What to Do if You Are Denied Disability Benefits

Receiving a denial from Social Security is a frustrating experience for most disability applicants. You might be surprised to learn that for fiscal year 2024, only 38% of SSDI and SSI claims were approved on the first try. Following reconsideration (the second stage of review), the allowance rate is even slimmer, with only 16% of claims being approved at this level.

With these statistics in mind, it can help you to know that you're far from alone if you didn't immediately receive disability benefits. Fortunately, there's a lot you can still do to get your claim awarded—mainly by filing a timely appeal. And if you know why Social Security denied your application and can submit evidence showing why the denial was incorrect, you can greatly increase your chances of success when you appeal.

Why Should I Appeal My Disability Denial?

The process of appealing your denial gives you valuable information about why Social Security didn't think you're disabled and gives you time to strengthen any weaknesses in your claim. For most applicants, this is usually reason enough to start an appeal instead of reapplying and having to begin the process all over again. And if you don't appeal, you'll miss your best chance of getting benefits by having a disability hearing.

Many people who get a denial notice are disheartened about the process and abandon their disability claim. However, this isn't always the wisest approach as you can end up leaving money on the table (in the form of disability backpay) if you file again. That's because your protective filing date will be calculated from your new application instead of your prior one, unless you're able to reopen your earlier claim. Reopening gets harder to do after one year has passed since the original denial, so it's generally better to appeal on the denied claim.

Why Was My Disability Claim Denied?

When the Social Security Administration (SSA) denies your claim, the agency must let you know why it was denied. Generally speaking, Social Security denials fall under two categories:

• Technical denials. A technical denial means that the SSA doesn't think that you met one or more threshold requirements to be considered for disability benefits. Typically, these requirements are financial in nature—for example, Social Security might find that you've been earning too much money to qualify for benefits.
• Medical denials. A medical denial means that even if you meet the threshold requirements to qualify, the SSA didn't think that your medical conditions prevented you from working full-time.

Depending on the type of benefit you applied for, and the type of denial you received, you'll likely want to shore up your evidence for your next steps. Below are some common types of technical and medical denials. Read your denial letter thoroughly to see which rationale best applies to your claim.

Technical Denials in SSDI Claims

SSDI (Social Security Disability Insurance) is a public disability insurance program. You pay into the program by way of payroll taxes that come out of your paycheck. It's similar to a private insurer in some ways—if you stop paying your insurance premiums (taxes), you'll stop getting insurance coverage. SSDI is more forgiving than a private insurer, however, because it's based on your work history and payroll contributions.

You can be insured under SSDI for about five years after you've stopped working, after which this coverage will lapse. The date that your coverage under SSDI ends is called your date last insured. You'll need to prove that your disability began before this date in order to qualify for SSDI. For example, if your date last insured was in 2024 because you stopped working in 2019, and you didn't get treated for your condition until 2025, Social Security will issue a technical denial for your SSDI claim.

Not having enough work credits for insurance coverage is another reason the agency might deny your claim. Work credits are based on the amount of money you've earned in the past. For example, you might have worked for a long time, but you didn't earn enough for your payroll taxes to cover your SSDI "premiums." Broadly speaking, you'll need to have spent at least half of the past 10 years earning work credits. If you haven't met that minimum, Social Security will issue a technical denial.

Technical Denials in SSI Claims

Unlike SSDI, SSI (Supplemental Security Income) is available regardless of how much you've worked. But it's needs-based, meaning that you'll need to show that you have less than $2,000 $3,000 for couples) in income and assets. For example, if Social Security finds that you have more than $2,000 cash in the bank as an individual, the agency will consider you to be "over-resourced" and ineligible for SSI benefits.

Medical Denials for SSDI and SSI

Even if you've worked enough to qualify for SSDI or don't have total assets above the SSI limit, Social Security could still deny your claim if the agency thinks that your medical conditions don't prevent you from working. Medical denials are less common than technical denials, but they're easier to overcome on appeal.

When you apply for disability benefits, one of the first questions the SSA asks you is to list the illnesses, injuries, or conditions that are preventing you from working. These can be physical conditions like a heart attack, mental illnesses such as depression, or a combination of both. In Social Security lingo, your response to this question is called your allegation of impairments. This is the "why" you're disabled.

The SSA will look at what you've said about why you're disabled and begin collecting medical records that can help in understanding your impairments. If you were issued a medical denial, it means that the agency doesn't think there's enough information in the medical record to show you can't work. Common reasons for a medical denial include:

• you're expected to recover from your impairments in under a year
• you can still manage most or all of your daily activities, despite your impairments
• you don't have enough medical evidence documenting your impairments
• you haven't followed your doctor's recommended treatment
• your impairments would go away if you stopped using drugs or alcohol
• you didn't let Social Security know where you get medical treatment, and
• you didn't attend a doctor's appointment set up by Social Security.

You can increase your chances that your application will be approved by making sure that you follow up regularly with your medical providers. Be sure to keep the SSA in the loop by letting the agency know when and where you get treatment from any new providers, including hospital visits. That way, even if you're denied at the reconsideration level, you'll have more medical evidence to present to the judge at a disability hearing.

What to Do After You've Received a Disability Denial

If this is your first ("initial") denial, your next step should be to file a request for reconsideration. This means that you're asking a different disability claims examiner than the one who issued the denial to look at your application and decide if the first decision was correct. You can start your appeal in any of the following ways:

• Use Social Security's online appeal tool.
• Send your request by mail, using Form SSA-561, Request for Reconsideration and Form SSA-3441, Disability Report – Appeal.
• Call 800-772-1213 from 8 a.m. to 7:00 p.m. Monday through Friday. If you are deaf or hard of hearing, you can call the TTY number at 800-325-0778.
• Go in person to your local Social Security field office.

Because few claims are awarded at reconsideration, it helps your chances if you can provide Social Security with information that addresses why you were initially denied. For example, if you received a technical denial because the agency found you were over the resource limit for SSI, you could submit a recent bank statement with your appeal. Or, if you were denied because the agency didn't think you had enough medical evidence, try to set up an appointment with your doctor.

If you're appealing your second denial following reconsideration, you'll need to submit the paperwork to request a disability hearing in front of a judge. You can do this using the same methods as you did with your reconsideration appeal, only with a different form (HA-501, Request for Hearing by Administrative Law Judge).

How Long Do You Have to Appeal a SSDI or SSI Denial?

Social Security gives you 60 days to decide whether you want to appeal a denial at each level. If you miss that deadline, and you don't have a good reason, you'll have to start your application from square one. However, if you have what the SSA considers to be "good cause," the agency will let you go ahead with the appeal despite missing the deadline. Make sure that you submit the request to waive the deadline in writing, and that your reason for missing the deadline is pretty serious. Simply forgetting to file the appeal won't cut it.

Should You Hire an Attorney to Help Appeal Your Disability Denial?

If you're not sure whether Social Security will consider your reason as good cause, or if you just want help with your appeal, consider consulting an experienced disability attorney. Your lawyer can tell you whether you can continue with your appeal or need to re-file a new application, help you keep on top of deadlines, and represent you at a hearing in front of a disability judge.

Disability attorneys work on contingency, meaning they don't get paid unless (and until) you win, so there's little up-front cost to you. And if you're on the fence about whether getting a lawyer is worth it, most disability lawyers offer free consultations, so you can ask around to find one that you think is a good fit for you.