THE NEXT STEP AFTER BEING DENIED FOR DISABILITY IN PENNSYLVANIA



The Next step after being Denied for Disability in Pennsylvania



 
Individuals who are denied for disability in Pennsylvania should obviously file an appeal with the social security administration. The appeal that is filed will depend on what level the Social Security Disability or SSI claim was at when it was last denied.

For a disability application, the appeal to file will be a reconsideration, a request for reconsideration to be exact. The reconsideration is handled by a second disability examiner at the same state agency (known in most states as DDS, or disability determination services) where the application for disability was decided. And for all intents and purposes, this is the only substantial difference between the two claim levels.

In other words, the process is identical. Why is why, of course, most reconsideration appeals are denied as well (current statistics indicate that, nationwide, about 87 percent of recons are denied).



Additionally, the fact that reconsideration appeals are typically evaluated within just a matter of weeks of the disability application being evaluated almost guarantees a subsequent denial. For the outcome to be different would be no less than disability determination services admitting that they had made a decisional mistake at the earlier level. And this only happens roughly 13 percent of the time.

In cases where the claim has been denied at the reconsideration level, the next appeal to file will be a request for a social security hearing. Filing the hearing request is very similar to filing the reconsideration request.

The primary difference, however, is that instead of the claim being transferred to DDS to be assigned to a new disability examiner, the case is sent to the nearest disability hearing office. Typically, once there, the claim will sit for several months before it is actually assigned to a federal administrative law judge whose staff will begin the workup on the case to get it ready for the hearing.

To address the specific question with which we started, which is "If I am denied for disability from social security, what is the next immediate step to take?", the answer will depend on whether or not the claimant is currently represented.

Claimants who are represented, upon receiving their notice of denial (notice of disapproved claim), should immediately contact their attorney. This is to A) let them know that a denial has been received (sometimes, the attorney does not get their copy first, and sometimes, as well, the attorney does not receive his copy at all) and B) let them know that the claimant has received their copy of the notice. At this point, a represented claimant will not need to do anything since the attorney will file the request for the appeal.

After filing the appeal, the attorney will usually send a copy of the appeal request to the claimant for their own records. Of course, if the claimant has had any recent or new medical treatment, this information should be transmitted to the attorney to better prepare them for the time when medical record updates are gathered for the hearing.

Claimants who are not represented should immediately contact SSA to notify them that the case will be appealed. This can be done online or by calling the SSA toll free line. However, it can also be done by contacting the local social security office. And this can be done by either visiting the social security office or by calling the office.

For most claimants, since the local office will do the intake for the appeal (and will then transfer the appeal to either disability determination services or the hearing office, depending on the level of the claim), it probably makes more sense to contact the local office.

Update: Presently, reconsideration appeals are suspended in the state of Pennsylvania. They may be reinstituted later at some point, and this seems likely. However, for the time being, for individuals who have been denied on a disability application, the first appeal will involve a hearing before an ALJ, or adminstrative law judge.

With nearly a 70 percent rate of denial on initial claims in Pennsylvania, this provides a substantial reason for considering early representation, if for no other reason than to help ensure that the case is developed properly by the time it is heard by a judge.


About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.







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