Steps to Appeal a Denial for Social Security Disability in Texas

Step 1: Understand the Denial

After receiving a denial letter from the Social Security Administration (SSA), carefully read the letter to understand the reason for the denial. The letter will explain why your claim was denied and provide guidance on the next steps. Common reasons for denial include:

• Insufficient medical evidence to prove disability.
• The SSA determined you can still work based on your functional abilities.
• Your condition does not meet the SSA’s criteria for disability.

Step 2: Request Reconsideration

The first step in appealing a denial is to request Reconsideration. This is a process where the SSA will review your case again, but this time, it will be examined by someone who wasn’t involved in the initial decision.

How to request reconsideration:

• You can request reconsideration online through the SSA’s website or by contacting the SSA directly at 1-800-772-1213.
• Make sure to submit any new medical evidence, treatment records, or updated information to support your claim.

The Reconsideration process typically takes around 3 to 6 months to complete, but it’s a necessary step before you can move on to the next phase of the appeals process if the decision is still unfavorable.

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

If your Reconsideration is denied, the next step is to request a hearing before an Administrative Law Judge (ALJ). This is a formal process where you will have the opportunity to present your case in person, submit additional evidence, and testify about how your condition affects your ability to work.

How to request a hearing:

• You must submit your hearing request within 60 days of receiving the decision on your reconsideration. This can be done online, by mail, or over the phone with the SSA.
• At the hearing, the ALJ will review your case and hear arguments from both sides. If necessary, you can have an attorney represent you and help present your case effectively.

Prepare for the hearing: Bring updated medical records, statements from doctors, and any other evidence that supports your disability claim. Having an attorney can make a significant difference during this stage.

Step 4: Appeal to the Appeals Council

If the ALJ denies your case, you have the right to request a review by the Appeals Council. The Appeals Council reviews whether the ALJ made any legal errors or if the decision was unsupported by the evidence. The council doesn’t hold a hearing but will decide whether the ALJ’s decision was correct.

How to request a review:

• You can file your request for review with the Appeals Council within 60 days of receiving the ALJ’s decision.

The Appeals Council will either:

• Approve your claim.
• Send your case back to the ALJ for further review.
• Deny your request for review, which would make the ALJ’s decision final.

Step 5: Federal Court Review

If the Appeals Council denies your claim, or if you disagree with its decision, you have the option to take your case to federal court. This is the final step in the appeals process and is typically only used when all other options have been exhausted.

How to file a lawsuit in federal court:

• You must file a complaint in the U.S. District Court within 60 days of receiving the Appeals Council’s decision.
• At this stage, an attorney experienced in Social Security Disability law can help you navigate the complexities of federal court procedures.

Tips to Improve Your Chances of Success in the Appeals Process

• Provide Detailed Medical Evidence: Make sure you have comprehensive, up-to-date medical records that document the severity of your disability. Include records from specialists and any additional tests or treatments you’ve received.
• Follow the Deadlines: Missing a deadline at any stage of the appeals process can lead to delays or the dismissal of your case. Be sure to submit your appeals on time.
• Get Expert Legal Help: Having a Social Security Disability attorney by your side can improve your chances of success. An attorney can help gather additional evidence, represent you at hearings, and guide you through the legal complexities of the appeals process.