SSDI & SSI denial appeals
A denial is a document. Answer it with the same rulebook SSA used to write it.
Dearbh reads the denial, maps your records against the rule it cites, shows what supports your appeal and what is still missing, and tracks every deadline — including the short ones.
SSDI · SSI · First denials · Reconsideration · Hearings · “Your benefits are stopping” notices
Dearbh is not a law firm and does not represent you before the Social Security Administration. It builds the file that you — or the representative you choose — take there.
Five denials, answered with held law
The letter gives a reason. The rulebook answers it.
These are the kinds of conditions Social Security denials name most often. Each card shows one line of an appeal: what the letter says, the rule that governs it quoted word for word, and the records that carry it.
SSA’s letter says
“Your condition is not severe enough to keep you from working.”
Dearbh finds
The rules say that if your condition meets the listing for your body system, you are disabled. Age, education, and work history do not even enter it.
“If you have an impairment(s) which meets the duration requirement and is listed in appendix 1 or is equal to a listed impairment(s), we will find you disabled without considering your age, education, and work experience.”
“We mean any disorder that affects the proper functioning of the heart or the circulatory system (that is, arteries, veins, capillaries, and the lymphatic drainage). The disorder can be congenital or acquired.”
You get
Documents received
- The denial letter
- Your cardiology records
Documents outstanding
- The test results the listing names, such as imaging or stress-test reports Dearbh drafts the requestThe listing decides on named tests, not on how you feel. If the tests are not in the file, the listing cannot be met on paper.
- Your doctor’s statement mapping the findings to the listing’s own criteria Dearbh drafts the requestA stack of records is not an argument. The statement ties each finding to the exact line of the listing it satisfies.
Get the tests on paper first.
“Not severe enough” is answered by the listing, not by adjectives. Dearbh drafts the record requests that put the listing’s own tests in your file, and keeps the appeal deadline in view while they arrive.
SSA’s letter says
“You can still do other work.”
Dearbh finds
“Other work” is not the examiner’s opinion. The rules decide it from your remaining capacity, your age, your education, and your past work.
“Your residual functional capacity is the most you can still do despite your limitations. We will assess your residual functional capacity based on all the relevant evidence in your case record.”
“The following rules reflect the major functional and vocational patterns which are encountered in cases which cannot be evaluated on medical considerations alone…”
You get
Documents received
- The denial letter
- Your treatment records for your back or joints
Documents outstanding
- Your doctor’s statement of what you can still do — sit, stand, walk, lift, and for how long Dearbh drafts the requestThis is the “residual functional capacity” the rule turns on. Without it, the examiner’s guess stands in for your doctor’s answer.
- Your work history, with what each job actually required Dearbh drafts the requestThe vocational rules run on your age, education, and past work together. The file has to say what those jobs demanded, not just their titles.
You can answer this.
“Other work” is a calculation, and a calculation can be checked. Dearbh lines your capacity, age, education, and work history up against the vocational rules, and shows which inputs your file still has to prove.
SSA’s letter says
“The records do not show serious functional limits.”
Dearbh finds
The rule names the exact four areas of functioning the records must speak to. The denial is really a list of what is missing.
“These criteria represent the areas of mental functioning a person uses in a work setting. They are: Understand, remember, or apply information; interact with others; concentrate, persist, or maintain pace; and adapt or manage oneself.”
You get
Documents received
- The denial letter
- Your clinic or therapy notes
Documents outstanding
- Your provider’s statement on each of the four areas, in the rule’s own terms Dearbh drafts the requestA note that says “doing well” answers none of the four areas. The statement has to speak to each one by name, because that is how the rule reads the file.
- Records that cover a stretch of time, not a single visit Dearbh drafts the requestMental health conditions rise and fall. One appointment on a better day is not the record of how you function at work, week after week.
Turn the denial into a checklist.
The rule already lists what the records must show. Dearbh maps your file against the four areas, names the ones with nothing behind them, and drafts the requests that fill them.
SSA’s letter says
“Your seizures are not documented as disabling.”
Dearbh finds
The listing spells out exactly what counts: the type of seizure, how often, for how long, and despite treatment. A seizure log that tracks the listing’s own terms answers it.
“Epilepsy, documented by a detailed description of a typical seizure and characterized by A, B, C, or D: A. Generalized tonic-clonic seizures (see 11.00H1a), occurring at least once a month for at least 3 consecutive months (see 11.00H4) despite adherence to prescribed treatment (see 11.00C)…”
You get
Documents received
- The denial letter
- Your neurologist’s notes
Documents outstanding
- A seizure log tracking the type, the date, and how long each one lasted Dearbh drafts the templateThe listing counts seizures by type and by month. A log kept in the listing’s own terms is the document that does that counting.
