SSDI Appeals Guide: SSA & SSI in Maryland, Maryland

SSDI Denials and Appeals in Maryland, Maryland: A Practical Guide

Receiving a Social Security Disability Insurance (SSDI) denial in Maryland can be overwhelming, but a denial is not the end of your claim. Many otherwise eligible claimants are denied at the initial stage and ultimately win benefits on appeal. This guide explains your federal rights, the SSDI appeals process, strict filing deadlines, and how to access local Social Security resources in Maryland. It also highlights issues that often lead to denials and practical steps Maryland claimants can take to strengthen an appeal. While this guide slightly favors protecting claimants, it remains grounded in federal law and official Social Security Administration (SSA) rules.

SSDI is a federal program administered by the SSA. If you live in Maryland, your initial medical eligibility decision is made by a state Disability Determination Services unit under SSA's rules, and appeals proceed through the same federal system used nationwide. The SSA’s headquarters is in Baltimore, Maryland, which means many national SSDI policy and program functions operate from within the state. Nonetheless, every Maryland claimant must still meet the same federal standards for disability, insured status, and earnings eligibility as claimants in any other state.

Because appealing an SSDI denial involves strict timelines and detailed evidentiary rules, understanding the process is essential. Federal regulations provide: (1) a 60-day deadline to appeal most decisions, with a five-day presumption that you received SSA’s notice after the date on the letter, and (2) a multi-level process that includes reconsideration, an Administrative Law Judge (ALJ) hearing, Appeals Council review, and federal court. This guide cites the specific federal regulations that control each step so you can check the rules yourself. If you need personalized help, consider consulting a Maryland disability attorney experienced in SSDI appeals or a qualified representative permitted under SSA regulations.

Understanding Your SSDI Rights

Basic SSDI Eligibility

To qualify for SSDI, you must be “insured” through sufficient work under Social Security and have a severe medically determinable impairment that prevents substantial gainful activity (SGA) for at least 12 months or is expected to result in death. The SSA evaluates disability using a five-step sequential evaluation process codified at 20 C.F.R. § 404.1520. The SSA also evaluates whether your work constitutes SGA under 20 C.F.R. §§ 404.1571–404.1576. If SSA finds your work activity exceeds SGA or that you retain the capacity to perform past work or other work in the national economy, it can deny your claim.

Your Right to Representation

You have the right to appoint a representative to help you with your SSDI claim and appeal, including an attorney or a qualified non-attorney representative. This right is guaranteed by 20 C.F.R. § 404.1705. Representatives can help you gather medical evidence, prepare written arguments, and represent you at a hearing before an ALJ. SSA regulates representative fees; in most SSDI cases, fees are contingent upon winning back benefits and must be approved by SSA under 20 C.F.R. § 404.1720. Even if you plan to proceed on your own, you can appoint a representative at any stage.

Your Right to a Hearing and to Present Evidence

If you are denied upon reconsideration, you have the right to a de novo hearing before an ALJ. See 20 C.F.R. § 404.929 (right to a hearing). You can submit evidence, examine the evidence used by SSA, and present witnesses. The ALJ will consider medical opinions and all relevant evidence consistent with SSA’s evidentiary rules, including 20 C.F.R. § 404.1512 (duty to submit all evidence known to you that relates to your disability) and 20 C.F.R. § 404.1545 (residual functional capacity, or RFC). For claims filed on or after March 27, 2017, medical opinions are evaluated under 20 C.F.R. § 404.1520c rather than the former “treating physician rule.”

Common Reasons SSA Denies SSDI Claims

1) Substantial Gainful Activity (Work Above SGA)

If your earnings exceed the SGA threshold, SSA can deny your claim at Step 1 of the five-step process under 20 C.F.R. §§ 404.1571–404.1576. Evidence of work activity, even part-time or inconsistent, can trigger closer scrutiny. If you attempted to work but had to stop or reduce hours because of your impairments, provide detailed documentation and employer statements to show unsuccessful work attempts where applicable.

2) Insufficient Medical Evidence

SSA requires objective medical evidence from acceptable medical sources to establish a medically determinable impairment and assess your functional limitations. See 20 C.F.R. § 404.1512. Claims are often denied when records are incomplete, outdated, or missing specialist evaluations or diagnostic tests. If SSA orders a consultative examination (CE) under 20 C.F.R. § 404.1519, attend and cooperate; failure to attend can lead to denial based on the evidence in the file.

