Understand Why Your Claim Was Denied

Before beginning the appeal, carefully review the denial letter you received from the Social Security Administration (SSA). The letter will outline the specific reasons for the denial, which may include:

• Lack of sufficient medical evidence
• Failure to follow prescribed treatment
• Earning income above the Substantial Gainful Activity (SGA) limit
• The SSA believes you can still perform some form of work

Understanding the reason behind the denial will help you target your appeal more effectively.

Appealing a Disability Denial in North Carolina: Step-by-Step

Step 1: Reconsideration

The first level of appeal is called reconsideration. You must request it within 60 days of receiving your denial letter.

• A different examiner at North Carolina's Disability Determination Services (DDS) will review your case.
• You can submit new or updated medical evidence to strengthen your claim.

Step 2: Administrative Law Judge (ALJ) Hearing

If your reconsideration is denied, the next step is to request a hearing before an Administrative Law Judge (ALJ).

• This is your best chance to present your case in person.
• You can provide new evidence and bring witnesses, including medical or vocational experts.
• The judge will ask you questions about your condition, work history, and limitations.

It may take 12 to 18 months to get a hearing date in North Carolina due to backlogs, but this stage has one of the highest approval rates.

Step 3: Appeals Council Review

If the ALJ denies your claim, you can request a review by the Social Security Appeals Council.

• The Council may agree with the ALJ, reverse the decision, or send your case back for a new hearing.
• They will only review cases where they believe a legal or procedural error was made.

Step 4: Federal Court Review

If all previous appeals are denied, you can file a lawsuit in federal district court. At this stage, it’s highly advisable to have legal representation.

Tips for a Successful Appeal

• Submit New Medical Evidence: Include any recent test results, diagnoses, or treatment records not available during your initial application.
• Stay Consistent With Treatment: Continue seeing your doctors regularly and follow all recommended treatments.
• Be Honest and Thorough: Clearly explain how your condition affects your ability to work and function in daily life.
• Meet Deadlines: Each stage of appeal has a strict 60-day window—missing it may force you to start over.