- Records showing you took the treatment as prescribed, such as pharmacy refill history Dearbh drafts the requestThe listing says “despite adherence to prescribed treatment.” Refill records are how adherence gets onto paper.
Track what the listing counts.
“Not documented” is a documentation problem, and documentation problems can be fixed. Dearbh sets up the log in the listing’s own terms and drafts the record requests, with the appeal deadline tracked alongside.
SSA’s letter says
“We have determined your disability has ended.”
Dearbh finds
Stopping benefits runs on a different test — medical improvement — and there are two clocks: 60 days to appeal, but only 10 days to ask that payments continue while you do.
“If your impairment(s) has not medically improved we must consider whether one or more of the exceptions to medical improvement applies. If medical improvement related to your ability to work has not occurred and no exception applies, your benefits will continue.”
“…10 days after the date you receive the notice of our initial determination that your physical or mental impairment(s) has ceased, has never existed, or is no longer disabling.”
You get
Documents received
- The letter saying your benefits are stopping
Documents outstanding
- The medical records from when SSA last found you disabled Dearbh drafts the request“Improvement” is a comparison against that earlier point. Without the old records, there is nothing to compare the new ones to.
- Your current treatment records Dearbh drafts the requestThey are the other half of the comparison — what your condition looks like now, from the people treating it.
Two clocks. The short one first.
You have 60 days to appeal, but only 10 days from receiving the notice to ask that your payments continue while the appeal runs. Dearbh puts the 10-day election first and the 60-day appeal behind it, so the short clock is never discovered late.
Each tab shows one line of an appeal. A real denial letter usually gives several reasons at once. Dearbh answers every one of them separately. Each line gets its own rule, its own records, and its own entry in the file, so you can see what backs it and nothing in the letter goes unanswered.
The quotes above come from the SSDI rules, in part 404 of the regulations. SSI uses the same disability test, written out again in part 416. Dearbh holds both, and works out which program — or whether both — applies to you before it writes a word.
SSDI vs SSI, in plain words
Two programs. One disability test.
The letters look alike and the rules live one part apart. What differs is how you qualify, not what “disabled” means.
SSDI runs on work credits
You earned it by working and paying Social Security taxes. Whether you qualify turns on your work record, not on what you own.
SSI runs on financial need
It does not depend on your work history. Whether you qualify turns on your income and what you own, on top of the same disability test.
The appeals run in parallel
The same disability test, and matching appeal ladders: part 404 of the regulations for SSDI, part 416 for SSI. Dearbh holds both, so a case that involves both programs is read against both.
The ladder
A denial is not the end. It is the first rung.
Social Security appeals climb in a fixed order. Each rung has its own 60-day window, counted from when you receive the decision — and a missed window can only be reopened for good cause, which is never the plan.
Initial determination
SSA’s first decision on your claim. Most denials happen here, on the paper file alone.
Reconsideration
A fresh look by someone who did not make the first decision. The file you build here is the file the next rung reads.
Hearing before a judge
An administrative law judge hears your case — the first time a person looks at you rather than at a file.
Appeals Council
Reviews the judge’s decision for errors. It can approve, return the case, or decline to look.
Federal court
Outside SSA entirely. A federal judge reviews whether the decision followed the law.
“Within 60 days after the date you receive notice of the initial determination…”
Sixty days sounds like a long time. It is the time it takes to get records out of a hospital, a statement out of a busy doctor, and a file into shape — which is why Dearbh starts the record requests on day one, not day fifty.
How it works
The appeal is won or lost in the records.
The hard part of a Social Security appeal is not the argument. It is getting the records, and knowing which ones the rule actually asks for. Every line of the appeal is traced to a record in your file; what is missing is named and requested, not papered over.
Add the denial and what you have
Drop in SSA’s letter and everything already in hand — medical records, work history, past decisions. Nothing is too messy to start with.
Dearbh maps records to the rule
It reads the reason SSA gave, finds the rule behind it, and checks your records against what that rule actually asks for — supported, or missing.
Get what is missing
Each missing record is named, and Dearbh helps write the request for it — to your doctor, your clinic, or for SSA’s own file — while the deadlines stay tracked.
Check the proof, then file
The appeal quotes every source word for word, and every line points at a record in your file. You see the real text behind every line before anything goes out.
Start here
Bring the letter. The rulebook is already here.
Dearbh is in live testing and verification review now. Join the waiting list and we will let you know the moment it opens.
Dearbh is not a law firm and does not represent you before the Social Security Administration. It builds the file that you — or the representative you choose — take there.