Social Security Disability Claim Denied and what to do about it

If your claim for Social Security Disability (SSD) or Supplemental Security Income (SSI) is denied (and the vast majority, about 70% of those filed each year, are denied) then you should appeal the decision.

This first appeal is referred to as a request for reconsideration, and it is decided by the same agency that denied the initial application, the state disability determination services (DDS). Given the fact that the same organization that denied the initial application is in charge of reviewing the denial, the following statistic should not come as any surprise: about 85% of all reconsideration appeals are denied as well.

So why bother appealing? Well, the purpose of filing a first appeal is not so much that it affords a claimant any real chance of winning, but that it allows the claim to advance to the second level of appeal, which is far more likely to be decided in favor of the claimant. Second appeals are decided by federal administrative law judges (ALJs) who, though bound by the same Social Security rules as DDS examiners, have a lot more discretion when ruling on disability cases.

In addition, at a disability hearing claimants are afforded the opportunity to elaborate on both their symptoms and exactly how those symptoms prevent them from earning a living wage. Claimants also have the option to be represented by a disability attorney at their hearing, which can absolutely improve their chances of winning—about 60% of all disability denials are overturned by ALJs when the claimants have legal representation.

Is it ever a good idea to forgo the appeal and simply start all over with a new claim? Rarely. Unless there is some highly significant new medical evidence, a new claim is likely to yield the exact same result as it did the first time around.

There are some exceptions, however. If your initial claim denial was based on a technicality, such as the fact that you had too many assets, or made too much money at the time, then a new claim makes sense (if your financial situation has worsened).

It’s also a good idea to immediately file a new claim if you have already been turned down by an administrative law judge and are appealing the judge’s decision to the Social Security Appeals Council. The Appeals Council agrees to review very few ALJ decisions, so it’s prudent to go ahead and file a new disability claim while waiting to hear if they will act on a request for review. It’s the only time throughout the entire disability determination process in which a claim can be active at two levels of consideration.

How the programs really work:

Social Security Disability and SSI Disability

Including Tips, Advice, Strategies & Common mistakes to avoid.

Topics and Questions