SSDI Denied? Appeal Step-by-Step (2025 Guide)

Use this 4-level appeal playbook—deadlines, forms, 5-day rule, evidence tips, and fee cap (2025).

The Four Levels of Appeal (at a glance)

Step-by-Step: How to Appeal a Denied SSDI Claim

Step 1 — Read your denial and calendar the 60-day deadline

SSA assumes you received the notice 5 days after the date on the letter. Count your 60 days from the date you receive it. If you missed a deadline, you may still qualify for a “good cause” extension (examples below). (Social Security)

Good cause (examples SSA recognizes): serious illness; death/serious illness in immediate family; records destroyed; language/education limits; SSA actions misled you. Cite 20 CFR 404.911 / 416.1411 in your request. (Social Security)

Step 2 — File Reconsideration (Level 1)

What to submit

• SSA-561 (Request for Reconsideration)
• SSA-3441 (Disability Report – Appeal) — update all treatment, tests, meds, limits since you applied
• SSA-827 (Authorization to Disclose Information to SSA)
  You can do this online when appealing a medical denial. (Social Security)

Goal: close the gaps SSA cited (e.g., lack of objective testing, not severe, can do past work). Add new medical records and work-related functional statements from your providers.

Pro tip: In your SSA-3441 narrative, tie symptoms to work functions (sitting, standing, lifting, pace, attendance), not just diagnoses.

Step 3 — Request an ALJ Hearing (Level 2) if Reconsideration is denied

What to submit

• HA-501 (Request for Hearing by ALJ) — or submit via your my Social Security account
• Updated SSA-3441 and SSA-827 as needed
• Any pre-hearing brief highlighting the issues, evidence, and applicable Listings/RFC rules. (Social Security)

The 5-day rule (critical): You must submit or inform SSA about any written evidence no later than 5 business days before the hearing. The ALJ must accept late evidence only if an exception applies (e.g., SSA misled you; you had limitations; circumstances beyond control). Cite 20 CFR 404.935(b), 416.1435(b). (Social Security)

How you can appear: In-person, online video via Microsoft Teams, or by telephone (availability varies). Online video hearings are optional—say “yes” only if it works for you. (Social Security)

What happens at a hearing: The ALJ asks about your medical conditions and work history; may call a vocational expert (VE) and/or medical expert. You or your representative can question the experts. (Social Security)

Step 4 — Ask the Appeals Council to review an unfavorable ALJ decision (Level 3)

When & how: File within 60 days using AC iAppeal (preferred) or HA-520. Request review for legal/technical errors (e.g., misapplied law, ignoring evidence, flawed VE basis). The AC can deny, issue its own decision, or remand to an ALJ. (Social Security)

Tip: Submit a short memo pointing to the exact hearing transcript pages/exhibits where the error occurred. If you add evidence, explain why it wasn’t available earlier and why it matters.

Step 5 — Consider Federal District Court (Level 4)

If the Appeals Council denies review or issues an unfavorable decision, you can file a civil action in U.S. District Court. You’ll argue legal errors in SSA’s decision (not simply re-try medical facts). Deadlines and procedures are set by the court. (Social Security)

Exactly What to File (with links)

• SSA-561 — Request for Reconsideration (paper/pdf; also online for medical denials). (Social Security)
• SSA-3441 — Disability Report: Appeal (updates your medical/work since filing). (Social Security)
• SSA-827 — Medical records authorization (SSA will request records). (Social Security)
• HA-501 — Request for Hearing by ALJ. (Social Security)
• HA-520 — Request for Review of Hearing Decision/Order (Appeals Council). (Social Security)

You can start at SSA’s Appeal a decision hub and follow your level. Keep copies of everything you submit. (Social Security)

Evidence Strategy That Wins Appeals

1. Fill the exact holes in the denial. If SSA said “not severe” or “can do past work,” focus your updates on functional capacity (sitting/standing/walking/lifting; concentration/pace; absences).
2. Objective tests: imaging, labs, pulmonary function tests, neuropsych testing—align to SSA Listings criteria when relevant.
3. Treating source opinions: Ask providers for work-related limits (how long you can sit, stand, lift; off-task %; expected absences).
4. Medication & side effects: List changes, dosages, side effects that affect work.
5. Consistency & dates: Make sure your testimony, forms, and medical records tell one timeline.
6. For the hearing: Organize exhibits, submit on time (see 5-day rule), and prepare simple answers about bad days, recovery time, and why you can’t do past jobs. (Social Security)

The 5-Day Rule: Your Pre-Hearing Checklist

• ⏱️ Deadline: Get all written evidence to SSA (or notify SSA about it) ≥ 5 business days before the hearing date.
• ✅ What counts as evidence? Medical records, imaging, labs, RFC assessments, third-party statements, school/work records, therapy notes.
• 🧾 Late evidence? Explain the exception (SSA misled you; limits prevented timely filing; something beyond your control). Cite 404.935(b)/416.1435(b). (Social Security)

