Understand Why Your Disability Claim Was Denied

Before taking any steps to appeal your denial, it’s important to understand the reason behind it. The SSA may deny your claim for a variety of reasons, including:

• Lack of Medical Evidence: If your medical records are insufficient or do not demonstrate the severity of your condition.
• Income or Work History: If your income or work history does not meet the required criteria for SSDI or SSI benefits.
• Failure to Meet SSA’s Definition of Disability: If the SSA determines that your condition does not meet the definition of disability (i.e., it does not prevent you from working for at least 12 months or result in death).

Review the Notice of Denial to see the specific reason for the decision. This will help you understand how to address the issues during the appeal.

The Appeals Process in Pennsylvania

If your disability claim is denied, you have several options for appealing the decision in Pennsylvania. The SSA provides four levels of appeal:

Reconsideration:

• Request a Reconsideration: The first step is to ask the SSA to review your claim again. You can do this online, by phone, or by visiting a local SSA office.
• New Evidence: If possible, provide new medical records, test results, or other relevant information that supports your disability claim.
  

Hearing by an Administrative Law Judge (ALJ):

• Request a Hearing: If your reconsideration is denied, you can request a hearing before an Administrative Law Judge (ALJ). The hearing will allow you to present your case in person, and you can have a representative (like a lawyer) with you.
• Prepare for the Hearing: Make sure to have all necessary medical documentation and evidence of your disability ready for the judge.

Appeals Council Review:

• Request a Review: If the ALJ denies your claim, you can request a review by the Appeals Council. They will review the judge’s decision to ensure it was made properly.
• Options After Review: If the Appeals Council agrees with the ALJ’s decision, you may have the option to file a federal court case.

Strengthen Your Appeal with New Evidence

One of the most important steps in appealing a disability denial is providing new or additional evidence to support your case:

• Updated Medical Records: Ensure your medical records are current and show the ongoing nature of your condition.
• Doctor’s Opinion: A letter from your treating physician can help strengthen your claim. Ask your doctor to explain in detail how your condition limits your ability to work and perform daily tasks.
• Work History and Vocational Information: Provide detailed information about your previous work experience, including any limitations or tasks you can no longer perform.

Consider Hiring a Disability Lawyer

While it is possible to handle the appeal process on your own, a disability lawyer can significantly improve your chances of success. An experienced attorney can help you:

• Understand the Appeals Process: A lawyer can guide you through each stage of the appeal, ensuring that all deadlines and procedures are followed.
• Gather Supporting Evidence: They can help you gather and organize medical records, testimony, and other evidence that will strengthen your case.
• Represent You at the Hearing: If your case goes to a hearing, a lawyer can represent you and present your case effectively to the judge.

Follow Deadlines and Stay Organized

The appeal process is time-sensitive. Missing a deadline can result in the dismissal of your case. Stay organized and ensure that you:

• File Appeals on Time: You must request reconsideration within 60 days of receiving your denial notice.
• Submit All Required Documents: Provide all requested evidence promptly to avoid delays.