Steps to Appeal a Social Security Disability Denial in Washington

If your claim for SSD or Supplemental Security Income (SSI) benefits was denied, here’s what you can do to appeal the decision:

Step 1: Understand the Reason for Denial

Before you can appeal, it’s important to understand why your claim was denied. The Social Security Administration (SSA) will send you a notice explaining the reasons for their decision. Common reasons for denial include:

• Insufficient medical evidence proving your disability.
• Not meeting the SSA’s definition of disability.
• Failure to meet work history or income requirements.

By understanding the reason for denial, you can address the issue during the appeals process.

Step 2: Request Reconsideration

The first step in the appeals process is Requesting Reconsideration. In Washington, if your initial application is denied, you can ask the SSA to review your claim again. During this stage, a different SSA representative will review your case, including any new evidence you submit.

How to Request Reconsideration:

• You have 60 days from the date of your denial notice to file for reconsideration.
• You can request reconsideration online through your My Social Security account or by submitting the appropriate forms at your local SSA office.
• Submit any new or additional medical evidence that supports your claim.

While the reconsideration process is a review of your original claim, it’s crucial to present any new, relevant information, such as updated medical records or reports from specialists, to strengthen your case.

Step 3: Request a Hearing Before an Administrative Law Judge (ALJ)

If your reconsideration is denied, you can request a hearing before an Administrative Law Judge (ALJ). This is a critical step in the appeals process, as it provides an opportunity to present your case in person.

How to Request a Hearing:

• After receiving a denial notice for your reconsideration, you have another 60 days to request a hearing.
• You can submit your request for a hearing through your My Social Security account or by contacting your local SSA office.
• During the hearing, you can present new evidence, have witnesses testify, and provide testimony yourself regarding your disability and its impact on your ability to work.

The ALJ will review your case, including medical records and testimony, and make a decision on your claim. It’s important to be fully prepared for this hearing, as it is one of the most critical stages of your appeal.

Step 4: Review the ALJ’s Decision

After your hearing, the ALJ will issue a written decision. If the ALJ approves your claim, you will begin receiving benefits. However, if the ALJ denies your claim, you have the option to take further action.

Step 5: Appeal to the Appeals Council

If the ALJ denies your claim, you can appeal to the Appeals Council. The Appeals Council will review the ALJ’s decision to ensure it was made correctly. They can either uphold the decision, reverse it, or send the case back for further review.

How to Appeal to the Appeals Council:

• You have 60 days from the ALJ’s decision to file an appeal to the Appeals Council.
• You can file your appeal online through your My Social Security account or by submitting a form to the Appeals Council.

Step 6: Federal Court

If the Appeals Council denies your appeal, your last option is to file a lawsuit in federal court. While this is the final step in the appeals process, it’s important to understand that the court will only review whether the SSA followed the correct procedures when making their decision. The court will not re-examine the facts of your case.

How to Strengthen Your Social Security Disability Appeal

To improve your chances of winning your appeal, consider these tips:

• Gather Additional Evidence: Include any new medical records, lab results, or opinions from your doctor or specialists that show how your condition prevents you from working.
• Follow Up on All Deadlines: Missing deadlines can significantly delay your appeal or result in a denial. Make sure to submit all forms and documents on time.
• Work with a Disability Advocate or Lawyer: While you are not required to have legal representation, working with a lawyer or advocate can be beneficial, especially if your case is complex or if you’re going through the hearing or appeals process.