The Social Security Disability (SSD) program is a safety net for people who cannot work due to physical or mental conditions. However, many applicants in North Carolina find their claims denied the first time they apply, often leading to frustration and concern. Learning about the appeal process and understanding the steps involved can make a significant difference. With the right knowledge and assistance, it is possible to appeal and receive the benefits needed. At, Phillips & McCrea, PLLC, we are here to guide you through the legal process and help you navigate the complexities of your case.
Understanding the Initial Denial
It can be disheartening to receive a denial letter after submitting a Social Security Disability claim. The Social Security Administration (SSA) denies many first-time applications. A denial does not mean the end of the journey; it only means that the SSA needs more convincing evidence or information about your condition. Reasons for denial often include insufficient medical records, lack of proof that your disability will last for at least 12 months, or a belief that you can still perform some form of work. Knowing the reason for denial helps in planning a more effective appeal.
Four Levels of Appeal in North Carolina
The SSA has four stages in the appeals process: reconsideration, hearing by an Administrative Law Judge, review by the Appeals Council, and filing a federal court case. Each level presents another opportunity to present your case and demonstrate your inability to work due to a disability.
Reconsideration Stage
The reconsideration stage is the first step after a denial. During this stage, a new representative at the SSA reviews your application along with any new evidence you submit. Many applicants overlook this stage, but it is crucial to provide updated medical records, doctors’ notes, and any new treatments or tests undergone since the original application. These updates may help show that your condition has worsened or is more limiting than initially thought. Reconsideration is a written review, so it’s essential to submit all relevant information to support your claim effectively.
Attorney Attorney Attorney
Michael Phillips
Marcel McCrea
Natalie Andruczyk
Requesting a Hearing by an Administrative Law Judge
If your claim is denied at the reconsideration level, the next step is to request a hearing before an Administrative Law Judge (ALJ). This stage allows you to explain your condition in person and provide further details about how your disability affects your ability to work. During the hearing, the ALJ reviews your records, listens to your testimony, and may hear from medical or vocational specialists. Having an attorney present during this stage can be helpful, as they understand what evidence is most compelling and can help present a clear argument.
Hearings are held in offices near your location in North Carolina, and the ALJ’s questions will focus on your daily life, medical treatments, and the limitations caused by your condition. The ALJ will consider all of this information to determine if the initial decision was incorrect. It may take several months to get a hearing date, but being prepared with updated records and detailed descriptions of your limitations can increase the chances of a favorable outcome.
Review by the Appeals Council
If the ALJ denies your claim, you may request a review by the Appeals Council. The Appeals Council examines the ALJ’s decision for any errors or issues. This level does not always grant every request for review; the Council may deny your appeal if it finds that the ALJ made no significant errors. However, if the Council decides to review your case, it may either decide the case itself or send it back to the ALJ with instructions for further review.
At this stage, you must clearly identify any mistakes made in the ALJ hearing or provide additional information that may have been overlooked. It is a challenging process, but it gives one last chance to have the claim reviewed before considering federal court. A well-organized submission with all relevant documentation can make a difference.
Michael was a pleasure to work with. He made sure all of my questions were answered in a timely manner. His compassion to help allowed me to receive excellence throughout my experience, i would highly recommend his expertise” - Anonymous Philips and McCrea Law firm provided excellent service to entire family and friends. There have been several situations that I/family /friends have depended on their legal service’s. On each occasion they have been professional, knowledgeable and dependable. Providing excellent representation and guidance under stressful situations. I would highly recommend their legal service." - Denise Simply great legal service. They were professional, easy to work with and thorough. I have been very pleased with their service and would highly recommend them to my friends and colleagues as exceptional Charlotte attorneys." - Logan Abrams 
Filing a Federal Court Case
If the Appeals Council denies your claim or refuses to review your case, the final step is to file a lawsuit in federal court. This level of appeal is complex and typically requires a legal representative with knowledge of Social Security laws. The federal court reviews the SSA’s decisions and determines if they were legally justified. While this stage can take a long time and does not guarantee approval, it provides an opportunity to argue that the SSA made an error in denying benefits.
