Can a refinance be denied after the appraisal?

Yes. The FDIC explains that a lender uses the appraisal to assess the property's value as collateral and also to determine the interest rate, required down payment, and whether the loan is approved, so a refinance can be denied if the appraised value does not support the loan. If you believe an appraisal is inaccurate, you can request a reconsideration of value from the lender, supported by evidence such as plat maps, measurements, photos and receipts of improvements, and a list of comparable sales from the past 12 months.