Why Disability Claims Are Denied

Before you appeal, it's important to understand why your claim may have been denied. Common reasons include:

• Lack of sufficient medical evidence
• Failure to follow prescribed treatment
• Earning too much income (for SSI or SSDI under Substantial Gainful Activity limits)
• Not meeting the Social Security Administration’s (SSA) definition of disability
• Errors or incomplete information in your application

Steps to Appeal a Disability Denial in Texas

Step 1: Request for Reconsideration

The first step is to file a Request for Reconsideration within 60 days of receiving your denial letter. During reconsideration, a new SSA reviewer will evaluate your claim. You can submit new or additional medical evidence at this stage.

Step 2: Request a Hearing Before an Administrative Law Judge (ALJ)

If your reconsideration is denied, you can request a hearing with an ALJ. This is your best chance to present your case in person, explain your medical limitations, and submit updated documentation. Many applicants win their claim at this stage.

Step 3: Appeals Council Review

If the ALJ denies your claim, you can request a review from the SSA’s Appeals Council. They will review your case to determine if the ALJ made a legal or procedural error.

Step 4: Federal Court Review

If the Appeals Council denies your request or upholds the denial, your final option is to file a lawsuit in federal district court. This step is more complex and typically requires legal representation.

How to Improve Your Appeal in Texas

• Gather updated medical records: Include new test results, treatments, or doctor statements that support your claim.
• Maintain consistent medical care: Ongoing treatment and medical follow-ups help demonstrate the severity of your condition.
• Be honest and detailed: When completing appeal forms, be clear and accurate about your condition and its impact on your ability to work.
• Meet all deadlines: Appeals must be filed within 60 days of the denial notice. Missing this deadline can result in starting the application process over.

Tracking Your Appeal

You can track the progress of your appeal by creating a “my Social Security” account at ssa.gov or by calling the SSA at 1-800-772-1213.