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Social Security Disability SSI and Medical Evidence

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What happens if you get denied for social security disability three times?


How to prove you are disabled
and win disability benefits


 
In a forum, an individual stated that they had gotten denied for disability benefits with the social security administration three times. They wondered what happened next in the process and what they should do.

There are two possible scenarios that might apply to this individual's situation. First of all, it may be that the individual has never filed an appeal, but, instead, has simply filed three separate disability applications. In other words, each time they were denied for disability they decided to start over from scratch instead of utilizing their appeal rights.

If that is the case, an individual in this position should contact the social security office where they filed their disability application and request an appeal. If they have a representative assisting them, such as a disability lawyer, they should contact this individual as soon as they learn that their claim has been denied so their representative can submit their appeal for them (one of the advantages of being represented is that your paperwork is handled for you and in a timely manner).

Note: in almost all cases, if your claim for disability gets denied, file an appeal. Eventually, if you persist, you will get your case in front of a federal administative law judge where, with representation, you will stand a better chance of being awarded disability benefits than being denied. If, on the other hand, you never file appeals, but continue to file brand new claims each time you get denied, you will probably just guarantee yourself more denials.

The other possible scenario is that this individual was denied on their disability application, was denied a second time on their request for reconsideration appeal (this is the first appeal that is available), and, finally, was denied a third time at their disability hearing before an ALJ (administrative law judge). If this is the case, the claimant has three separate choices:

1. Give up on their claim. Not recommmended, of course, simply because most claimants who are persistent and follow the appeals process will eventually win their claim. This probability is enhanced at the hearing level for those claimants who have representation since a representative will typically prepare the case for hearing (which includes obtaining medical record updates, attempting to get statements from treating physicians, and reviewing the social security file for prior decisions).

2. File an appeal with the appeals council. The appeals council is located in Falls Church, Virginia. Appeals filed with this body are essentially requests for review of the administrative law judge's decision.

3. File an appeal with the appeals council AND file a brand new disability application. Yes, this is the only level of the system where a claimant and their disability lawyer may file the next available appeal and simultaneously file a new disability claim. Very often, the claimant will receive a decision on the new claim before the appeals council has reviewed the decision of the administrative law judge on the prior claim. It makes sense to file a new claim in addition to filing an appeals council appeal because by the time a case has gotten this far there may be considerably more medical evidence in the file for a disability examiner (who would be deciding the new disability application) to review and base a new decision on.















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Information on the following topics can be found here: Social Security Disability Questions

Social Security Disability SSI decisions | The Disability Decision Process and What gets taken into Consideration | Getting Denied for Disability Benefits | Questions about Social Security Disability Approvals and Being Approved | Social Security Disability Hearings | Social Security Medical Examinations | Social Security SSI Doctors | Social Security Disability Representation | Social Security Disability SSI Reviews