Step 1: Understand Why You Were Denied

Before appealing, review the SSA’s denial letter carefully. Common reasons for denial include:

• Insufficient medical evidence
• Failure to follow prescribed treatment
• Income or resource limits exceeded (for SSI)
• SSA does not believe your condition prevents work

Understanding the reason helps you build a stronger case on appeal.

Step 2: File a Request for Reconsideration

In North Carolina, the first step in the appeals process is the Request for Reconsideration:

• Must be filed within 60 days of the denial notice.
• This step is a complete review of your claim by someone who wasn’t involved in the initial decision.
• You can submit new medical evidence or information.

Tip: Continue seeing your doctors and gathering records during this time.

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

If your reconsideration is denied (which is common), you can request a hearing:

• You must request it within 60 days of the reconsideration denial.
• The hearing is conducted by an Administrative Law Judge (ALJ) at the Office of Hearings Operations (OHO) in North Carolina.
• You’ll present your case in person, often with a representative or attorney.

Important: This is your best chance to win your case. The majority of approvals happen at the hearing level.

Step 4: Prepare for the Hearing

A successful hearing depends on preparation:

• Collect updated medical records and supporting doctor statements.
• Be ready to explain how your condition affects daily life and work ability.
• The judge may also hear testimony from vocational experts or medical professionals.

Step 5: Additional Appeals (If Needed)

If the ALJ denies your claim, you can continue to appeal:

• Appeals Council Review: The Council can deny, remand, or overturn the decision.
• Federal District Court: If necessary, you can take your case to federal court.

Each level becomes more complex, and representation is highly recommended at this stage.