Overview of Disability
Disability Back Pay
Requirements for Disability
Applications for disability
Tips and Advice for Disability Claims
How long does Disability take?
Winning Disability Benefits
Common Mistakes after a Denial
Mental Disability Benefits
Denials for Disability
Appeals for denied claims
Disability Benefits from SSA
Child Disability Benefits
Qualifications and How to Qualify
Working and Disability
Disability Awards and Notices
Disability Lawyers, Hiring Attorneys
Social Security List of Conditions
What Social Security considers disabling
Medical Evidence and Disability
Filing for Disability Benefits
Eligibility for Disability Benefits
SSD SSI Definitions
SSDRC authored by Tim Moore
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How to Appeal a disability claim denial from Social Security
If your initial disability claim is denied, you need to contact your local Social Security office or the toll free number 1-800-772-1213 for an appeal. If you have an attorney, you may contact that individual and they will submit the necessary appeal forms for you. Typically, that individual will become aware of a denial at approximately the same time as you since SSA notifies both parties with regard to all mailed correspondence.
Appeals may also be done online by a claimant or their representative or attorney. If an attorney or representative is handling your case, they are directed by the Social Security Administration to use the online process though claimants are allowed both options.
If you submit a paper appeal, you should do the following: 1) make a copy of your paperwork; 2) within a certain amount of time (perhaps 10 ten days after submitting), make a followup call to the Social Security field office where your appeal was submitted. This will be for the purpose of verifying that your appeal was received and avoiding an "untimely appeal" situation.
If the appeal was not received, you may wish to do a second followup. Or, if you are very close to the appeal deadline, you may wish to utilize the copy you have kept to submit the appeal again. For individuals who submit a paper appeal and live within close distance to the field office, dropping the forms off personally may be practical.
It is important to always remember that all appeals for social security disability and SSI have a sixty-day appeal period and this is not negotiable with SSA. Appeal requests that are received outside the deadline date will generally not be accepted by the social security administration (unless "good cause" for the late appeal can be shown, such as a medical emergency), meaning that a claimant who files late will probably have to start over with a new disability application.
If you have had recent medical treatment, particularly at a new medical treatment source, you will want to indicate this when you submit your appeal. This is more relevant for reconsideration-level appeals that are handled, like disability applications, by disability examiners. This will serve to put the examiner on notice to obtain these records for consideration of your claim. Unfortunately, for appeals at the hearing level, Social Security will not gather additional evidence for your claim.
This responsbility is left to the claimant who attends their hearing and their represenative or attorney if they are represented. The representative will know at what point to begin obtaining medical evidence since the timing of these requests will be important for the purpose of submitting both older and recent documentation to the administrative law judge. Note: claims cannot be won without at least some evidence that is "recent", meaning not older than 90 days. Therefore, timing of the requests for records is imporant.
DDS level appeal
The Social Security appeals process consists of four primary levels, ranging from reconsideration requests to federal court. The first appeal is known as a request for reconsideration, and once you fill out and return your appeal paperwork, your claim will be sent back to the same state agency responsible for Social Security medical decisions for another decision. This is the agency at which a disability examiner rendered a decision on your initial disability application and in most states it is known as DDs, or disability determination services.
At DDS, after your appeal request is received by the social security office, a different disability examiner will review your reconsideration claim. However, your claim will be decided using the same rules and regulations as the initial social security disability or SSI claim. This accounts for why most reconsideration appeals are also denied.
Disability hearings and beyond
If your reconsideration is denied (currently 87-89 percent of such appeals are denied), you may request a hearing before an administrative law judge. Often a hearing is your best chance of receiving a disability allowance, because an administrative law judge, while bound by the same rules and regulations as the state disability agency, has much more room for independent interpretation of the medical evidence.
Also, the judge will receive professional input from the disability attorney representing your case, should you choose to appear with representation, as well as any medical or vocational experts that the judge has chosen to have appear (one of your attorney's jobs will be to respond to hypothetical situations brought up by one of these experts, or to cross examine the testimony that they deliver to the judge).
Most claimants, for a variety of reasons, should consider getting a Social Security representative (an attorney or a non-attorney advocate) who is familiar with Social Security rules and regulations. As with any other court, it is usually a good idea to have a representative who knows the specic law and regulatory framework.
Claimants who appear unrepresented will generally be at a strong disadvantage, even in being able to interpret the information contained in their own file (which will be made available to them if they appear alone, so that they may examine the evidence that has been accumulated at all the prior steps of the process).
If your disability hearing before an ALJ (administrative law judge) is denied ,you may file an appeal of this decision to the Appeals Council (note: not many decisions are reversed there), and after that your only course would be Federal Court.
However, it should be stated that some individuals will pursue all appeal levels, be denied at each, and then will later begin the process all over with a new claim and be granted benefits. With SSD and SSI disability claims, persistence can often result in ultimately being approved for benefits.
Return to: Social Security Disability Resource Center, or read answers to Questions
How to Appeal a disability claim denial from Social Security
Common Mistakes after Receiving a Denial of Social Security Disability or SSI Benefits
What is a Social Security Disability Denial based on?
Are there ways to avoid being denied for SSI or social security disability?
What does a Disability Denial Letter from Social Security say?
Reconsideration of a Social Security Disability denial- what does it involve?
What to do if you receive notification of a Social Security Disability or SSI claim denial
If you receive a Social Security Disability Denial quickly does that mean the case is weak?
What happens if my SSI or Social Security Disability Application is denied?
Social Security Disability Denied — The Reasons Why (medical denials)
Turned down at my disability hearing: should I appeal or refile?
Information on the following topics can be found here: Social Security Disability Questions and in these subsections:
Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI
These pages answer some of the most basic questions for individuals who are considering filing a claim.
Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
How to Apply for Disability - What medical conditions can you apply and qualify for?
Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
What happens if I file a disability application and it is denied by a disability examiner or Judge?
How to Prove you are disabled and qualify to win disability benefits
How do you prove your disability case if you have a mental condition or impairment?
Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
Social Security Disability SSI - Eligibility Requirements and Qualifications Criteria