Why Was My Social Security Disability Claim Denied? Steps You Can Take in Philadelphia

The shock of a denial letter

After months of waiting, a 55-year-old restaurant manager in Center City opens a long-awaited envelope from the Social Security Administration (SSA). Their doctor had assured them that their heart condition and neuropathy made full-time work impossible. They take a deep breath, unfold the letter, and see the word denied. It’s a gut punch. Questions race through their mind: Did I do something wrong? Is my condition not serious enough? What happens now? If this scenario sounds familiar, don’t lose hope. Denials are common, but many are based on issues that can be corrected.

By understanding why claims are denied and learning how to appeal, you can turn that “no” into a “yes.” If you’re unsure what to do next, a quick search for “SSDI Lawyer Philadelphia” can help you find local advocates who can review your denial and outline the next steps.

Why Social Security disability claims get denied

1. Insufficient medical evidence
   SSA examiners base their decisions on medical records. If your files lack detailed documentation—such as diagnostic tests, specialist reports, and statements about how your condition limits your daily activities—your claim will likely be denied. Gaps in treatment or missing doctor opinions create doubt about the severity of your impairment.
2. Earning above the SGA or not meeting non-medical rules
   You must show that you cannot engage in substantial gainful activity (SGA). In 2025, the SGA limit is $1,620 per month for non-blind individuals and $2,700 for individuals who are blind. Even part-time work or self-employment can push you over the limit if you earn too much. Claims are also denied when applicants don’t meet non-medical requirements—for example, lacking enough work credits or having assets above the SSI resource limit.
3. Not meeting Social Security’s definition of disability
   SSA doesn’t pay benefits for partial or short-term impairments. Your condition must prevent you from working for at least 12 months and either meet a listed impairment or leave you unable to perform any job in the national economy. If examiners believe you can adjust to another type of work based on your age, education, and skills, your claim will be denied.
4. Failure to follow prescribed treatment
   Examiners expect you to follow your doctor’s recommendations unless you have a valid reason (such as severe side effects or lack of access). Skipping medications, missing therapy sessions, or refusing recommended procedures can lead SSA to conclude that your condition isn’t as severe as claimed.
5. Incomplete or inconsistent paperwork and missed deadlines
   Applying for disability involves multiple forms, including the initial application, work history reports, and functional reports. Inconsistent answers or missing information can raise red flags. Equally important, you must adhere to strict timelines. You have 60 days from the date you receive a denial notice to file an appeal. Missing this deadline can result in your case being dismissed.

How to strengthen your claim

Collect comprehensive medical evidence: Work with your healthcare providers to obtain treatment notes, diagnostic tests, and detailed statements describing your functional limitations. Include mental health records if relevant. Don’t assume SSA will request every document.

• Check your work credits and income: Review your Social Security Statement to confirm your earnings record. Ensure you have earned enough credits to meet the 20/40 rule or the requirements for younger workers. If you are working part-time, ensure your earnings remain below the SGA limit.
• Follow treatment plans or document reasons you can’t: Communicate with your doctors about side effects or costs that prevent compliance. Document any barriers—SSA may excuse non-compliance when it’s reasonable.
• Be meticulous with forms: Take time to complete applications and questionnaires thoroughly. Keep copies of all documents you submit and ensure that your answers align with your medical records.
• Respond promptly to SSA requests: If SSA schedules a consultative exam or asks for more information, comply quickly. Missed appointments can sink an otherwise strong claim.

If you need legal guidance at this stage, searches such as “SSDI Attorney Philadelphia” can connect you with counsel experienced in local SSA procedures.

Understanding the appeals process

A denial does not end your claim; it opens the door to the appeals process. SSA provides four levels of review, and many applicants win at the second or third stage:

1. Reconsideration – Within 60 days of your denial, you can request a reconsideration. A new examiner reviews your case, and you can submit additional medical evidence. Many technical errors and missing documents can be fixed at this stage.
2. Administrative Law Judge (ALJ) Hearing– If reconsideration fails, request a hearing before an ALJ. This is a formal court-like proceeding where you can testify and present witnesses. An attorney can cross-examine vocational and medical experts and argue your case.
3. Appeals Council Review– If the ALJ denies your claim, you can ask the Appeals Council to review the decision for legal or procedural errors. The council can affirm, reverse, or remand the case for another hearing.
4. Federal Court– As a final option, you may file a lawsuit in federal district court. At this stage, representation by an experienced disability attorney is critical.
   Appeals can be time-consuming, but success rates are higher at the hearing level, particularly when applicants present updated evidence and credible testimony.

Filing a new application instead of appealing often results in repeated mistakes and a loss of back pay. Many people choose to work with counsel—try a focused search for “SSD Lawyer Philadelphia” to identify firms that regularly handle hearings and appeals.

When to hire a Social Security attorney — Disability Attorney Philadelphia

It’s rarely too early to seek legal guidance. An experienced Social Security attorney in Philadelphia can:

• Diagnose the reason for denial:Lawyers review the denial letter and your file to identify missing evidence or legal issues.
• Gather and organize evidence:They work with your doctors to obtain comprehensive records and tailored opinions.
• Prepare you for the hearing:Attorneys explain what questions you’ll face, help you craft honest and persuasive testimony, and handle cross-examination of experts.
• File appeals on time:Meeting deadlines and navigating SSA regulations reduces delays and protects your right to back pay.
• Represent you at every level:From reconsideration to federal court, a lawyer stands beside you, using their expertise to present your case.
  Legal fees are contingency-based and must be approved by SSA. You pay nothing unless you win, and fees are limited to 25% of past-due benefits, capped at $9,200. No fees come from future benefits.

Q & A: Denial and appeal questions

1. Can I appeal after 60 days?Exceptions are rare. SSA may extend the deadline for good reasons, such as serious illness or an incorrect address, but you must request an extension in writing as soon as possible.
2. Should I file a new application?Generally, no. Appealing preserves your original filing date and back pay. Filing a new application without addressing the problems in your first claim usually results in another denial.
3. Can I work during my appeal?Yes, but keep earnings below the SGA limit and document any attempt to return to work. Working too much can hurt your case.
4. What if my condition worsens?Submit updated medical records and reports. New diagnoses and worsening symptoms can strengthen your claim during reconsideration or at a hearing.

Turn your “no” into a path forward

A denial letter isn’t a final judgment on your disability—it’s a call to action. By understanding why SSA denies claims and taking strategic steps—collecting complete evidence, staying within income limits, following treatment, and filing timely appeals—you can build a winning case.

Weisbord & Weisbord’s Social Security attorneys in Philadelphia have decades of experience helping clients navigate denials and appeals. We handle each case personally, staying with you from the initial consultation through every level of appeal.

Call (215) 592-1111 or reach out online to schedule a complimentary consultation and begin transforming your denial into an approval.