What happens if a reconsideration for Social Security Disability or SSI is denied?

If your reconsideration appeal has been denied, and you are still disabled and unable to go back to work, you need to contact Social Security to appeal your denial. You have sixty-five days from the date of your denial notice (the date is usually stamped in the upper right hand corner of the notice of denial) to file a request for a hearing before an administrative law judge.

Late appeals and good cause

At this point, you must be especially careful to file your appeal "timely" as administrative law judges are not very flexible with regard to appeals that, for whatever reason, are not filed on time. If you are late in filing your hearing request, you should send evidence that supports the reason you were late filing your appeal. In some instances, a late appeal can be accepted under good cause. If you do not have a good reason for filing late, of course, your hearing request is likely to be dismissed by the administrative law judge after they receive your case.

Submitting the disability hearing request

As with the request for reconsideration, the hearing request is submitted to the Social Security office where your claim was initiated. After the request is processed, your file is transferred to the hearing office, officially known as ODAR, the office of disability adjudication and review.

However, after your disability hearing request has been submitted, you should not be surprised if you do not hear anything for a few months. Due to an increase in disability hearing requests, you are likely to wait anywhere from five months to fifteen months to get a hearing scheduled.

While the wait may seem never-ending, the administrative law judge hearing offers you the best chance of being approved for SSI or approved for Social Security Disability benefits. While statistics vary from state to state, the national average approval rate for disability hearings fluctuates between sixty and sixty-five percent, thus making it the most favorable level of the Social Security Disability process at which a claimant can hope to win disability benefits.

The disability hearing and what happens

When you get to the hearing office, you will be taken to a conference room for your disability hearing. Social Security Disability hearings are not open to the public, so there are very few people in attendance. Generally, the judge, you, your disability representative, and a court reporter are in the conference room. However, there may be medical and/or vocational experts in the room as well.

The judge will most likely ask you questions about your disabling condition and how it limits your ability to perform routine daily activities including work activity. The important thing to remember is to answer the questions honestly and thoroughly; but remember that the judge probably has a busy schedule of hearings for the day. Some ALJs schedule hearings every half hour. Some even schedule hearings every ten minutes apart. Obviously, disability hearings tend to be somewhat brief.

The judge may also ask your representative questions or your representative may be asked to present specific medical evidence that supports an approval for disability, or they may have to present your disability case.

If you did not obtain the services of a Social Security representative for your reconsideration appeal, you should consider obtaining representation for your disability hearing. Although administrative law judge disability hearings are less formal than ordinary hearings, they still involve a judge, rules, and guidelines. Social Security representatives, being familiar with the Social Security Disability guidelines and vocational rules that are used to direct decisions on cases, can help to maximize a claimant's chances of winning benefits.

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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