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Receiving a denial from an Administrative Law Judge (ALJ) can feel like the end of the road. But an ALJ denial doesn’t necessarily mean you’re out of options. Many claimants go on to win their Social Security Disability (SSD) benefits, either through an appeal or by filing a new application. The key is knowing what went wrong, understanding your options, and taking smart steps moving forward.
Why ALJ Denials Happen
ALJ denials are typically based on one or more of the following:
- Insufficient medical evidence
- Non-compliance with treatment plans
- Inconsistencies in your testimony or medical records
- A belief that you can still perform some type of work
- Concerns about substance abuse impacting your ability to work
Judges are supposed to base their decisions on the evidence in the record, but mistakes do happen, and personal biases can affect decisions. Sometimes the ALJ fails to properly weigh certain medical opinions, overlooks relevant records, or misinterprets how your impairments limit your ability to work.
Understanding exactly why your case was denied is critical, because that’s where you’ll need to strengthen your next effort.
Appeal or New Claim: What’s the Right Next Step?
If you’ve received a denial from an ALJ, your next move generally comes down to two options: appeal the decision or file a new claim. Here’s a closer look at when each path may make sense.
When to Appeal
You should strongly consider appealing if:
- You’re still within the 60-day deadline to request review by the Appeals Council
- You believe the ALJ committed legal or factual errors, such as ignoring medical opinion, making faulty credibility findings, or misapplying rules
- Your condition has not changed significantly since your hearing
- You want to preserve your original filing date, which affects how much back pay you might be eligible to receive
Appealing keeps your original case alive rather than starting over. You may also be able to submit new evidence to the Appeals Council, if it meets certain criteria. To learn more, see our article on submitting new evidence to the Appeals Council.
When to File a New Claim
Refiling, also known as filing a subsequent claim, may be the better option if:
- You missed the appeal deadline
- Your health has worsened or you’ve developed new impairments
- You now have medical evidence that was not available during your prior hearing
- Enough time has passed so your current claim relates to a different period than your prior claim
There are pros and cons to refiling after a denial. You may lose out on potential back pay, and the Social Security Administration might dismiss your new claim if it appears too similar to the old one. For more on how to evaluate this decision, read our article on whether you should refile for Social Security Disability after an ALJ denial.
Strategies for Overcoming a Prior Denial
Whether you’re appealing or starting fresh, here’s how to build a stronger case.
1. Gather Stronger Medical Evidence
Include updated treatment records, recent test results, and detailed opinions from your healthcare providers. If new impairments have developed, document them thoroughly.
2. Address the ALJ’s Reasoning
Take time to understand why your claim was denied. Was the judge skeptical of your credibility? Did they misinterpret your medical records or overlook an important opinion? Address these issues directly with new evidence or clarification.
3. Use New Evidence Effectively
If you’re appealing and have new medical documentation that wasn’t available before the hearing, find out if it qualifies for submission to the Appeals Council. Not all new evidence will be accepted, so be sure to meet the SSA’s specific requirements.
4. Show Worsening or New Conditions
If your situation has changed, make sure to show how. Whether it’s worsening symptoms or a new diagnosis, new medical documentation can be the key to a successful claim.
5. Work with an Experienced Representative
An experienced disability attorney or representative can help identify weaknesses in your previous case, address legal errors, and submit the strongest possible claim or appeal.
RELATED POST: How To Prepare For Your Social Security Disability Hearing
Don’t Let a Denial Define Your Future
An ALJ denial can feel like a major setback, but it doesn’t have to be the end of your Social Security Disability claim. With the right evidence and a well-planned approach, you still have a real chance of winning benefits.
Attorney Nick Ortiz has helped many clients recover disability benefits even after a previous ALJ denial. In some cases, he has successfully overcome two prior denials to secure a favorable outcome. The Ortiz Law Firm helps clients across the United States build stronger cases and move forward with confidence.
Have Questions About a Denied Social Security Disability Claim?
If you’re unsure whether to appeal or refile, or you need help presenting new evidence, we’re here to help. Call (888) 321-8131 to explore your options.
RELATED POST: How Experience Won a Social Security Disability Hearing
