Level : Request For Reconsideration
This is the most straightforward stage of the appeals process. Within 60 days of receiving your denial letter, you can request reconsideration. Reconsideration simply means that someone at Disability Determination Services will perform a complete review of your application to see if an error was made. The representative that completes this review must be different from the original reviewer. You are also allowed to submit more information during this review process if your application was incomplete or if you were denied due to lack of evidence, though this is not required. This stage of appeals typically takes four to 12 weeks to receive a decision.
Required Social Security Appeal Form
The form you use to request reconsideration depends on the reason for your denial. If you were denied for medical reasons, you must submit Form SSA-561 , Form SSA-3441 , and Form SSA-827 . If you were denied for a non-medical reason, you only need to submit Form SSA-561. These forms can be printed, filled out, and mailed to the SSA, or it can also be done entirely online.
Should I Hire A Disability Attorney
Most people can benefit from seeking legal advice during the Social Security disability process. Some may even choose to consult a disability lawyer before their initial application, though this is not required. In general, the higher you move up in the appeals process, the more helpful a disability attorney will be for you. This is especially true if you have a complicated case that requires detailed documentation and a thorough medical record to substantiate your claim. Most people choose to retain a lawyer when they get to the Appeals Council review stage since it typically requires additional evidence and a considerable amount of time.
A good disability lawyer can help you understand why your application has been denied and can work with you to gather needed documentation to increase your chances with your subsequent appeals. Lastly, per federal law, you cannot be charged by a disability lawyer or advocate unless you are ultimately approved. Even then, disability attorneys are capped at what they can charge you. If you are approved, they can only collect 25% of your disability back pay or $6,000, whichever is less.
Do I Need A Disability Appeals Lawyer To Appeal A Social Security Disability Denial Decision
While you are not required to have a social security appeal lawyer for the first three stages of the SSDI appeals process, we encourage you to consider enlisting the help of an experienced North Carolina Social Security Disability attorney for your appeal.
The following chart is a depiction of the decisions made at each level of the Social Security Disability claims and appeals process in 2020 on a national level. At the initial determination level, 61% of the claims were denied many because the applicants did not qualify but some disabled people were likely denied because they did not understand the application process, include all the necessary information, or file on a timely basis.
86% of the appeals at the reconsideration stage were rejected, and more than half of the appeals at the ALJ hearing were dismissed or denied in 2019. We strongly advise you to seek the guidance of a lawyer for Social Security appeals who knows how to:
- gather and index medical records
- question the claimant and witnesses
- obtain detailed statements from treating doctors
- interpret the complex rules and regulations that govern Social Security programs
And if you decide to appeal your case to the Appeals Council or Federal Court, a skilled Social Security Disability attorney can refer to past case experience and prior rulings when providing the Council or judge with a detailed, issue-focused argument.
Also Check: Social Security Office Cleveland Ohio
Do I Need Representation
While it is not necessary to have representation during the appeals hearing, it can significantly improve your chances for approval. A qualified disability advocate can:
- Ensure the hearing is properly held and completed
- Gather all required, updated medical documentation
- Ensure the necessary questions are asked
- Help prepare your witnesses and yourself for the hearing
- Use of personal knowledge of the ALJ
- Argue on-set of disability for a larger back-due benefits check
- Cross-examine the vocational expert
For more information, see our article the Advantages of Representation or contact the Disability Care Center at .
Request For A Hearing
If your Request for Reconsideration is denied, then we will file a Request for a Hearing on your behalf. In West Virginia, the hearing will be scheduled within about 10-13 months after we file the request.
Your hearing will be relatively informal, and it will be held before an administrative law judge. Before the hearing, we will meet with you to prepare you for the hearing.
Your attorney will review with you all the kinds of questions you may be asked. We will also make sure you completely understand your claim for disability benefits. As your Social Security Disability lawyers, we will be present with you at all times during the hearing. These hearings, including your testimony, usually take about 30-45 minutes.
After the hearing, you should receive a formal decision in the mail within 30-90 days. If your application is approved at this stage, you will start receiving benefits in approximately four to five months.
Don’t Miss: How To Freeze My Social Security Number
What Can I Do If My Disability Claim Is Denied On A Technically
There are two ways claims can be denied by Social Security Disability. The first way is through a medical denial. Either the applicant didnt supply enough medical information or documentation to support a claim, or the reviewer determined that the applicant wasnt severely disabled enough.
In many cases, applicants can appeal these claims successfully. However, there is another kind of denial. This denial is known as technical denial. Individuals must have earned enough work credits to qualify for Social Security Disability. If you havent worked recently or if you havent worked enough in the past, you could be denied on this technicality. These kinds of appeals are more difficult.
