Denied SSDI Benefits? Here’s What to Do Next

If your application for Social Security Disability Insurance (SSDI) has been denied in Louisiana, you’re not alone. Many applicants face an initial denial, but that doesn’t mean your case is over. The SSDI reconsideration process in Louisiana offers you a second chance to prove your eligibility and secure the benefits you need. 

Understanding the steps involved is critical to improving your chances of success. In this guide, we’ll walk you through the key steps to take during the SSDI reconsideration process in Louisiana, helping you strengthen your case and manage this challenging phase with confidence.

Key Points: 

  • Many SSDI applications in Louisiana are initially denied, but the reconsideration process provides an opportunity to appeal the decision. Reasons for denial often include insufficient medical evidence, failure to meet SSA’s disability criteria, or earning too much income. Reviewing the denial letter is critical to identifying issues and preparing a stronger appeal.
  • You can appeal your SSDI denial by submitting a Request for Reconsideration within 60 days. If reconsideration is denied, further steps include a hearing before an Administrative Law Judge (ALJ), an Appeals Council review, and, ultimately, filing a lawsuit in federal court. Each step in the appeals process allows you to present additional evidence to support your claim.
  • To improve your chances of a successful appeal, you should provide updated medical records, detailed statements from your doctors, and opinions from specialists. Additional evidence, such as new diagnostic tests, functional capacity evaluations, or personal statements from family and coworkers, can demonstrate the severity of your condition and its impact on your ability to work.

What is Social Security Disability Insurance? 

Social Security Disability Insurance is a federal program that provides financial assistance to individuals who are unable to work due to a severe, long-term disability. It is designed to offer monthly benefits to those who have paid into the Social Security system through payroll taxes during their working years. 

Once approved, SSDI provides monthly cash benefits, and after two years of receiving SSDI, beneficiaries are also eligible for Medicare. SSDI is intended to support individuals who can no longer work due to their disabilities, offering financial relief and access to health care.

What Reasons Can Cause My SSDI Claim Denial?

There are several reasons why your SSDI claim might have been denied in Louisiana. Understanding the specific reason for your denial is important, as it will help you strengthen your case during the reconsideration process. Here are some common reasons why SSDI claims are denied:

  • Lack of Sufficient Medical Evidence: The SSA requires detailed medical documentation proving that your condition is severe and long-term. If your records do not clearly demonstrate that your disability prevents you from working, your claim may be denied.
  • Your Condition Doesn’t Meet the SSA’s Definition of Disability: The SSA has strict guidelines for what qualifies as a disability. If your condition is not severe enough to prevent you from engaging in substantial gainful activity or is expected to improve within 12 months, your claim may be rejected.
  • Failure to Follow Prescribed Treatment: If you have not followed the medical treatments or recommendations of your healthcare providers without a valid reason, the SSA may deny your claim. They expect that you are doing everything possible to improve your condition.
  • You Earn Too Much Income: SSDI benefits are intended for individuals who cannot work due to their disability. If you are earning above the SSA’s substantial gainful activity threshold, your claim will likely be denied because you are considered capable of working.
  • Insufficient Work Credits: SSDI requires that applicants have earned enough work credits by working and paying Social Security taxes. If you haven’t accumulated enough credits, particularly if you haven’t worked recently, your claim could be denied.
  • Previous Denials Without Significant New Information: If you’ve filed for SSDI in the past and were denied, your claim may be rejected again if you haven’t provided new or updated medical evidence showing that your condition has worsened.
  • Failure to Cooperate with the SSA: Not attending medical exams required by the SSA, not responding to requests for information, or submitting incomplete applications can lead to a denial. Full cooperation is essential in the application process.
  • Your Disability is Related to Drug or Alcohol Use: If your disability is caused by, or worsened due to, drug or alcohol abuse, the SSA may deny your claim.
  • Not Following the Appeals Process Correctly: Missing deadlines, such as failing to request reconsideration within 60 days of your denial, can result in your claim being dismissed without further review.

If your claim was denied, the next step is to carefully review the denial letter you received from the SSA. The letter will outline the specific reasons for the decision, which can help guide you in addressing those issues during the reconsideration process.

Can I Submit an Appeal for Reconsideration?

Yes, you can submit an appeal for reconsideration after your SSDI claim has been denied in Louisiana. Once you receive the denial notice, you typically have 60 days to file your appeal. This process allows you to challenge the decision and present any new evidence or information that may support your claim.

What is the SSDI Reconsideration Process?

Appealing SSDI denial is a common and necessary step for many applicants, as a large percentage of initial claims are denied. The SSA offers a multi-step appeals process, allowing you to present additional evidence or correct any issues with your initial application. Here’s how the appeals process works:

1. Request for Reconsideration

You must file a request for reconsideration within 60 days of receiving the denial notice. During reconsideration, someone who was not involved in the initial decision will review your case, including any new medical evidence or information you provide.

You can request reconsideration online, by mail, or in person at your local Social Security office. This is your chance to submit additional medical records, correct errors, and strengthen your claim.

