Receiving a denial letter for your Social Security Disability Insurance (SSDI) claim can feel frustrating and discouraging, especially when you’re unable to work due to a medical condition. However, don’t lose hope—denials are common, and you have the right to appeal.
At Peña & Bromberg, we understand how challenging this process can be. In this blog, we’ll guide you through the four key steps to appealing a denied Social Security disability claim, ensuring you have the best chance of securing the benefits you need.
Watch this quick video from Jonathan at Peña & Bromberg explaining what to do if your SSDI claim is denied:
Step 1: Request a Reconsideration (First Appeal Level)
If your disability claim is denied, the first step in the appeals process is to request a reconsideration. You must do this within 60 days of receiving your denial letter. This step is crucial because missing the deadline could force you to start the application process all over again.
What Happens During Reconsideration?
- A different examiner at the Social Security Administration (SSA) will review your case.
- They may request additional medical records or other evidence to support your claim.
- The reconsideration decision is usually based on medical documentation, work history, and any new information submitted.
Many applicants still receive denials at this stage, but don’t be discouraged—this is just the first step in the appeals process.
Step 2: Request a Hearing Before an Administrative Law Judge (ALJ)
If your claim is denied at reconsideration, you can request a hearing before an Administrative Law Judge (ALJ). This is one of the most critical steps in the appeals process because it gives you the opportunity to present your case in person.
What Happens at the ALJ Hearing?
- The hearing takes place before a judge who specializes in Social Security Disability cases.
- You can attend in person or have a representative (such as an attorney) present on your behalf.
- You may submit new medical records, expert testimonies, and vocational assessments that provide evidence of your disability.
- The judge may ask you and expert witnesses questions about your condition and ability to work.
The ALJ hearing significantly increases your chances of approval because it allows for a more detailed review of your case. In fact, many applicants win their disability claims at this stage with the help of strong evidence and legal representation.
Step 3: Appeal to the Social Security Appeals Council
If the ALJ denies your case, don’t worry—you still have another level of appeal. The next step is to take your case to the Social Security Appeals Council.
What Does the Appeals Council Do?
- This panel of SSA reviewers will assess whether the ALJ’s decision was fair and based on sufficient evidence.
- They may approve your claim, deny your appeal, or send your case back to another ALJ for further review.
- The Appeals Council does not hold a hearing but will base its decision on the evidence and legal arguments presented.
Keep in mind that the Appeals Council reviews thousands of cases, so the process may take several months. However, it’s a necessary step for those who believe they were wrongfully denied benefits at the ALJ level.
Step 4: File a Lawsuit in Federal Court
If the Appeals Council denies your claim, the final option is to file a lawsuit in federal court. At this stage, a federal judge will review your entire case to determine whether the SSA’s decision was based on substantial evidence.
What Happens in Federal Court?
- A federal judge will review all previous decisions made on your case.
- They will examine whether the SSA followed the law correctly in denying your claim.
- If the court finds errors in how your case was handled, they may overturn the denial or send it back for further review.
This is the final step in the Social Security disability appeals process. While it’s rare for cases to reach federal court, having an experienced disability attorney can improve your chances of success.
Why Are SSDI Claims Denied?
Understanding why Social Security denies claims can help you strengthen your appeal. Here are some common reasons for denial:
- Insufficient Medical Evidence – Your medical records do not prove that your condition is severe enough to prevent you from working.
- Earning Too Much Income – If you earn more than the Substantial Gainful Activity (SGA) limit, you may not qualify.
- Failure to Follow Treatment – If you do not follow prescribed medical treatments, SSA may assume you can improve and return to work.
- Failure to Provide Documentation – Missing deadlines or failing to submit required forms can lead to an automatic denial.
If your claim was denied for any of these reasons, working with an attorney can help you gather the right evidence to strengthen your case.
Why Work with Peña & Bromberg for Your Disability Appeal?
Navigating the Social Security Disability appeals process can be overwhelming, especially if you’re dealing with a serious medical condition. At Peña & Bromberg, we’ve helped countless clients in Fresno, CA successfully appeal their denied claims.
What We Offer:
Experienced Representation – We understand the SSA’s complex rules and fight for your rights.
Personalized Attention – Every case is unique, and we take the time to build a strong appeal based on your medical history.
No Upfront Costs – We work on a contingency fee basis, meaning you only pay if we win your case.
Need Help Appealing a Denied Social Security Disability Claim?
If you or a loved one has been denied SSDI benefits, don’t wait—time is limited to appeal. Contact Peña & Bromberg today for a free consultation and let us help you fight for the benefits you deserve.
Contact us at www.jonathanpena.com or visit our office in Fresno, California to get started on your appeal.
Final Thoughts
Getting denied for Social Security Disability benefits is not the end. Most applicants are denied at first, but with the right legal strategy, you can increase your chances of approval.
By following the four appeal steps—reconsideration, ALJ hearing, Appeals Council, and federal court—you can keep fighting for the financial support you need.
If you have questions or need assistance with your disability appeal in Fresno, Peña & Bromberg is here to help. Don’t face this process alone—contact us today!
