When you've applied for Social Security disability and your claim's denied, the process can feel frustrating. Fortunately, an initial denial for Social Security disability insurance (SSDI) or Supplemental Security Income (SSI) benefits isn't the end—more like the beginning of the determination process for most applicants.
You have the right to appeal Social Security's decision to deny your disability benefits. And you should. Social Security approves less than 37% of disability claims after the initial application. Everyone else who eventually gets SSDI or SSI benefits is approved on appeal.
Do you need a lawyer to appeal a disability denial, or can you win a disability claim on your own? The answer to both questions is: It depends on your case. Here's what you need to know about when you'll benefit from hiring a disability lawyer and when you might be able to go it alone.
Appealing a Social Security claim that's been denied is a process with several levels of appeal that your claim can go through. Each appeal level is handled by a different person or group of people. The four stages of the Social Security disability appeals process are as follows:
Some of the stages involve a simple review of the evidence in your case. Others include hearings or court proceedings with witness testimony and give you the opportunity to speak directly to the person who'll decide your appeal.
Reconsideration is the first level of the appeals process. The Social Security disability reconsideration process simply involves a review of your application by a disability claims examiner who was not involved in the initial decision. It doesn't usually take as long as your initial disability determination but can take three to four months to complete.
Most reconsiderations are denied, so your chances of winning at that stage of appeal aren't good unless you have the following:
You're not required to have a lawyer in order to request a reconsideration, but it could help your case. Over 70% of disability applicants hire a lawyer for the reconsideration stage. An attorney can help you:
Winning at the reconsideration stage of the appeals process means your disability benefits could start up to a year sooner than if you have to wait for an appeal hearing.
If you lose the reconsideration (as most people do), you'll need to file a Request for Hearing by Administrative Law Judge (Form HA-501). It can take a year or more to get an appeal hearing date after your claim is denied at reconsideration. But it can be worth the wait, since the appeal hearing is the stage where you have the best chance of winning your disability claim.
Disability appeal hearings are also called "ALJ hearings" because an administrative law judge (ALJ) will conduct your hearing. The ALJ will:
Disability lawyers are familiar with the appeal hearing process and many of the ALJs who preside over them. Your attorney will know what kind of evidence the ALJ is looking for and the most convincing way to present your case. Over 80% of disability applicants hire a lawyer before their hearing.
Unlike the simple reconsideration review, you'll have the opportunity to explain your case to the ALJ and answer questions at your disability appeal hearing. You'll also be able to:
Working with a disability attorney allows you to better prepare for your appearance before the ALJ. Before your hearing, your attorney will review all the evidence you've already submitted, looking for weaknesses in your case (like gaps in your testing or treatment history or inconsistencies in your medical reports). Your attorney will gather additional evidence and present it in a way that strengthens your case.
A lawyer will also know how to refute any evidence that might harm your case—like an unfavorable report after a Social Security consultative exam (CE). A disability attorney also knows how to cross-examine a Social Security vocational expert to show the ALJ that, given your age, condition, work history, and the job market, there are no jobs you can be expected to do.
Having a legal expert who understands the Social Security disability appeals process in your corner can have a big impact on the outcome of your case. Disability applicants who hired a lawyer before the ALJ hearing were twice as likely to win as those who didn't.
But should you lose your appeal hearing, you can ask for a review by the disability Appeals Council, and if that doesn't work, you have the right to take your case to federal district court. You will need an attorney before going to court.
Learn more about how hiring a disability attorney can help you win benefits.
If you hire a disability lawyer to represent you, Social Security will need to approve the fee agreement you make with that representative. Disability lawyers generally work on "contingency." That means you don't pay your lawyer unless you win your appeal. If you do win, your lawyer will get a percentage (usually 25%) of the Social Security back pay awarded to you, up to a maximum of $7,200.
If you want to hire a lawyer, you can use our attorney locator tool or the resources on this page to find a disability lawyer in your area.
Updated October 27, 2022