How to Appeal an SSDI Denial in New York

Receiving a Social Security Disability Insurance (SSDI) denial letter is discouraging, but it is far from the end of the road. The Social Security Administration (SSA) denies the majority of initial applications—often over 60%—yet a substantial number of those claimants ultimately win benefits after appealing. New York applicants have specific procedural pathways and deadlines that must be followed precisely to preserve their right to benefits. Understanding each step of the appeals process gives you the best possible chance of a successful outcome.

The Four Levels of the SSDI Appeals Process

The SSA provides four formal levels of appeal. Each level must generally be exhausted before advancing to the next, and strict deadlines apply at every stage.

• Reconsideration: A different SSA examiner reviews your original file along with any new evidence you submit.
• Hearing before an Administrative Law Judge (ALJ): An in-person or video hearing where you present your case directly.
• Appeals Council Review: The SSA's Appeals Council evaluates whether the ALJ made a legal error.
• Federal District Court: If all administrative remedies fail, you may file a civil lawsuit in U.S. District Court.

The 60-day deadline is critical at every level. You have 60 days from the date you receive an SSA notice—plus five additional days the SSA allows for mailing—to file your appeal. Missing this window without good cause almost always means starting the entire application process over from scratch.

Step One: Requesting Reconsideration

Reconsideration is the mandatory first appeal for most New York claimants. You submit Form SSA-561 (Request for Reconsideration) either online through the SSA's website, in person at your local Social Security office, or by mail. New York has numerous field offices across all five boroughs of New York City, as well as locations throughout Long Island, the Hudson Valley, Western New York, and upstate regions.

Reconsideration has a low approval rate—historically below 15%—but it must be completed to preserve your right to an ALJ hearing. Use this stage to gather and submit additional medical evidence. If your treating physician has not submitted a detailed residual functional capacity (RFC) assessment, obtain one now. The RFC form documents precisely what physical and mental tasks you can and cannot perform, which is central to the SSA's disability determination.

New York claimants should also be aware that the SSA contracts with a state agency called the New York State Office of Temporary and Disability Assistance (OTDA) to make initial and reconsideration determinations. Disability Determination Services (DDS) examiners handle these reviews. If they deny your reconsideration, you move to the ALJ level, which is administered directly by the SSA's Office of Hearings Operations.

Step Two: The ALJ Hearing—Your Most Important Opportunity

The ALJ hearing is statistically your best chance of winning. Approval rates at this level have historically ranged from 45% to 55% nationally, and experienced representation significantly increases those odds. In New York, ALJ hearings are conducted at Office of Hearings Operations locations in Albany, Buffalo, Brooklyn, Garden City, Jericho, Manhattan, Queens, Rochester, Syracuse, and White Plains, among others.

At the hearing, the ALJ will examine your medical records, work history, age, education, and functional limitations. A vocational expert (VE) is typically present to testify about whether someone with your limitations could perform any jobs in the national economy. Challenging the VE's testimony—particularly by identifying conflicts between the VE's opinion and the Dictionary of Occupational Titles (DOT)—is often a pivotal strategy.

Prepare thoroughly for your hearing by:

• Ensuring all treating physicians have submitted updated records and supportive opinion letters.
• Obtaining mental health records if anxiety, depression, PTSD, or cognitive impairment is part of your disability claim.
• Preparing a detailed description of your daily activities and functional limitations.
• Reviewing the SSA's listing of impairments (the "Blue Book") to determine whether your condition meets or equals a listed impairment, which can fast-track approval.
• Securing legal representation before the hearing date.

Hearings are typically scheduled 12 to 24 months after the request is filed, though wait times at New York offices can vary. During this period, continue all medical treatment and maintain thorough records of every appointment, hospitalization, and prescribed medication.

Strengthening Your Case with Medical Evidence

The SSA's decision ultimately turns on medical evidence. Claimants in New York frequently lose appeals not because they are not disabled, but because their medical records do not adequately document functional limitations. A diagnosis alone is insufficient—what matters is how your condition affects your ability to work on a consistent, full-time basis.

Work closely with your treating physicians to obtain detailed narrative reports that address the SSA's five-step sequential evaluation process. Specifically, evidence should establish that your impairment has lasted or is expected to last at least 12 months, that you cannot perform your past relevant work, and that no other work exists in significant numbers in the national economy that you could perform given your age, education, and RFC.

If the SSA schedules you for a consultative examination (CE) with one of their contracted physicians, attend without fail. Failing to appear without good cause can result in denial. However, understand that CE physicians spend very limited time with claimants. Your own treating physicians' longitudinal records carry far more weight with an ALJ.

When to Consider Federal Court

If the Appeals Council denies review or issues an unfavorable decision, you have the right to file a complaint in the United States District Court for the district where you reside. In New York, cases are heard in one of four federal districts: the Southern, Eastern, Northern, or Western District of New York. Federal court review is limited to whether the ALJ's decision was supported by substantial evidence and applied correct legal standards—courts do not re-weigh evidence de novo.

Filing in federal court requires strict compliance with procedural rules and deadlines under the Federal Rules of Civil Procedure. The SSA is represented by an Assistant United States Attorney, so having an attorney with federal litigation experience is strongly advisable at this stage. That said, federal remands back to the ALJ level for further proceedings are not uncommon, and some claimants ultimately prevail after a remand.

Throughout every stage of this process, persistence and thorough documentation are your most powerful tools. Many claimants who are genuinely disabled give up after a denial or two, not knowing that approval rates improve substantially with proper representation and a well-developed medical record.

Need Help? If you have questions about your case, call or text 833-657-4812 for a free consultation with an experienced attorney.

Related Articles

• How Much Does SSDI Pay in Missouri?
• SSDI Reconsideration in Montana: What to Do
• PTSD and SSDI Benefits in Florida