1. Why Are SSDI Claims Denied?

Common reasons for denial include:

• Lack of sufficient medical evidence proving disability
• Failure to follow prescribed treatment
• SSA determining you can perform past work or other work
• Earning above Substantial Gainful Activity (SGA) limits

Understanding the reason for your denial, which is explained in your SSA denial letter, is the first step in preparing an effective appeal.

2. What Are the Steps to Appeal an SSDI Denial in Ohio?

The appeals process includes four levels:

Step 1: Request for Reconsideration

• Deadline: File within 60 days of receiving your denial notice
• SSA will conduct a complete review of your claim by a different examiner at Ohio’s Disability Determination Services (DDS)
• You can submit new medical evidence or documentation to strengthen your case

Step 2: Hearing Before an Administrative Law Judge (ALJ)

If reconsideration is denied:

• Deadline: File a hearing request within 60 days of the reconsideration denial
• The hearing is held before an Administrative Law Judge (ALJ), often via phone or video, though in-person hearings occur at your nearest Office of Hearings Operations (OHO)
• You or your representative can present testimony, submit additional evidence, and cross-examine SSA’s vocational or medical experts

Step 3: Appeals Council Review

If the ALJ decision is unfavorable:

• Deadline: Request review within 60 days
• The Appeals Council reviews your case to determine if the ALJ made a legal or procedural error
• They may approve your claim, deny the review, or send it back for another hearing

Step 4: Federal Court Review

If the Appeals Council denies your claim or upholds the ALJ decision:

• You can file a lawsuit in Federal District Court
• This is a formal legal process, requiring filing a civil complaint and following court procedures

3. How to Strengthen Your SSDI Appeal in Ohio

• Review your denial letter carefully to understand SSA’s reasons
• Gather updated medical records, including test results, specialist evaluations, and treatment summaries
• Obtain detailed doctor’s statements explaining your functional limitations and inability to work
• Attend all scheduled consultative exams (CEs) arranged by SSA during the appeals process
• Consider working with an experienced disability attorney or representative to present your case effectively and avoid procedural mistakes

4. How Long Does the SSDI Appeals Process Take in Ohio?

• Reconsideration: Usually takes 1-3 months
• Hearing: May take 12-18 months or longer due to hearing backlogs at Ohio OHO offices
• Appeals Council: Often takes 6-12 months
• Federal Court: Timeline varies, typically 1 year or longer

Being proactive in providing requested documents quickly and attending all appointments can prevent unnecessary delays.

5. What Happens to Your Benefits During an Appeal?

If you were already receiving SSDI benefits and SSA is ceasing them after a Continuing Disability Review (CDR), you may request to continue benefits during your appeal if you file within 10 days of the cessation notice. Otherwise, benefits generally do not continue during the appeals process unless you win your appeal.