Most PDF accessibility work goes wrong at the first step, because the file was never inspected. A document can look finished and still carry no tag tree at all, or carry a tag tree that describes a different reading order than the one on the page. Start with the PDF accessibility checker to see what the machine can prove, then open the tag viewer to read what the structure actually claims.
If the file has no usable text under the image, tagging cannot help until the text is recovered. Run scanned PDF recovery first in that case. If the text is present but the structure is missing, the auto-tagger adds a logical structure without altering the page as drawn.
These tools report machine-detectable conditions. A clean automated result is not a conformance claim, and it does not replace testing with a screen reader. The PDF accessibility checklist sets out the manual checks that remain, and PDF/UA vs WCAG explains which standard each finding belongs to.
When a whole backlog needs the same treatment rather than one file at a time, compare the remediation paths before committing: hosted accessible HTML, a rebuilt tagged PDF, and manual exact-layout remediation solve different problems and cost different amounts of work.