Getting a denial letter is discouraging, but it's not the end. Most people who eventually receive disability benefits were denied at least once. Here's what to do next.
In this article, we'll cover:
- Understanding your denial
- Your appeal options
- Strengthening your case
- Getting help with your appeal
1. Understanding Your Denial
Read the letter carefully:
- Why were you denied?
- What evidence was considered?
- What was missing?
- What are your deadlines?
Common denial reasons:
- Insufficient medical evidence: Not enough proof of disability
- Condition not severe enough: SSA thinks you can work
- Failure to follow treatment: Not taking prescribed medications
- Technical denial: Income or resources too high (SSI)
- Didn't cooperate: Missed appointments or requests
The numbers:
- About 65-70% of initial applications are denied
- But many win on appeal
- Don't be discouraged
- Denials are common, not final
2. Your Appeal Options
Level 1: Reconsideration
- First appeal step
- New reviewer looks at your case
- Submit additional evidence
- Must file within 60 days
- Success rate: ~10-15%
Level 2: ALJ Hearing
- Before Administrative Law Judge
- Testify about your condition
- Bring witnesses
- Highest success rate: ~45-60%
- May wait months for hearing
Level 3: Appeals Council
- Reviews ALJ decision
- Paper review (usually)
- May grant, deny, or remand
- Lower success rate
Level 4: Federal Court
- File lawsuit
- Need attorney
- Reviews legal issues
- Last resort
Important: You have 60 days from each denial to file the next appeal. Don't miss this deadline.
3. Strengthening Your Case
Get more medical evidence:
- See your doctors regularly
- Request detailed statements
- Get objective test results
- Document all symptoms
What doctors should include:
- Specific diagnoses
- How conditions limit function
- Why you can't work
- Expected duration
Describe your limitations:
- What you can't do
- How long you can sit, stand, walk
- Concentration problems
- Bad days vs. good days
- Daily activities affected
Don't minimize:
- Be honest about struggles
- Describe worst days
- Explain all limitations
- Don't try to appear capable
Address the denial reason:
- If insufficient evidence: Get more
- If not severe enough: Document limitations better
- If non-compliance: Explain why
- Focus on what went wrong
4. Getting Help With Your Appeal
Disability attorneys:
- Paid only if you win (contingency)
- Usually 25% of back pay (max $7,200)
- Know the system well
- Higher success rates
When to get a lawyer:
- At any point, but especially for hearings
- If your case is complex
- If you've been denied multiple times
- If you have mental health conditions
Finding representation:
- Ask for referrals
- Legal aid organizations
- Disability advocacy groups
- State bar referral services
Non-attorney representatives:
- Some advocates aren't lawyers
- Can still represent you
- May have lower fees
- Check qualifications
Free resources:
- Legal aid
- Protection & Advocacy organizations
- Disability Rights centers
- Social Security advocates
Preparing for a Hearing
If you get to the ALJ level:
- Review your file
- Prepare your testimony
- Bring supportive witnesses
- Arrive early
What to expect:
- Relatively informal
- Judge asks questions
- You describe your limitations
- Medical expert may testify
- Vocational expert may testify
Tips for testimony:
- Be honest
- Be specific
- Don't exaggerate
- Don't minimize
- Take your time
While You Appeal
Continue treatment:
- See doctors regularly
- Follow medical advice
- Document everything
- Build your record
Keep applying:
- Can file new application while appealing
- Protects potential back pay
- Multiple paths to approval
- Don't put all eggs in one basket
Stay organized:
- Keep all documents
- Track dates and deadlines
- Save copies of everything
- Know your case
How Purple Helps
Once you're approved, Purple is here:
- Early access to back pay deposits
- Track your first benefit payments
- Manage ongoing benefits
- SSI resource limit tracking
- Simple, supportive banking