2. Administrative Law Judge (ALJ) Hearing

If your reconsideration is denied, you can request a hearing before an Administrative Law Judge. Again, you have 60 days from the denial of your reconsideration to request a hearing.

The ALJ will review your case and any new evidence in a more formal setting. You can testify, bring witnesses (such as doctors), and have a representative (such as an attorney) speak on your behalf. This is often the most successful stage for applicants because it allows for a more detailed review of your case.

3. Appeals Council Review

If the ALJ denies your claim, you can request a review by the Appeals Council. The council will either review your case, send it back to the ALJ for further review, or decline your request if they believe the ALJ’s decision was correct.

4. Federal Court Review

If you disagree with the Appeals Council’s decision, you can file a lawsuit in federal court. This is the final step in the appeals process and typically requires legal representation.

If you are asking yourself if you should appeal, yes, you should consider appealing. If you believe your condition qualifies for SSDI benefits and you have the necessary medical documentation, request for reconsideration. Many applicants are successful at the reconsideration or hearing stages, especially if they submit additional evidence or get help from a legal representative familiar with SSDI cases.

What Evidence Can I Provide to Strengthen My SSDI Reconsideration?

When appealing an SSDI denial, providing additional evidence can greatly increase your chances of success. Since initial denials often result from insufficient documentation or unclear medical records, strengthening your case with new or updated evidence is essential during the reconsideration and appeal stages. Here are some key types of additional evidence you can provide:

  • Updated Medical Records

One of the most important pieces of evidence you can submit is updated medical documentation. This includes any new records since your original application that show the progression of your condition. Medical reports from specialists, new diagnoses, or treatment results can help demonstrate the severity of your disability and how it limits your ability to work. Be sure that your healthcare providers document all symptoms, treatments, and the limitations you face in daily activities.

  • Detailed Statements from Your Doctors

Your doctor’s detailed statement is important for your appeal, offering a professional view on how your condition affects your work abilities. It explains your ability to stand, sit, lift, concentrate, and predicts any future improvements. The SSA values such statements, especially from long-term treating physicians.

  • Specialist Opinions

If your initial claim relied mostly on general medical evidence, seeking the opinion of a specialist in your condition can make a big difference. Specialists, such as neurologists, psychiatrists, or orthopedists, can provide more specific and authoritative insights into how your condition affects you. Their expert opinion is often considered more credible by the SSA.

  • New Diagnostic Tests or Imaging Results

If you’ve undergone any new diagnostic tests, such as MRI scans, X-rays, or blood tests, these results can provide objective evidence of your disability. For example, imaging that shows worsening joint damage in a person with arthritis or test results showing the progression of a neurological condition can directly support your appeal by validating the severity of your condition.

  • Functional Capacity Evaluations

A functional capacity evaluation (FCE) is a test performed by a medical professional to determine your physical or mental abilities to perform work-related tasks. This evaluation can provide specific evidence about how your disability limits you in areas like lifting, walking, or concentrating for extended periods. Results from these evaluations can be very persuasive, especially if your ability to work is a central issue in the denial of your claim.

  • Mental Health Evaluations

If you suffer from a mental illness or cognitive disorder, additional psychiatric or psychological evaluations can help prove the extent of your mental health limitations. These evaluations can assess issues such as memory problems, difficulty concentrating, mood disorders, or anxiety, which might not be fully documented in your initial application. Mental health conditions often require thorough documentation to meet the SSA’s criteria for disability.

  • Personal Statements or Third-Party Testimonies

Besides medical evidence, personal statements and testimony from others can help. You can explain how your disability affects daily life, while friends or coworkers can share what they’ve noticed. These add a personal view of how your condition affects you outside the doctor’s office.

  • Work History and Job Performance Documentation

Evidence related to your previous employment, such as performance evaluations or documentation showing an inability to meet job demands, can help show that your disability has affected your workability. If you’ve had to reduce your hours, take extended sick leave, or were unable to keep up with job requirements due to your condition, these records can provide important support for your claim.

  • Social Security Questionnaires

Sometimes, the SSA sends questionnaires to you or your healthcare providers to gather more information about your condition. Responding thoroughly and promptly to these can also help clarify details about your disability. The SSA looks for consistency between your medical records, personal statements, and questionnaire answers.

Providing additional evidence during your appeal is critical to building a strong case. Whether it’s updated medical records, professional opinions, or functional evaluations, the more detailed your evidence, the better your chances of overturning the initial denial and securing the benefits you need.

Your Legal Help in Your SSDI Reconsideration Process in Louisiana

Appealing an SSDI denial can be a challenging process, but providing the right additional evidence can make a significant difference in the outcome of your claim. You are not required to have an attorney to appeal, but if you’re unsure about how to proceed or need help, consider consulting with our Monroe social security disability attorney at E. Orum Young Law Social Security Disability who can guide you through each step and help you present the strongest possible case. 

Remember, persistence is key—many Supplemental Security Income or Social Security Disability Insurance claims are approved at later stages of the process. The road to securing your benefits may seem long, but with the right support and preparation, you can improve your chances of getting the financial relief you deserve. Contact us today for a free case review!