3) Failure to Meet or Equal a Listing

SSA maintains the Listing of Impairments in Appendix 1 to Subpart P of Part 404. If your impairment does not meet or medically equal a listing at Step 3, SSA proceeds to assess your RFC. Many denials occur because the evidence does not match listing criteria. However, not meeting a listing does not end your claim—your limitations may still prevent all substantial work, leading to a favorable finding at later steps.

4) RFC Findings That Support Past Work or Other Work

Under 20 C.F.R. § 404.1545, SSA formulates your RFC based on medical and non-medical evidence. Denials often result when SSA concludes you can perform your past relevant work (Step 4) or adjust to other work in the national economy (Step 5). Vocational evidence and accurate descriptions of your functional limits (standing, walking, lifting, sitting, concentration, persistence, pace, absenteeism) are critical to challenge these findings.

5) Noncompliance or Gaps in Treatment

SSA may discount symptom severity if the record shows inconsistent treatment or failure to follow prescribed treatment without good reason. Ensure the file reflects explanations for any gaps, such as lack of access, medical contraindications, or other acceptable reasons.

6) Technical Issues: Insured Status and Onset

SSDI also requires insured status—sufficient work credits—and disability must be established on or before your date last insured (DLI). Technical denials can occur if earnings records are incomplete or the alleged onset date conflicts with work or treatment evidence. You can request correction of earnings records if needed and provide corroborating documentation.

Federal Legal Protections & Regulations

The Five-Step Sequential Evaluation

SSA adjudicates disability under the five-step framework in 20 C.F.R. § 404.1520:

• Step 1: Are you engaging in SGA? See 20 C.F.R. §§ 404.1571–404.1576.
• Step 2: Do you have a severe impairment (or combination) that significantly limits basic work activities for at least 12 months?
• Step 3: Does your impairment meet or equal a listed impairment (Appendix 1 to Subpart P of Part 404)?
• Step 4: Can you perform your past relevant work based on your RFC (20 C.F.R. § 404.1545)?
• Step 5: Can you adjust to other work considering your RFC, age, education, and work experience?

SSA bears the burden at Step 5 to show other work exists in significant numbers in the national economy that you can perform.

Evidence Requirements and Duty to Submit

You must submit all evidence known to you that relates to whether you are blind or disabled, including both favorable and unfavorable evidence. See 20 C.F.R. § 404.1512. SSA evaluates medical opinions and prior administrative medical findings under 20 C.F.R. § 404.1520c for claims filed on or after March 27, 2017, considering supportability and consistency.

Your Appeal Deadlines

SSA’s appeal timelines are strict. In general, you must request the next level of appeal within 60 days of receiving the notice. SSA presumes you receive notices 5 days after the date on the letter unless you show otherwise. See 20 C.F.R. § 404.909(a)(1) (reconsideration deadline), 20 C.F.R. § 404.933(b)(1) (requesting an ALJ hearing), 20 C.F.R. § 404.968(a)(1) (Appeals Council review), and 20 C.F.R. § 422.210(c) (judicial review receipt presumption).

If the Appeals Council denies review or issues an unfavorable decision, you generally have 60 days to file a civil action in federal court under 42 U.S.C. § 405(g). Missing deadlines can lead to dismissal, though SSA can extend time for good cause under 20 C.F.R. § 404.911.

Right to Federal Court Review

After exhausting administrative remedies (ALJ decision plus Appeals Council review), you may file a civil action in the U.S. District Court having jurisdiction where you reside, including the U.S. District Court for the District of Maryland. Judicial review is limited to whether SSA’s decision is supported by substantial evidence and whether the proper legal standards were applied, as set out by 42 U.S.C. § 405(g).

Steps to Take After an SSDI Denial

1) Read Your Denial Letter Carefully

Your decision notice explains why SSA denied your claim and how to appeal. Note the date on the letter and calendar your 60-day deadline. Consider the five-day mailing presumption in 20 C.F.R. § 422.210(c). If you did not receive the notice timely, keep evidence (e.g., envelope with postmark).

2) File a Timely Appeal

Do not start a new application unless instructed by a representative after a strategic review. File a Request for Reconsideration if this is the first denial (20 C.F.R. § 404.909). If reconsideration is denied, file a Request for Hearing before an ALJ (20 C.F.R. § 404.933). If the ALJ denies your claim, request Appeals Council review (20 C.F.R. § 404.968), and if necessary, pursue federal court under 42 U.S.C. § 405(g).

3) Strengthen the Record

• Update medical records: Obtain complete records from all relevant providers. Include imaging, test results, treatment notes, and specialist opinions.
• Functional evidence: Ask providers to describe specific functional limits (e.g., lift/carry, sit/stand tolerances, off-task time, absenteeism) relevant to 20 C.F.R. § 404.1545.
• Address work activity: If you tried to work, document why the attempt failed, hours worked, accommodations, and dates.
• Medication side effects: Ensure side effects appear in treatment notes.
• Consistency: Keep consistent statements about symptoms, daily activities, and limitations across forms, exams, and testimony.

