The Social Security Administration (SSA) will send a disability denial letter that is to inform the applicant their claim is denied as they are not eligible for seeking the Social Security disability benefits. 

The SSDI denial letter includes all the basic information about their disability claim such as:

  • Date of their disability onset
  • Diagnosis of their disability
  • Whether they are currently working or not

The denial letter will also give the specific reason for the denial of the claim and will also provide the appropriate instructions on how to appeal the decision. 

What To Do If You Get a Social Security Disability Denial Letter?

There are 3 phases for appealing in case of denial of disability claim:

  • Request for hearing:

A disability applicant must appeal within 60 days to request a hearing before an administrative law judge (ALJ).  It is not mandatory to hire a disability lawyer to represent your case. However, appealing at the court hearing with an attorney representing your disability claim before the administrative law judge (ALJ) will be beneficial and will increase your chances of approval. 

In case, you are representing yourself and you lose, you may have to apply again. Therefore, legal representation may create a huge difference. They are experts in the appeal process, reconsideration process, and will prepare your case that will reverse your denial while presenting before ALJ. 

These judges will uphold and overturn decisions based on Social Security Disability Benefits. On an estimation, ALJ grants approximately 50% of disability claims that will reach the hearing stage.  

  • Appeals Council:

In case the ALJ decides you are not disabled, you may file an appeal to the Appeals Council. You must file an appeal within 60 days when the judge gives the decision. The decision of the appeals council depends on the evidence that includes medical records. The Appeals Council may not allow you to present your disability claim again with exceptions to certain cases. 

  • Federal Court Review

In case the Appeals court denies your claim, you can appeal to the Federal Court. You must file an appeal within 90 days of the Council’s decision. The federal judges will determine whether the Administrative Law Judge adopted appropriate procedures in your disability hearing process. They will further analyze whether ALJ made any error in denying your disability benefits or not.

Do Not Worry After Receiving A Denial

Navigating the SSDI application process can be challenging, with a significant waiting period of three to five months to learn about your acceptance or denial. Receiving an SSDI denial letter is not uncommon, as the initial acceptance rate hovers around 24.6%. 

The crucial thing to remember is that a denial doesn’t necessarily mean you’re ineligible. Most people who appeal at the hearing stage are eventually approved. This article will guide you in understanding and responding to your SSDI denial letter, emphasizing the importance of the appeals process.

Reasons For Denial Of SSDI Application

SSDI applications can face denials for both medical and non-medical reasons, highlighting the importance of addressing various aspects of the application process.

Medical Denials:

  • Insufficient Medical Evidence: The most common medical denial occurs when the applicant’s medical records fail to demonstrate the severity and impact of the disability adequately.
  • Failure to Meet Blue Book Criteria: The SSA’s Blue Book outlines specific criteria for various disabling conditions. If your medical condition doesn’t align with these criteria, it can result in denial.
  • Medical Improvement Expected: If the SSA anticipates that your medical condition could improve within a year, it might result in a denial.
  • Failure to Follow Treatment: If you haven’t followed prescribed medical treatments without a valid reason, the SSA may question the seriousness of your disability.

Non-Medical Denials:

  • Engaging in Substantial Gainful Activity (SGA): If the SSA believes you can perform substantial work despite your disability, your application may be denied on non-medical grounds.
  • Lack of Cooperation: Failure to provide necessary documentation, attend medical exams, or respond to SSA inquiries can lead to a non-medical denial.
  • Inability to Contact You: If the SSA cannot contact you for additional information or clarification, your application may be denied.

Understanding the specific nature of the denial is crucial for preparing a targeted appeal. Seeking guidance from a disability attorney can help navigate the complexities of medical and non-medical denials.

How Can A Disability Attorney Help You?

If your SSDI application is denied, a Social Security Disability Lawyer can be a crucial ally in your appeal. They possess the expertise to navigate the complex legal process, gather necessary evidence, and present a compelling case before an administrative law judge (ALJ). 

Their knowledge of disability law and experience with the appeals process significantly improve your chances of overturning the denial and securing the benefits you deserve.