Online Video Hearings (when they help)

You can choose an online video hearing via Microsoft Teams from a private place with a camera and internet. It’s optional—if you don’t consent, SSA schedules another format. Make sure your device/mic/camera work; test joining via the email link. (Social Security)

Right to Representation & 2025 Fee Rules

• You have the right to a representative (attorney or non-attorney). SSA explains your rights in Pub. 05-10075. Appoint one with SSA-1696 (paper or e-1696 online). (Social Security, Social Security Administration)
• Fees (2025): Under the fee-agreement process, SSA caps fees at the lesser of 25% of past-due benefits or $9,200. (Effective Nov 30, 2024, per SSA notice.) (Federal Register, Social Security)

You generally don’t pay a fee unless you win and there are past-due benefits—SSA approves and pays the fee from back pay under the cap.

Common Appeal Mistakes (and easy fixes)

• Waiting too long → Appeal within 60 days. If late, write a good-cause explanation citing 404.911 / 416.1411. (Social Security)
• Submitting diagnoses, not limitations → Translate medical facts into work-function limits.
• Missing the 5-day rule → Notify SSA of pending records before the deadline and document your efforts; invoke an exception if applicable. (Social Security)
• Skipping the online appeal → Medical reconsiderations can be filed online, which prompts all required forms. (Social Security)
• Not tracking your case → Use my Social Security to check status and messages. (Social Security)

Timeline & Status: What to expect

SSA’s workloads vary by office and case complexity. You can track your appeal status online and respond quickly to requests for forms or consultative exams. For hearing scheduling and format (in-person/phone/video), watch for notices and reply promptly. (Social Security)

Mini-Guide: What happens the day of your ALJ hearing

1. Set the record: The judge confirms exhibits and admits evidence (subject to 5-day rule exceptions). (Social Security Administration)
2. Your testimony: Clear, concrete answers about daily limits and past work demands.
3. Experts: A vocational expert may testify about jobs and how your limits affect employability; you/your rep can cross-examine. (Social Security)
4. Closing: Brief summary of why the record supports a favorable decision (Listings or RFC + vocational rules).
5. Decision: By mail later; if unfavorable, move to Appeals Council within 60 days. (Social Security)

FAQs

1) How long do I have to appeal a denied SSDI claim?
Generally 60 days from when you receive the notice; SSA presumes you received it 5 days after the date on the letter unless you show otherwise. (Social Security)

2) Can I appeal online?
Yes—medical reconsiderations can be appealed online (you’ll complete SSA-3441 and e-sign SSA-827). Non-medical decisions and later levels also have online options. (Social Security)

3) What is the 5-day rule for hearings?
You must submit—or tell SSA about—written evidence no later than 5 business days before your hearing. Exceptions allow late evidence in limited circumstances. (Social Security)

4) Which forms do I need for each level?
Reconsideration: SSA-561, SSA-3441, SSA-827.
ALJ hearing: HA-501 (+ updated SSA-3441/827).
Appeals Council: HA-520 or online AC iAppeal. (Social Security)

5) Do I need a lawyer—and how are fees handled?
You have the right to representation. If you use the fee-agreement process, SSA caps fees at the lesser of 25% of past-due benefits or $9,200 in 2025. Appoint with SSA-1696. (Social Security)

6) What if I missed the deadline?
Ask SSA to accept a late appeal for good cause and explain your reason(s) (serious illness, destruction of records, language/education limits, SSA actions). Cite 404.911 / 416.1411. (Social Security)

7) What happens at an ALJ hearing?
A judge reviews your evidence, questions you, and may call experts. You can testify, present evidence, and question the experts; you may choose online video via Microsoft Teams. (Social Security)

8) What can the Appeals Council do?
It can deny review, issue a new decision, or remand to an ALJ. File within 60 days of the ALJ decision. (Social Security)

Copy-Paste Appeal Checklist

• ⏱️ Calendar 60 days from receipt; if late, write a good-cause request citing 404.911/416.1411. (Social Security)
• 🧾 Reconsideration: file SSA-561 + SSA-3441 + SSA-827 (online if medical). (Social Security)
• 📑 Evidence: request all records since filing; obtain provider RFC statements; highlight objective tests; align to Listings/RFC limits.
• 🧠 Hearing prep: submit evidence before the 5-day deadline; prep testimony; decide on in-person vs online video. (Social Security)
• 📨 After hearing: when the decision arrives, move to Appeals Council within 60 days if needed. (Social Security)
• 👥 Representation: consider appointing a rep with SSA-1696; know the 2025 fee cap (25% or $9,200, whichever is less). (Social Security)

Bottom line

Appealing a denied SSDI claim is a structured process with strict deadlines, specific forms, and evidence rules that you can manage step by step. File on time, plug the exact gaps the denial cites, follow the 5-day rule for hearings, and consider a representative—you control more of this than it feels at first. (Social Security)