4) Consider a Representative

An experienced representative can identify evidentiary gaps, prepare written arguments addressing the specific regulations (for example, why you meet or equal a listing or why vocational evidence supports a Step 5 allowance), and examine expert witnesses at hearing. Your right to representation is set out in 20 C.F.R. § 404.1705.

5) Prepare for the ALJ Hearing

• Review your file: You or your representative can review the exhibits in the electronic record before the hearing.
• Submit evidence timely: Comply with submission deadlines and the duty under 20 C.F.R. § 404.1512.
• Vocational issues: Be prepared to question vocational expert testimony about job numbers and whether hypothetical limitations match your actual RFC.
• Lay witnesses: Consider statements from family or former supervisors if they provide specific, corroborating observations.

6) Good Cause for Late Filing

If you miss a deadline, you may request an extension for good cause under 20 C.F.R. § 404.911. Provide a detailed explanation and evidence (e.g., hospitalization records, mail delivery issues) supporting why you could not meet the deadline.

When to Seek Legal Help for SSDI Appeals

While you can handle an appeal yourself, representation can be useful if:

• Your case turns on complex medical issues, conflicting opinions, or borderline age categories.
• You have past work with skills that may transfer, making Step 5 analysis more complex.
• You need to challenge vocational expert testimony or present a theory involving medical equivalence to a listing.
• You face a technical issue (insured status, onset date, or prior application effects) that requires careful legal development.

SSA permits attorneys and qualified non-attorney representatives to represent claimants. See 20 C.F.R. § 404.1705. If you choose an attorney located in Maryland, ensure the attorney is licensed and in good standing. You can verify a Maryland attorney’s status through the Maryland Judiciary’s official attorney directory.

Local Resources & Next Steps in Maryland

How to Contact SSA in Maryland

SSA Headquarters (Baltimore, Maryland): 6401 Security Blvd, Baltimore, MD 21235. Although this is SSA’s national headquarters, most claimants will interact with their local field office for applications, appeals, and benefit issues. Use SSA’s office locator to find the closest Maryland field office and confirm office hours and appointment options.

Find Your Local SSA Field Office (Office Locator)You may also contact SSA by phone at 1-800-772-1213 (TTY 1-800-325-0778). Always keep copies of everything you submit, note dates and times of calls, and request written confirmations when possible.

Where Your Appeal Happens

• Reconsideration: Your case is reviewed by a different team than made the initial decision, under 20 C.F.R. § 404.909.
• ALJ Hearing: If reconsideration is denied, you may have a hearing conducted by an Administrative Law Judge under 20 C.F.R. § 404.929. Hearings may be held by video, telephone, or in person depending on SSA procedures.
• Appeals Council: Review is discretionary and governed by 20 C.F.R. § 404.968 and related provisions.
• Federal Court: If you receive a final decision that is unfavorable, you may file a civil action in the U.S. District Court for the District of Maryland under 42 U.S.C. § 405(g), subject to the 60-day filing period and the five-day mailing presumption in 20 C.F.R. § 422.210(c).

Local Considerations for Maryland Claimants

• Medical records: Maryland claimants should ensure records from all in-state providers are requested early, including specialists, primary care, and mental health providers. Provide detailed release forms and follow up with providers to confirm transmission to SSA.
• Transportation and access issues: If you have difficulty attending consultative exams or hearings, inform SSA in advance and request accommodations or alternative formats (e.g., phone or video), when permitted by SSA procedures.
• Representative selection in Maryland: If you prefer a Maryland-based attorney, confirm active licensure and familiarity with SSA hearings. SSA allows representation by attorneys admitted in any state if in good standing, but a Maryland attorney may offer familiarity with local medical providers and hearing practices.

SSI vs. SSDI: Similar Appeals, Different Eligibility

Though this guide focuses on SSDI, many Maryland residents also consider Supplemental Security Income (SSI). SSI has different financial eligibility rules but uses a similar medical disability standard and appeals process. If you applied for both programs (a concurrent claim), ensure evidence is submitted for both, and verify that all adverse determinations are appealed within the applicable deadlines. For SSI-specific appeals, analogous deadlines appear at 20 C.F.R. § 416.1409 (reconsideration), 20 C.F.R. § 416.1433 (hearing), and 20 C.F.R. § 416.1468 (Appeals Council).