Gathering Evidence to Strengthen Your Appeal
Each stage of the appeal process provides an opportunity to present new information. A well-documented appeal is key to success. The SSA values evidence such as detailed medical records, statements from doctors, reports on treatments and medications, and descriptions of daily limitations. Gathering this evidence and organizing it can show how the disability impacts your daily life and prevents employment.
It is helpful to request a statement from your healthcare providers, explaining why you cannot work and outlining the specific restrictions that prevent employment. Statements from friends or family members who witness your struggles can also be valuable. These additional perspectives may give the SSA a better understanding of how your condition affects your life.
Avoiding Common Mistakes in the Appeals Process
Many applicants unknowingly make mistakes that hurt their chances during the appeal. Common mistakes include missing deadlines, failing to provide updated medical information, and not thoroughly explaining the limitations caused by the condition. Missing a deadline can result in losing the right to appeal entirely, making it crucial to stay organized and meet all submission dates.
Keeping detailed notes about how the disability affects daily life can help provide evidence that may be difficult to gather later. Following medical advice and attending all doctor’s appointments also strengthens your case by showing that you are actively trying to manage your condition. These steps demonstrate that you are doing everything possible to improve, even though your disability prevents you from working.
Choosing an Attorney Can I appeal a VA Disability Denial?Related Videos
How an Attorney Can Help
The appeal process can feel overwhelming, and having an attorney by your side can make a difference in your chances of success. Attorneys familiar with Social Security Disability cases know what evidence is most effective and how to prepare for each stage of the appeal. They can help gather and organize medical records, prepare you for the ALJ hearing, and ensure that you meet all deadlines.
An attorney’s understanding of legal procedures is valuable when challenging decisions by the SSA, especially at higher levels of appeal such as the Appeals Council or federal court. Legal representation can give you confidence, knowing that your case is in capable hands, and can relieve some of the stress of navigating a complex system.
Why You Should Not Give Up After a Denial
A denial can be discouraging, but it does not have to be the end of your efforts to secure benefits. Many applicants are eventually approved through the appeals process, sometimes after one or more levels of appeal. Staying persistent and committed can pay off, especially with the help of updated evidence and professional assistance. Appealing a denial is common and can help provide the financial support you need.
Each level of appeal offers a fresh opportunity to present your case, and it is important to use each opportunity fully. By taking each step seriously and remaining determined, applicants can often achieve a positive outcome. Success may require time and patience, but the benefits can significantly impact your quality of life.
How to Begin Your Appeal Process in North Carolina
Starting an appeal begins by closely reading your denial letter. This letter includes the reason for the denial and instructions on how to appeal. The first appeal, called reconsideration, must be filed within 60 days of receiving the denial notice. Preparing as soon as possible and gathering the necessary evidence will help set a strong foundation for the appeal.
Each stage has specific requirements and deadlines, making it important to stay organized. Missing a deadline or forgetting a step can delay your appeal, so creating a schedule and tracking your progress may be helpful. Reaching out for assistance and understanding your rights during this process can prevent unnecessary delays and increase your chances of approval.
Navigating an appeal for a denied Social Security Disability claim in North Carolina can be complex, but it is possible to succeed with determination and the right guidance. Understanding the stages of appeal, gathering compelling evidence, and avoiding common mistakes can improve the likelihood of approval. The process may be challenging, yet each level of appeal offers another chance to obtain the benefits you need.
If you or a loved one is dealing with a denied Social Security Disability claim, Phillips & McCrea, PLLC, is here to support you. Our firm has experience with Social Security Disability cases in North Carolina, and we are dedicated to helping clients secure the benefits they deserve. Contact Phillips & McCrea, PLLC, today to start your appeal journey and take the first step toward a secure future.