Yet, if you applied for Social Security Disability and your claim was denied, and then your time ran out, you may have options when it comes to appealing your case. For example, sometimes an individual files a claim and it is denied. The individual may become discouraged or not be aware of his or her right to appeal. Then, when the individual files again at a later time, he or she may be told that he hasnt worked recently and doesnt qualify. In this case, a qualified Tampa SSD attorney may be able to help you appeal your case. Your attorney can show the date you initially filed and were denied and use this date rather than the later date you re-applied for SSD.
How Long Does A Disability Appeal Take
When you want to apply for a Social Security disability benefits appeal, you must apply for Request for Reconsideration, the first stage of the appeals process. This request allows applicants to potentially have a hearing before an administrative law judge and have the initial denial decision overturned. Once you receive your initial determination , you will be granted 60 days to file a request for Reconsideration with Social Security.
Once your Social Security appeal form is completed and submitted, the next step in the process is the hearing stage where most applicants receive benefits. However, remember that it will take time. In Florida, you will have to wait an estimated 376 to 682 days for your disability hearing. After your hearing, youll receive the administrative judges decision regarding your claim between another 45 to 90 days as well.
However, you also dont want to rush the appeals process. You have already been denied once. Before submitting an appeal for disability, consider contacting a disability consultant who is trained in Florida disability benefits applications and appeals. Hiring a disability expert to oversee your appeal can strengthen your claim, improve your evidence submission and possibly expedite your case with online filing of your appeal.
You May Like: Credit Header Social Security Trace
Why Are Disability Benefits Claims Denied
Nearly two-thirds of benefits applications are denied. SSDI is typically denied because the applicant did not have sufficient work credits, there were errors or omissions in the application, or the submitted medical information did not support the claim. As for SSI, these benefits are reserved for those with limited financial resources and the method of determining income and assets is complicated. The best way to avoid mistakes during the application phase is to work with an experienced disability benefits attorney.
Who Evaluates The Claim
Medical ExpertsVocational Experts
- Medical Experts are doctors who review all of the medical records in your application before the hearing. The ALJ will ask the ME questions about your condition at the hearing.
- Vocational Experts are professionals who review the information in your claim and give their opinion on your ability to do past work or other types of work.
Read Also: Social Security Emergency Advance Payment
How Many Times Can You Appeal A Ssdi Decision
You have the right to appeal our decision to deny your retirement, disability, Supplemental Security Income , or non-medical reason. You have 60 days from the date on which we notify you that we will ask for an appeal. Reconsideration is the most common level of appeal.
Multiple appeals can be filed against an unfavorable SSDI decision in a variety of ways. The Disability Determinations Section in Lincoln will be your first port of call for the claim. If you received treatment at either Alegent Creighton Health Center or St.Eliabeths Hospital, you must keep all previous records. If your SSDI or SSI claim is denied, Social Security may require you to file a disability hearing request. If you request a hearing, your disability claim will be reviewed and handled by the Office of Disability Adjudication and Review . Beneficiaries are frequently granted their appeals if they can show that additional medical evidence is required.
Supplementing The Reconsideration Forms
If you have any additional relevant information such as medical records, etc, attach it to your appeal forms. Or if you appealed online, you can mail or take the additional information to the Social Security office address that appears on your denial letter.
Relevant information includes items bearing on your ability to function such as any disability findings from other entities like workers’ compensation judges or insurance carriers, weak attendance records before withdrawal from school or job, or poor performance notices from school or work.
Recommended Reading: Social Security Office Beaumont Texas
Common Reasons Ssd Claims Are Denied
There are many reasons your SSD claim may be denied, but some reasons are more common than others. Some of the most common reasons given for denying an SSD claim include:
- You dont meet the basic requirements. These typically have nothing to do with your medical history. Instead, this essentially means that you earn more than the substantial gainful activity limit, or you dont have enough work credits.
- Your medical condition is not severe enough. If you do not meet the SSAs definition of disabled or the condition will not last longer than one year, you will not qualify for SSD.
- You dont follow doctors orders. You must be willing to help yourself and your condition. If the SSA believes that you are not following prescribed treatment plans, it will deny your claim.
- Youre uncooperative with the SSA. Its always in your best interests to cooperate with the SSA. This means releasing your medical files, showing up for consultative exams, and otherwise complying with the SSAs requests.
- The SSA cannot reach you. If you move or change your phone number, you must inform the SSA.
- You dont have enough medical evidence. Medical evidence is crucial in any SSD claim. If you cannot provide enough evidence showing the extent of your condition, your claim will be denied.
