ROADMAP: Appealing a Social Security Denial for the First Time

Read the Notice and Gather Evidence

What does your notice say?

At the beginning of your case, the most important source of information is the notice from Social Security. Open mail from Social Security right away.

Read the notice carefully. The notice should tell you:

  • whether Social Security thinks you have medical impairments
  • the doctors or medical providers Social Security talked to, and the medical evidence they looked at
  • how much work Social Security thinks you can do
  • whether Social Security thinks there is another job you can do even with your impairment(s), and
  • the date of the decision. This tells you how long you have to appeal. You have 60 days from the date on the top of the notice, plus 5 days for mailing, to appeal Social Security’s decision in writing.

Checking your notice will also tell you if this is one of the situations where you should call us for advice and a referral to a lawyer. For example, if the notice talks about appealing to an “Administrative Law Judge” or the “Appeals Council,” that tells you this is not your first appeal of this denial of your application for benefits. You should contact us. Or maybe it mentions that you had benefits before, and they are being stopped, or Social Security wants money back from you. In those situations, stop and contact us at Legal Services Vermont right away for advice and referral.

Understand Social Security’s 5-step disability process

Social Security goes through five steps to decide whether not you qualify for disability benefits. Understanding the steps will help you understand where in the process you were denied and what kind of evidence to prepare.

These are the steps that the Social Security Administration uses:

  1. Are you still performing “substantial gainful activity” (SGA)? (See what Social Security means by SGA.)
  2. Do you have a “medically determinable severe impairment” that will last at least 12 months? (Visit the Social Security website to see what this means.)
  3. Do you have an impairment or combination of impairments that meets a “listing” in Social Security’s rules? (See what this means.)
  4. Does your impairment or impairments keep you from doing your past work? (See what this means.)
  5. Is there another job you can do in the national economy? (See what this means.)

Helpful link: You can also find out about Social Security appeals on the Social Security website.

Gather evidence

Once you understand the decision, you can start gathering evidence for your appeal.

Your doctor is your best source of medical evidence. Ask them to write a letter explaining why your medical conditions keep you from working.

It’s fine to send in evidence after you have submitted your appeal forms.

You can also write down:

  • which medical providers know the most about why you can’t work. If possible, talk to these providers and let them know that you may need them to talk to Social Security or write letters for you.
  • a friend or relative (not one of your medical providers) who knows about your conditions
  • the dates of any upcoming medical tests, doctor’s appointments or procedures
  • any medications you take or therapies you use to treat your medical conditions, and
  • what you do in a typical day—including preparing meals, hobbies, exercise, and social activities.

Regardless of why Social Security decided you didn’t qualify, you will have to tell Social Security about:  

  • your most recent work
  • your medical providers, and
  • your treatment.

You will need this information and supporting documents to complete the next step: filling out the appeal forms.

Updated: Nov 02, 2021