If you applied for Social Security Disability Insurance (SSDI) and your claim was denied, you aren’t alone. More than 60% of all initial SSDI applicants are denied.
The good news is, you are allowed to appeal the decision. There are four distinct levels to the SSA disability appeal process. We’ll explore each of them below.Do You Have a Case?
The Social Security Administration (SSA) receives millions of SSDI applications every year. And yet, less than 40% of these applications are approved during the application stage. If your initial attempt is denied, you can appeal the decision at the first appeal level: Reconsideration.
If your original SSDI application was denied, the appeals process could help you meet the eligibility requirements that you missed the first time.
It can be challenging to provide all of the necessary information and ensure that all of the forms are completed correctly. For example, you might have overlooked a doctor’s note or failed to include a report, which resulted in an unfavorable decision.
It’s important to note that you have 60 days from the date that SSA made their decision on your file to ask for a reconsideration. In other words, 60 days from the date on the SSDI denial letter.
The SSA may grant you an extension beyond the 60-day timeframe in exceptional situations, but these instances are rare. You should always attempt to submit your request for reconsideration within 60 days, even if incomplete. You can add to the file after you’ve submitted the request for reconsideration paperwork.
When you ask for a reconsideration, you’re essentially asking for SSA to look at your initial application with fresh eyes. It’s also an opportunity for you to include any additional information that may not have made it into your first application, such as results of tests or additional medical reports. The same state agency that reviewed your initial application will assign your case to a different case examiner to review the entire file.
It can take anywhere from four to six months for reconsideration to take place.
If the SSA denies your application after completing the reconsideration, you can escalate your case to the second appeal level: Appeal Hearing.
You have 60 days to request an appeal hearing if your SSDI application was denied at the reconsideration level.
You can request a social security disability appeal hearing in one of three ways:
Once scheduled, an Administrative Law Judge (ALJ) will review your case and decide on one of the following outcomes:
You will actively participate in the hearing and have the opportunity to explain why you feel your application for SSDI benefits should be approved.
It’s important to remember that an appeal hearing is a legal environment. Many people with a Social Security disability appeal benefit from having an attorney present to help them navigate the legal proceedings and ensure they get the best possible results.
If your SSDI application is denied at this stage, you can escalate your claim to the third appeal level: Appeals Council.
As with the previous levels, you must submit your request to the Appeals Council within 60 days of the decision at the Appeals Hearing level.
At this level, it can take anywhere from six to twelve months for the Appeals Council to hear your appeal — that is, if they hear it. Unfortunately, the Social Security Appeals Council doesn’t guarantee they will hear every request for an appeal that they receive.
It’s important to note that the Appeals Council does not review your claim’s medical validity. They review the legality of the decision rendered by the judge at the Appeal Hearing stage.
If the council reviews your case, you will receive the result of their review by letter. They will either uphold the ALJ’s previous decision or send your case back to level 2 for another appeals hearing.
The council can overturn the previous decision if they determine the judge did one of the following:
If, at the end of this stage, your SSDI application is still denied, to escalate your appeal you will need to file a new appeal with the Federal District Court. This is the fourth and final Social Security Disability appeal level: Federal Court.
As with all other levels, you have 60 days to file in Federal court.
The Federal Court level appeal process is complex and can be confusing for anyone without a legal background. Having a disability lawyer represent your claim at this stage is important.
Your lawyer will file your case, called a “complaint.” This will outline your reason for appealing the SSDI decision and detail why you should be entitled to receive the benefit.
A judge will be assigned to your case and will review your file. The judge can make a decision strictly on the documents you provide, or they can request that your SSDI lawyer argue your case. At this point, your attorney will argue the ways in which you meet the eligibility and how that aligns with current laws.
The judge will typically make one of the following decisions:
If you recently received a denial on your SSDI application, you can submit your appeal request online. To submit online, you’ll be asked to provide specific information to the SSA.
Your appeal requires personal information, such as your name, SSN and address. You will also need to provide details about your application, such as the date of the letter from Social Security denying your claim and your lawyer’s name, address and phone number, if you have one. You will also be expected to provide medical information and documents that support your appeal.
Because a disability lawyer has a comprehensive understanding of the law and your rights within the law, they can argue persuasively — citing exact laws or relevant precedents — to help you get the benefits that you deserve.
A disability lawyer can help determine why your initial SSDI application was denied. They can also advise ways to strengthen your reconsideration or appeal application, giving it an improved likelihood of being accepted.
It’s been shown that applicants have more success when using a disability lawyer compared to going it alone.
Without a lawyer, only about 10% to 15% of reconsideration applications are approved. At the appeals council stage, only about 3% of the appeals are approved.
Overall only 34% of applicants who didn’t work with a disability lawyer were approved for disability benefits. However 60% of those who did partner with a disability lawyer ultimately received benefits.
Your disability lawyer can also help you complete the complex forms, get additional medical records and determine what information you should include with your application for disability benefits.
Non-lawyer representatives can also help with your appeals process.
However because non-lawyers don’t have an extensive and specialized understanding of SSDI and the law, it can be challenging for this type of representative to make a significant impact on the outcome of your appeal. They can, however, provide considerable personal support.
We’ve put together the answers to several FAQs about the SSA disability appeal process.
There is a 60-day window to apply between each level of appeal. How quickly you apply can impact the overall time frame.
A reconsideration, the first level of appeal, can take three to five months.
Beyond the first level of the appeal process, the timeline can vary widely, based on several factors including the following:
Note that the timeframes above are taken from the point at which each level receives a complete application package. If your application is in any way incomplete (missing doctor’s notes, test results, signature, etc.), your claim will essentially be put on hold until the necessary information is received.
Appeals without a disability lawyer only have an approximate 30% approval rate, compared to 60% of applicants who are approved when using a disability lawyer.
If your initial SSDI application is denied, you have four appeal levels available: Reconsideration, Appeal Hearing, Appeals Council and Federal Court.
All appeals process levels require you to file your appeal within 60 days of receiving a decision.
Successfully filing an appeal can be challenging. There is a lot of information out there to help you, but sometimes the nuances of each individual’s case make it hard to be sure you’re taking all the right steps to get the SSDI income you deserve. That is why we encourage you to contact The Sam Bernstein Law Firm, today if you are interested in filing an application, or if your application or request for reconsideration were denied..
Social Security Disability Law is complicated, but finding the right Michigan disability lawyer is simple.
Click the button below to fill out a quick form or Call 1-800-CALL-SAM today for a free, no-obligation remote consultation from the safety of your home.Do You Have a Case?
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