How to Appeal Denied Social Security Claims

How to Appeal Denied Social Security Claims

If you have already applied for benefits in the past and were denied, don’t give up! Most people are initially denied when they apply on their own. You can still re-apply or appeal denied Social Security claims with the help of a qualified social security disability advocate or attorney.

Many applicants, after working so hard on their application, accept the first denial without realizing that the majority of initial disability applications are rejected, sometimes solely on the basis of a technicality. It is important to understand that denial of your initial application is not the end of the application process.

Here’s what you need to know about how to appeal denied Social Security claims for disability benefits.

Why Denied Social Security Claims for Disability Benefits Happen

Most often, the SSA determines that a claimant’s disability does not prevent him or her from performing all types of work. The SSA will typically cite the following as reasons for denial:

  1. A claimant’s residual functional capacity is not diminished enough to stop you from working.
  2. Inadequate medical documentation for a claim of disability or that the consultative examination has produced evidence to refute the medical opinion of your primary physician.
  3. The Disability Determination Services (DDS) evaluation may find that your disability is not categorized as long-term.

If you receive a denial for your disability claim you should appeal the decision.

Process to Appeal Denied Applications for Disability Benefits

There are four stages to appeal denied Social Security claims for disability benefits:

  1. Reconsideration
  2. Administrative Hearing
  3. Appeals Council Review
  4. Federal Court

After denial of your initial claim by the DDS you must file a “request for reconsideration” within 60 days of your denial. DDS conducts this stage internally at a local office in your state of residence. An examiner for the DDS that hasn’t seen your claim before evaluates it to determine if the agency made any errors in denying you benefits. However, statistics show DDS rarely reverses claim denials at the reconsideration stage. In recent years, just 2% of claimants won SSD benefits during reconsideration.

Timeline to Appeal Denied Disability Claims After Reconsideration Fails

If you receive a denial of your reconsideration, you again have 60 days to file for an administrative hearing. (This is technically the second step out of four when it comes to filing appeals for denied Social Security claims.) This hearing is where you present your disability claim to an administrative law judge. Your judge may schedule your hearing date any day from three months to one year after your filing date. Once in court, the judge will have reviewed your claim before proceedings begin. The focus of the hearing will be upon your residual functional capacity. This is a very typical court proceeding.

You can make your case before the judge, who will ask questions to further evaluate your claim. Witnesses may be called to testify on your behalf. Occasionally, experts can submit their opinion based upon an evaluation of your claim. The judge will conclude the hearing once all supporting evidence has been submitted. After the closing of the hearing, the judge will make a determination and notify you of the decision in writing. The notification process typically takes two months.

Final Step to Appeal Denied Social Security Claims for Disability Benefits

Should your appeal be denied at the administrative hearing, the next stage in the process is to file an appeal with the Appeals Council. Once again, you have 60 days to file this appeal after receiving the judgment from the administrative hearing. The Appeals Council must complete your disability claim review before your case goes to the United States District Court. The Appeals Council will review the decision made by the judge and the evidence presented at your administrative hearing. The possible outcomes of this review by the Appeals Council include refusal, a request for additional information, a reevaluation by your administrative hearing judge, or a reversal of the decision.

You May Qualify for Legal Assistance

Once your disability claim moves past reconsideration without approval, we strongly recommend getting professional legal assistance. Because the SSA is such an extensive bureaucracy, Social Security advocates and attorneys are exceptionally helpful in securing benefits during the appeals stage. It is extremely difficult to establish evidence of a disability that’s eligible for benefits without knowledge or experience equal to the SSA’s own agents. Attorneys almost exclusively represent disability claims once they enter the third appeals stage (an administrative hearing). Click the button below to start your free disability benefits evaluation now with a qualified attorney or advocate.

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