- You are in jail. You cannot receive SSDI benefits if you are incarcerated. You can receive them once you are released.
What You Need To Know About Your Social Security Administrative Hearing In Tampa
If you disagree with the reconsideration decision sent to you for your Social Security Disability Benefits, you have the right to request a hearing before an administrative law judge. To request a hearing, your application must first have been denied at the initial and reconsideration levels. When requesting a hearing and when appearing before the judge, it is important to understand that you have the right to hire a Tampa Social Security disability lawyer. Youll need to file an appeal in a timely manner. In general, individuals have 60 days to make an appeal. Failure to meet the time frame can result in the dismissal of your appeal. Your hearing will be scheduled and usually, the hearing will take place at a location within 75 miles of your house. If you find it difficult to make your hearing, you may be permitted to teleconference in.
So, what do you need to know before your hearing? In general, it is wise to seek qualified legal counsel. A lawyer can review your application, determine if any crucial information is missing, and help you gather together the witnesses and documentation required to make a strong case. Our team of Tampa Social Security disability lawyers have seen other cases before a judge and will know what generally makes a strong case. We can also let you know honestly, whether you meet the criteria for disability.
Read Also: Social Security Office Cary Nc
Chances Of Winning Social Security Appeal
The appeal process for social security is fairly long and difficult, and the chances of winning are slim. However, if you have a strong case and are persistent, it is possible to win an appeal. The first step is to file a request for reconsideration, which must be done within 60 days of the initial denial. If that is unsuccessful, you can then file an appeal with an administrative law judge, which is a hearing. The judge will make a decision based on the evidence and testimony presented. If you are still not satisfied, you can file a civil suit in federal district court.
How can I get disability benefits? In this article, well go over what constitutes a social security disability benefits appeal. There is a very low chance of an appeal succeeding on reconsideration, which occurs at around 13% of the time. Hearing is the level at which a slight increase in likelihood is expected up to 47%. At the hearing level, 47% of disability applicants have their applications approved. If you hire an attorney for your disability case, you will have a better chance of winning it. The Appeals Council is the one you are most likely to appeal to, and it currently stands at 1%.
How To Win Your Social Security Disability Appeal
Americans seeking Social Security disability benefits must navigate a complex application process, and the majority of applicants are unfortunately denied. With denial rates so high across the country, applicants should be familiar with the Social Security appeals process. Unfortunately, most people will have to go through one or more appeals to obtain their benefits. By appealing your disability denial, you can increase your chances of approval and get the financial assistance you need.
Don’t Miss: Is The Social Security Office Open On Saturday
Do Not Delay In Filing Your Appeal
If you receive a denial or fewer benefits than you are entitled to, you must file your appeal to the SSA within 60 days from receipt of your decision letter. You forfeit your right to appeal if you miss this strict deadline and you may have to start the application process over again. We urge you to contact our office as soon as you receive a negative decision so we can advise you of your rights. Your claim evaluation is free, and we do not bill you until we have successfully recovered benefits on your behalf, so there is no risk in learning about your options with the help of our Tampa SSD attorneys.
Should You Hire A Lawyer For Ssdi Appeals
Lets return to our source authority.
At 62, Windy City attorney Grossman considers himself an expert in exactly two things: arm wrestling and winning Social Security Disability appeals.
Its not a stretch to say the two require a similar skill set: Each involves overpowering an opponent determined to deny your success by outlasting you and wearing you down.
But even Grossman advises against acting hastily.
Having a lawyer for your original filing isnt necessary. Its a benefit only if you are interested in getting a head start on your almost inevitable appeal. Your disability attorney will help guide you through what documents to gather and how to make certain your application is complete and accurate.
Most people are not great historians, Grossman says. An attorney will help you assemble the right information and the correct evidence.
But initiating a claim is not where lawyers earn their keep. Your chances of succeeding at the first level by hiring an attorney improve only marginally, Grossman says. Theres no personal interface. Your application may be filled out more expertly, but he wont be making a face-to-face argument.
Recommended Reading: Social Security Office In Topeka Kansas
How Many Times Can You Appeal A Social Security Disability Denial
If you count your reconsideration as an appeal, then you have four opportunities to appeal your original Social Security Disability denial. These include:
If your reconsideration is denied, it is important that you speak to an attorney who will immediately file an appeal on your behalf for a hearing before an Administrative Law Judge. This should be done as quickly as possible because it can take up to a year for your case to be heard. As noted, the appeals process is lengthy, but if you are approved, your benefits will go back to the time of your original disability application.