by a new person not involved in your initial decision.
Administrative Law Judge Hearing
If your request for reconsideration fails, you may file a request for a hearing before an administrative law judge (ALJ). The appeals process leaves the state level at this point. Claimants can make their voices heard at the ALJ hearing stage. You may speak to the administrative law judge directly about your medical condition and explain how it limits your ability to work. The ALJ level typically has a much higher rate of approval than the initial and reconsideration levels. It may be wise to prepare and understand what happens at a disability hearing.
If you want to appeal the administrative law judge's decision, you'll submit Form HA-520 and request an appeal before the Appeals Council. This is the final level of review at the agency level. Before making a decision, the Appeals Council will review the administrative law judge's decision for legal errors and also review any new medical evidence.
Federal District Court
Finally, if you want to appeal the decision of the Appeals Council, you can file an action in your local U.S. district court (federal court).
You Don't Have To Solve This on Your Own – Get a Lawyer's Help
A Social Security disability attorney can help you understand your appeal options. A disability lawyer can provide legal advice on eligibility for monthly benefits under the SSDI and SSI programs. Even if you have limited income, it may be wise to seek a consultation with a disability attorney. Visit our attorney directory to find a lawyer near you who can help.
You Don’t Have To Solve This on Your Own – Get a Lawyer’s Help
Meeting with a lawyer can help you understand your options and how to best protect your rights. Visit our attorney directory to find a lawyer near you who can help.
Contact a qualified social security lawyer to assist in your social security disability or retirement benefits issue.