Social Security Disability (SSDI) helps provide financial assistance to individuals who are unable to work due to a disability. This program allows individuals who have a disability that prevents them from working to make a living and live more financially stable. To qualify, applicants must meet specific eligibility requirements. Some common reasons for denial of SSDI benefits include lack of medical evidence, not meeting work history requirements, or not proving the severity of the disability. Applicants have the option to appeal the decision if they disagree with it, which can be a very complex process. This blog aims to provide applicants who are considering filing an appeal with the steps they should take to have a smooth appeal process.
Understanding Why Your SSDI Claim Was Denied
The first thing you should do before you start the appeals process is understand why exactly your SSDI claim was denied. You should fully read the decision and pay close attention to the explanation for the denial. It’s important to understand the reasons behind the decision so you can address them properly in an appeal.
Below are some common reasons SSDI claims get denied:
- Insufficient Medical Evidence
- Income or Assets Exceeding Limits
- Work History Issues
The SSDI Appeals Process Overview
Once you have determined the reasoning behind your denied claim and are ready to start the appeals process, you should be aware of what the appeals process entails. There are four different stages in the appeals process: Reconsideration, Hearing by an Administrative Law Judge, Appeals Council Review, and Federal Court Review. In the next few sections, we will go over each step in more detail.
Learn More: Is it Worth it to Appeal an SSDI Denial?
Step 1: Reconsideration
The first step in the appeals process is to request reconsideration. You have 60 days from the date of the denial letter to request reconsideration. Missing this deadline could result in losing the right to appeal. This process involves asking the Social Security Administration to review your case again, often bringing new or additional information to further support your claim. Some types of additional evidence you can consider adding include new medical documentation, supplemental information, or a medical nexus letter.
Step 2: Hearing by an Administrative Law Judge (ALJ)
If your request for reconsideration is denied, the next step would be to request a hearing before an Administrative Law Judge (ALJ). This gives you a chance to present your case in person. You will have 60 days from the date you received the reconsideration denial notice to request a hearing. In order to request a hearing, you can use the SSA’s online portal or submit a paper form (Form HA-501) to formally request a hearing. Similar to when you are requesting reconsideration, you will need to gather any new or supporting documentation to strengthen your claim. This is especially important in this stage as you will be presenting your case to a judge. It can be helpful to work with a disability attorney during this stage to help prepare for the hearing.
Step 3: Appeals Council Review
If the Administrative Law Judge denies your SSDI claim after the hearing, there is still an option to appeal further. You can continue your appeal by requesting a review by the Appeal Council. This review focuses on making sure the proper legal procedure was followed with your claim, rather than reexamining your evidence. Similar to the previous steps, you have 60 days after receiving the ALJ’s decision to request a review. This can be completed through the SSA’s website, mail, or at a local SSA office. The Appeal Council can approve the claim if the find the denial was unjustified, they can decide to uphold the decision, or they can send the case back to the ALJ for further review.
Step 4: Federal Court Review
If all other appeal options were unsuccessful, the last option is to file a lawsuit in federal court. This involves having a federal judge review your case and determine if the SSA followed proper procedures and legal considerations. This is a more complex and intensive process, making it very important to work with an experienced attorney. The judge does not re-hear your case or look at new evidence, instead, they take a look at the records from previous stages to see whether the SSA followed the law. This is a critical opportunity to address the errors made in your claim from all stages.
Don’t Give Up on Your SSDI Benefits
While the appeals process may seem overwhelming, each step can increase your cases of success. At Tabak Law, we specialize in helping individuals navigate the complexities of SSDI claims and appeals. Let us fight for the benefits you deserve.
Contact Tabak Law today to schedule a free consultation and take the next step toward securing your SSDI benefits.
Nothing posted on this website is intended, nor should be construed, as legal advice. Blog postings and site content are available for general education purposes only.