What to Do If You Get a Social Security Disability Denial Letter

While over 10 million Americans receive Social Security Disability Insurance (SSDI), most applicants know getting benefits isn’t easy. From the time you apply, it usually takes about six to eight months to find out whether you’ve been accepted or denied. 

If you’re reading this, there’s a good chance you’ve learned that already. Whether you have an SSDI denial letter or anticipate one soon, it’s time to take action. In this article, you’ll learn how to navigate your SSDI denial letter and how to chart your next steps.

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You may still qualify for Social Security disability benefits

Don’t worry! Just because you received a denial letter doesn’t mean you don’t qualify for SSDI. 

Having your initial application rejected is more common than you’d think. Most people who apply for SSDI get rejected.

As of 2019, the average initial acceptance rate was only 24.6%. The biggest mistake people make at this point is giving up or reapplying rather than appealing the initial decision. At the hearing stage, almost half of applicants get approved for disability benefits.

Decoding your denial

If you are denied disability, the Social Security Administration (SSA) must send you a letter detailing why you didn’t qualify. 

Your claim number, important contact information, and eligibility for other benefits will be clearly stated on the first page when you get your letter. Here’s an example of what it will look like.

The most important part of the letter is the reason for the denial. Understanding why the SSA denied your claim is essential, as this helps you and your lawyer formulate your appeal. 

Sample denial letter

Social Security Administration

Notice of Disapproved Claim

From: [Your Local SSA Office] [City, State, Zip Code]

Date: [Month, Day, Year]

Claim Number: [Your Social Security Disability Claim Number]

[Your Name]

[Your Phone Number]

[Your Address]

We have determined that you are not entitled to disability insurance benefits.

[Reason for denial. If the reason is simple — for example, you do not have enough work credits or did not provide additional evidence when requested — it may be on the letter’s first page. If the reason is more complex, this section may say something like “See the enclosed Personalized Disability Explanation.”]

Other Social Security Benefits

[Other Social Security benefits you may qualify for or a notice like “You do not qualify for any other Social Security benefit.”]

You will receive another letter if you filed for Supplemental Security Income payments.

If You Disagree With the Decision

If you do not agree with this decision, you have the right to appeal. We will review your case and look at any new evidence you have. A person who did not make the first decision will decide your care. We will review the parts of the decision you think are wrong and correct any mistakes. We may also review the parts of our decision that you think are right. We will make a decision that may or may not be in your favor.

• You have 60 days to ask for an appeal in writing.

• The 60 days start the day after you receive this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

• You must have a good reason if you wait more than 60 days to ask for an appeal.

• You must ask for an appeal in writing. Please use our “Request for Reconsideration” form, SSA-561-U2.

Why was I denied?

Your SSDI denial letter will explain whether the SSA based your rejection on non-medical or medical criteria.

Non-medical denials

If you receive a denial for a technical or logistical reason, you did not meet the criteria based on working hours, employment history, or income requirements. If you work too many hours or make too much money, your chances of being denied are high. 

Occasionally, more nuanced problems like tax discrepancies or an abundance of assets could cause a denial. If you receive a non-medical denial, you have fewer options. 

If you’re working too many hours, you can work fewer. If you haven’t sufficiently paid into the SSDI program, you can ensure your taxes are correct. If you didn’t cooperate with the SSA’s requests for more paperwork or an exam, you may also receive a non-medical denial.

Some common rejection letter language that may indicate a non-medical denial:

• The individual is found not disabled because he/she is engaging in substantial gainful activity.

• The individual is found not disabled because of failure to cooperate with a request for evidence or action or a request to attend a consultative examination when that evidence is necessary for the determination.

Medical denials 

Lack of sufficient medical evidence is the most common reason the SSA rejects applications. A documented disability must meet precise criteria supported by documentation or test results showing that you physically cannot work due to the medical condition. 

If you receive a medical denial, there are many things you can do to strengthen your case. You often have better chances of approval once you can speak directly to a judge, and appealing is your best next step.

Some rejection letter language that may indicate a medical denial:

• The individual is found not disabled on medical considerations alone because the impairment is not severe.

• The impairment is severe but not disabling because it does not cause marked and severe functional limitations.

• The individual has a severe impairment(s) but is found not disabled because he or she has the functional and vocational capacity to engage in substantial gainful activity in relevant past work.

• The individual willfully, without justifiable cause, fails to follow therapy prescribed by the treatment source for a disabling impairment.

What rights do I have to appeal?

It’s 100 percent within your right to appeal the SSA’s decision within 60 days of receiving a notice of denial. The SSA calls this process “filing for reconsideration,” no matter whether you have a medical or non-medical determination. 

Here’s a description of each level of appeal:

• Reconsideration. In reconsideration, someone who wasn’t involved in your initial eligibility decision reviews your appeal. To start the reconsideration process, you must create an account on the SSA’s website. The SSA rejects most reconsiderations.

• Hearing with an Administrative Law Judge. If the SSA denies your application for reconsideration, you can request a disability hearing with an administrative law judge (ALJ). This higher-level review will require significant preparation with a disability lawyer.

• Review from the Appeals Council. If a judge doesn’t grant you SSDI, you can accelerate the decision to the Appeals Council. The Council will reconsider the ALJ’s decision. After this, the Council can either return the request to an ALJ, issue a new decision on your case, or deny the request altogether.

• Federal Court Review. Accelerating an appeal to the Federal level is the highest attempt to resolve a discrepancy and is the last step in the appeals process.

How can a lawyer help me? 

You don’t have to go through the appeals process alone. Working with a lawyer is the best way to navigate getting the most accurate SSDI decision despite the potential for repeated rejections. 

It’s fairly common to get denied multiple times for different reasons. With legal help, however, your chances of reversing that denial are significantly higher.

At Atticus, we’ll pair you with a lawyer who will understand and be well-versed in the specifics of your case — for free! Reach out to us today to get started on your appeal.