Building a Strong Maryland SSDI Appeal Record

Medical Evidence Strategies

• Longitudinal records: Demonstrate ongoing impairment severity over time, not just isolated visits.
• Objective testing: Provide imaging, labs, pulmonary function tests, neuropsychological testing, or other objective measures relevant to your condition.
• Specialist input: Opinions from specialists that explain clinical findings and functional limits often carry more persuasive weight when well-supported and consistent.
• Function-by-function analysis: Ask providers to address sitting, standing, walking, lifting, manipulative functions, and mental capacities (understanding, remembering, carrying out instructions; interaction; concentration; persistence; pace; adaptation) relevant to 20 C.F.R. § 404.1545.

Non-Medical Evidence

• Work history: Accurate job titles, duties, and physical/mental demands help evaluate past relevant work at Step 4.
• Activities of daily living (ADLs): Be precise and consistent in forms and testimony. Explain how you perform tasks, the time they take, and whether you need help.
• Third-party statements: Well-detailed statements from people who observe your limitations can corroborate your symptoms.

Responding to SSA Examinations

If SSA sends you to a consultative examination under 20 C.F.R. § 404.1519, attend and give your best effort. Immediately request the CE report and review it for accuracy; if it contains errors, submit clarifying statements and supporting evidence.

Deadlines Recap and What Happens If You Miss One

• Reconsideration: 60 days from receipt of the initial denial (20 C.F.R. § 404.909(a)(1))
• Hearing before ALJ: 60 days from receipt of reconsideration denial (20 C.F.R. § 404.933(b)(1))
• Appeals Council: 60 days from receipt of ALJ decision (20 C.F.R. § 404.968(a)(1))
• Federal Court: 60 days from receipt of final decision (42 U.S.C. § 405(g); receipt presumed within 5 days, 20 C.F.R. § 422.210(c))

If you miss a deadline, request more time and explain good cause under 20 C.F.R. § 404.911. Provide documentation such as hospitalization records or evidence of mail delays.

Frequently Asked Questions for Maryland Claimants

Do I have to stop all work to qualify?

Not necessarily, but work above SGA can result in denial under 20 C.F.R. §§ 404.1571–404.1576. If you work, keep detailed records of hours, earnings, accommodations, and difficulties.

What if my condition worsens after my denial?

Submit updated evidence as soon as possible. Worsening may support a favorable RFC or, in some cases, meeting or equaling a listing. If a new severe impairment arises, disclose it promptly consistent with your duty under 20 C.F.R. § 404.1512.

How long does the process take?

Timeframes vary based on SSA workload and case complexity. While many cases take months or longer to resolve through all appeal levels, you can reduce delays by promptly submitting complete evidence and responding to SSA requests.

Can I appoint a representative at any time?

Yes. You may appoint or change representation at any stage under 20 C.F.R. § 404.1705. Fees generally require SSA approval under 20 C.F.R. § 404.1720.

Key Takeaways for SSDI Denial Appeal Maryland Maryland

• Act fast: Most appeals must be filed within 60 days of receipt. Include the five-day mailing presumption when you count deadlines.
• Build the record: Focus on objective evidence, function-by-function limitations, and consistent treatment notes.
• Use the rules: Tie your evidence to the five-step framework (20 C.F.R. § 404.1520), RFC (20 C.F.R. § 404.1545), and evidence duties (20 C.F.R. § 404.1512).
• Consider representation: You have a right to a representative (20 C.F.R. § 404.1705), and fees require SSA approval (20 C.F.R. § 404.1720).
• Know your court option: After the Appeals Council, you can seek judicial review in the U.S. District Court for the District of Maryland under 42 U.S.C. § 405(g).

How to Verify a Maryland Attorney and Find Local Help

If you choose a Maryland disability attorney, verify licensure and good standing through the Maryland Judiciary’s official attorney directory. SSA also permits qualified non-attorney representatives per 20 C.F.R. § 404.1705. When interviewing potential representatives, ask about their familiarity with SSA’s five-step process, medical evidence development, and vocational testimony at hearings.

Authoritative Resources

SSA: How to Appeal a DecisioneCFR: 20 C.F.R. Part 404 (Disability Insurance)42 U.S.C. § 405(g) (Judicial Review)SSA Office Locator (Find a Local Field Office)Maryland Judiciary: Attorney Directory

Legal Disclaimer

This article is for informational purposes only and is not legal advice. Laws and regulations change, and application of law depends on specific facts. For advice about your situation, consult a licensed Maryland attorney or qualified representative.

Next Step

If your SSDI claim was denied, call Louis Law Group at 833-657-4812 for a free case evaluation and claim review.