In this article, appealing a decision by the SSA and how the appeals process unfolds after your claim for Social Security Disability Insurance (SSDI) has been denied.
Most people who go through the process of applying for Social Security Disability are denied in their first attempt. Surprisingly, 75% of all people who apply for Social Security Disability on their own are denied. However, playing the blame game in a situation like this isn’t necessarily the best strategy either. Due to the various stages involved in the process,it can be complicated for someone who hasn’t gone through the claims process before.
There can be many reasons why the Social Security Administration (SSA) might deny your claim for your disability benefits. For instance, you might be denied benefits because you weren’t able to accumulate the required number of work credits under the Social Security Disability Insurance (SSDI) program. You could also be denied because you exceed the asset requirements for Supplemental Security Income (SSI) program.
Or, more frequently, a person can also be denied benefits because, according to the SSA, their disability wasn’t limiting enough. Typically the SSA denies people by telling them that, even though they have certain conditions and may not be able to return to any of their past jobs, that there are other jobs that the SSA believes that they can do. As you might already know, the SSA is strict about who gets awarded benefits and who they don’t. The SSA has state agencies that process these portions of the claims and these adjudicators help them in evaluating who deserves benefits and who doesn’t.
The SSA also has a Blue Book, which has a list of all impairments that can get the applicant qualified almost instantly for disability benefits. However, if your disabling condition isn’t written in the Blue Book, you can still get benefits if your disability is long-term (expected to last a year). If it’s short-term, the SSA might not evaluate your case further.
Let’s start with the first step.
How Do You File an Appeal?
The appeals process begins immediately after your claim for benefits has been denied. When this has happened, you’re supposed to send a request for reconsideration to the SSA in writing. You only have 60 days to do this, and if you take more than 60 days, you’re appeal can be automatically turned down as not having been filed in time (unless you meet a few narrow exceptions).
There are three ways you can file an appeal.
Every state in America has a Social Security Administration office. You can go to the office in your respective state and tell them you’re applying for a request for reconsideration. Each office will have a claims representative, and they can help you fill out all the forms that apply to your situation.
The second method to file an appeal is by mail. After you’ve requested a special form for appeal at the Social Security Office in your state, the SSA will mail you the form entitled SSA-827. This form grants the SSA the ability to access your updated medical records.
The third and most commonly used method of appealing is by applying online on the SSA’s website. This is the fastest way one can appeal the SSA’s decision. After you’ve appealed, you can also print your request for reconsideration.
Although you have these options to do the appeal on your own, your chances of approval are GREATLY increased by calling an experienced disability attorney. To learn more about your rights under the Social Security Disability laws, call our FREE Disability Hotline at 1-866-4-MY-SSDI (469-7734) to speak with one of our friendly disability rights advocates who, once they obtain all the required information, will evaluate your claim in 60 seconds or less or fill out our FREE Disability Case Assessment form and one of our representatives will contact you immediately.
The Appeals Process
The first stage isn’t too different from the initial application process. The only difference is that the claimant will now have a different person looking over their case and making a new decision based on the prior records, and any other updated records since the claim was first filed. In most cases, the claimant’s files will be reviewed without them being present.
2. Administrative Law Judge Hearing
However, if the applicant still receives a denial during the reconsideration stage, they can take their appeal to the next stage by requesting a hearing. This also has to be filed within 60 days of the denial at the reconsideration level. An Administrative Law Judge (ALJ) has the authority to make a new and independent decision, and many times the approval rates are higher than at the first two stages. The hearing is an informal proceeding that takes place with the Office of Hearing Operations where the judge and attorney question the claimant, and also have the opportunity to typically question a Vocational Expert or Medical Expert to support the claim.
3. The Appeals Council
If the ALJ has denied your claim for benefits, you can take your case in front of the Appeals Council by filling the form HA-520. However, to do this, you’re going to have to appeal within 60 days of the unfavorable decision from the ALJ. The Appeals Council consists of Judges, Support Personnel and Appeal Officers. The Appeals Council can overturn a decision if any of these 4 acts have been committed:
- Abuse of judgment by the Administrative Law Judge
- Error in law
- The conclusions of cases don’t have logical explanations
- A broader policy issue that can change how cases are applied by the public
The Bottom Line
If you are disabled and your long-term disability is a hindrance in your ability to work and make a living for your family, you should think of applying for disability benefits. Your disability attorney will collect the documents you have and start preparing your claim.
Here at Kahn and Associates we take our cases on a contingency fee basis, which means we do not require any payment unless we are successful in securing benefits for you.
To learn more about your rights under the Social Security Disability laws, call our FREE Disability Hotline at 1-866-4-MY-SSDI (469-7734) to speak with one of our friendly disability rights advocates who, once they obtain all the required information, will evaluate your claim in 60 seconds or less. Alternatively, you can fill out our FREE Disability Case Assessment form and one of our representatives will contact you immediately.