Denied Disability Claims

Denied Social Security Disability Claim

If you are denied on your Social Security disability benefits claim, you should request an appeal immediately, within the 60-day deadline. Most disability claims that are denied are not appealed. Claimants either give up on the process, or file an untimely appeal, or file a brand new claim.

A failure to appeal timely or filing a brand new claim will have the same end result. You lose all appeal rights and start over at the very beginning with a new application. By going through the Social Security disability appeals process a claimant has the best chance of winning a claim and being awarded benefits.

Filing a new application, either because of a missed appeal deadline or thinking that a new claim would be a benefit is a waste of valuable time. Subsequent applications for disability will likely be denied for the same reasons as the first application.

If your Social Security disability claim is denied, immediately contact the Social Security office with your attorney or representative and request an appeal.

How to Appeal Denied Social Security Disability

Claimants who are represented should contact their disability representative or attorney immediately. In almost all cases, a representative will complete the paperwork to appeal the denial and submit it to Social Security on the claimant’s behalf.

SSDI and SSI claimants who are not represented should call social security as soon as they receive a denial letter. After an appeal has been requested, the social security district office will mail the required appeal forms to the Claimant.

Statistically, denials that are pursued through the appeals process (versus filing a new application) will have a much greater chance of winning.

How Long Does the Disability Appeals Process Take?

As with initial claim for benefits, there is simply no way to know how long a disability appeal with the Social Security Administration will take. Disability cases do not have deadlines (despite the fact that the social security office will often represent “90-120” days as the expected time frame for processing a decision). All cases are different as far as a claimant’s impairments and medical evidence are concerned.

If your claim for Social Security Disability benefits is denied at either the initial or appeal levels, you should not panic. Though it’s an unfortunate fact, most claims for Social Security Disability and SSI benefits are denied at the Initial level (60-70%). Even more, are denied at the appeal level (80-85%).

With this in mind, if you are denied for Social Security disability or SSI you should not doubt the strength of your case or the severity of your impairments. Simply realize that most disability claims are turned down, making it necessary for appeals to be filed.

Therefore, as soon as a denial letter is received, immediately contact the Social Security office where you originally filed your social security disability or SSI claim and request the appropriate appeal. If you have representation, let your attorney representative handle this for you.

How do I React if my Case is Denied?

How Can I Appeal a Denied Disability Claim?

If you wish to appeal, you must make your request in writing within 60 days from the date you receive our letter. We assume you receive the letter five days after the date on the letter unless you can show us you received it later. Call your local Social Security office if you need help with your appeal.

If you filed for Social Security disability benefits or SSI and your claim was denied for medical reasons, you may request an appeal.

Disability Appeal Levels

Generally, there are four levels of appeal. They are:

  • Reconsideration;
  • Hearing by an administrative law judge;
  • Review by the Appeals Council; and
  • Federal Court review.

Disability Claim Reconsideration

A reconsideration is a complete review of your claim by someone who did not take part in the first decision. They will look at all the evidence submitted when the original decision was made, plus any new evidence.

Most reconsiderations involve a review of your files without the need for you to be present. But when you appeal a decision that you are no longer eligible for disability benefits because your medical condition has improved, you can meet with a Social Security representative and explain why you believe you still have a disability.

Hearing by Administrative Law Judge

If you disagree with the reconsideration decision, you may ask for a hearing. The hearing will be conducted by an administrative law judge who had no part in the original decision or the reconsideration of your case. The hearing is usually held within 75 miles of your home. The administrative law judge will notify you of the time and place of the hearing.

Before the hearing, we may ask you to give us more evidence and to clarify information about your claim. You may look at the information in your file and give new information.

At the hearing, the administrative law judge will question you and any witnesses you bring. Other witnesses, such as medical or vocational experts, also may give us information at the hearing. You or your representative may question the witnesses.

In certain situations, they may hold your hearing by a video conference rather than in person. We will let you know ahead of time if this is the case. With video hearings, they can make the hearing more convenient for you.

Often an appearance by video hearing can be scheduled faster than an in-person appearance. Also, a video hearing location may be closer to your home. That might make it easier for you to have witnesses or other people accompany you.

It is usually to your advantage to attend the hearing (in person or video conference). You and your representative should come to the hearing and explain your case.

If you are unable to attend a hearing or do not wish to do so, you must explain in writing as soon as you can. Unless the administrative law judge believes your presence is necessary to decide your case and requires you to attend, you will not have to go. Or other arrangements may take place for you, such as changing the time or place of your hearing. You have to have a good reason to make other arrangements.

After the hearing, the judge will make a decision based on all the information in your case, including any new information you give. You will receive a letter and a copy of the judge’s decision.

If you disagree with the hearing decision, you may ask for a review by Social Security’s Appeals Council. We will be glad to help you ask for this review.

The Appeals Council looks at all requests for review, but it may deny a request if it believes the hearing decision was correct. If the Appeals Council decides to review your case, it will either decide your case itself or return it to an administrative law judge for further review.

If the Appeals Council denies your request for review, you will receive a letter explaining the denial. If the Appeals Council reviews your case and makes a decision itself, they will send you a copy of the decision. If the Appeals Council returns your case to an administrative law judge, they will send you a letter and a copy of the order.

Review by Appeals Council

Federal Court Review

If you disagree with the Appeals Council’s decision or if the Appeals Council decides not to review your case, you may file a lawsuit in a federal district court. The letter we send you about the Appeals Council’s action also will tell you how to ask a court to look at your case.

You have the right to be represented by an attorney or another qualified person of your choice when you do business with Social Security. More information is in Your Right To Representation (Publication No. 05-10075), which is also available from Social Security.

Social Security Disability Attorney in Arlington & Mansfield

Sometimes, the examiners who process Social Security Disability claims gather information from you, your neighbors, and your former coworkers. It is important to discuss this with your SSI attorney.