1. Understand Your Denial Notice

When SSA denies your SSDI claim, you will receive a notice explaining:

• The reasons for denial: Often due to insufficient medical evidence or the SSA’s belief that you can perform work
• The deadline to appeal: You must request an appeal within 60 days of the date on your denial notice

Reading your denial notice carefully helps you address the specific issues SSA identified in your initial application.

2. The Four Levels of Appeal

A. Reconsideration

• What it is: A complete review of your claim by a new disability examiner who was not involved in the initial decision
• How to file:
• Submit Form SSA-561 (Request for Reconsideration) online at ssa.gov or by mailing it to your local SSA office
• Include new medical evidence, updated doctor’s statements, or test results that support your disability claim

If SSA denies your claim again at reconsideration, you can move to the next appeal stage.

B. Hearing Before an Administrative Law Judge (ALJ)

• What it is: A formal hearing where you present your case before a judge
• How to request:
• File Form HA-501 (Request for Hearing by ALJ) within 60 days of your reconsideration denial
• What to expect:
• You or your attorney will explain why you are disabled
• You can present medical experts, vocational witnesses, or personal testimony

C. Appeals Council Review

If the ALJ denies your claim, you can request a review by the SSA Appeals Council:

• What it is: The council reviews whether the ALJ made errors in applying the law
• How to request:
• File Form HA-520 (Request for Review of Hearing Decision/Order) within 60 days of receiving the ALJ decision

The Appeals Council can uphold the decision, reverse it, or send it back to the ALJ for a new hearing.

D. Federal Court Review

If the Appeals Council denies your request or upholds the ALJ’s decision against you:

• You can file a lawsuit in federal district court within 60 days of the final denial
• This is a formal legal action, and hiring an experienced disability attorney is highly recommended at this stage

3. Preparing a Strong Appeal

To improve your chances during the appeals process:

• Gather new medical evidence: Updated records showing your condition has worsened or remained severe
• Obtain detailed doctor statements: Specifically explaining your limitations and inability to work
• Review your initial application: Identify any errors, incomplete sections, or missing documentation
• Consult a disability attorney: Legal professionals can help organize your appeal, prepare you for hearings, and present your case effectively

4. Common Reasons for SSDI Denials in New Jersey

Understanding why claims are denied helps you address weaknesses:

• Insufficient medical evidence
• Failure to follow prescribed treatments
• Earning above Substantial Gainful Activity (SGA) limits
• Lack of work credits for SSDI eligibility
• Incomplete application forms or missing documentation