To win Disability benefits, you may have to appeal a denial

This title of this post would seem obvious. However, a significant percentage of applicants for Social Security Disability and SSI benefits do not appeal their claim after they have have received a notice of denial.

As a disability examiner working on SSD and SSI claims at disability determination services (the agency that makes disability claim decisions for the social security administration), I was able to see, firsthand, that an astonishing number of cases are turned down and are never appealed. What happens to those cases? They generally fall into one of the following categories.

1. The applicant is denied for disability benefits and then gives up entirely.

2. The applicant decides to do nothing after they receive their notice of denial, basically allowing their appeal period to expire (the appeal period is sixty days from the date of the denial). In some cases, those same individuals decide that this was a bad move on their part and later decide to revisit their case.

However, at that point, they learn that their claim is effectively dead in the water and that they must start fresh with a brand new claim...which includes having to go through another disability application interview, filing out the forms for a new claim, possibly being sent to consultative medical exams once again, and having to wait weeks or months to receive another decision.

3. The applicant decides "to appeal" but somehow proceeds from the mistaken assumption that starting a new disability application is the same thing as filing an appeal. As a disability examiner, I saw this phenomenon occur thousands of times.

Why does it happen? I frankly do not know. It may be that many individuals simply do not understand that they are allowed to appeal a denial of a claim. Others may not understand that appealing is far more beneficial than starting a new claim because it dramatically improves the chances of being approved for benefits. And others...may actually think that when they are initiating a new claim, they are doing the same thing as appealing. And this is absolutely not the case.

Individuals who receive a notice of denial and then pass up the chance to file an appeal, instead choosing to start a new disability application will simply get denied again.

On the other hand, individuals who decide to utilize the appeals process will eventually get their case heard by an administrative law judge (ALJ) at a hearing and will probably be approvedn -- even more likely if they are represented by someone who has done the proper preparation on their case and effectively presents their claim before the ALJ (administrative law judge).

continued at: Receiving a notice of denial on a disability case

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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