Understanding Why Disability Claims Get Denied

Before you appeal, it’s helpful to understand common reasons for denial, such as:

• Insufficient medical evidence.
• Failure to follow prescribed treatment.
• Incomplete or inaccurate application information.
• SSA determination that you can perform other work.

Identifying the reason for your denial will help you address the issues in your appeal.

The Disability Appeals Process in Tennessee

The Social Security Administration offers a four-level appeals process:

1. Reconsideration

• A new SSA examiner will review your case, including any new evidence.
• You can submit additional medical records or clarifications.
• This step is entirely paperwork-based—no hearing is required.

2. Administrative Law Judge (ALJ) Hearing

• If reconsideration is denied, you can request a hearing before an ALJ.
• You’ll present your case in person, by phone, or via video.
• Providing testimony, additional evidence, and expert witnesses can be very helpful here.

3. Appeals Council Review

• If the ALJ denies your claim, you can request a review by the SSA’s Appeals Council.
• The Council may uphold the decision, overturn it, or send it back for another hearing.

4. Federal Court Review

• As a last resort, you can file a lawsuit in federal district court to challenge the SSA’s decision.

Important Deadlines for Appeals

• You typically have 60 days from the date of the denial notice to request an appeal at each level.
• Missing this deadline could mean losing your right to appeal, so act quickly.

Tips for a Successful Disability Appeal in Tennessee

• Submit New and Stronger Medical Evidence: This could include updated doctor’s notes, specialist evaluations, or additional tests.
• Stay Organized: Keep copies of all correspondence and documents.
• Be Honest and Detailed: Clearly explain how your condition impacts your daily life and ability to work.
• Consider Representation: Navigating appeals is complex, and professional assistance can significantly improve your odds.