How to file for disability, Filing for SSI
Disability Requirements, Disability Status
How long is the wait?, Disability Application
The Social Security List of Impairments
Qualifying for Disability, Mental Disability
Disability Lawyer Info, Disability Back Pay
Winning a Social Security Disability Appeal or SSI Appeal
You will have the best chance of winning a disability appeal when you provide some or all of the following:
1) Additional medical evidence.
2) Updated medical evidence.
3) Statements from a physician who has a history of treating you.
4) An argument for approval based on the facts of the case and a knowledge of Social Security rules and regulations.
If the appeal you are filing is for what is known as request for reconsideration, the chances are that you won't have more recent, or updated, medical evidence to provide. This is simply because the disability application and the reconsideration are often separated by just a few weeks.
However, if your appeal is for a disability hearing, there will be months of separation between the time you request the hearing and the time you get a hearing date. Therefore, there will nearly always be additional medical evidence to gather simply due to the passage of time.
Note: Social Security does not gather your medical evidence for you at the hearing level. You, or your disability attorney if you are represented, will need to obtain your most recent records and submit these to the hearing office.
In some cases, however, particularly if you have a disability attorney or disability representative, it may come to light that Social Security did not obtain all your records that needed to be considered. When this occurs, it will be important for you and your attorney to obtain the evidence and make it available to the hearing office. Discovering that Social Security did not obtain and consider all your records will generally not be known until the full file or exhibit list can be viewed, something the attorney will do prior to the disability hearing.
Statements from your doctors can certainly help you win your disability appeal. However, these should not be generic statements, but rather specific statements that testify as to your functional limitations. The type of statement that can assist your case is called a medical source statement and this is usually obtained by your disability representative or lawyer before a hearing is held. It is usually not obtained for a reconsideration appeal since disability examiners who work on those appeals generally do not give those statements much consideration.
Finally, an argument for approval of your case is sometimes referred to as a theory of the case. In essence, this is simply an assertion that you, the claimant, with your age, level of education, type of work history, and types of physical and/or mental limitations do, in fact, meet the Social Security definition of disability. This claim will have to be supported by an analysis of the medical evidence, and usually an analysis of your past work history. The attorney who represents you at the hearing may also have to cross-examine a vocational expert or a medical expert if the judge has such experts called for the hearing.
Disability appeals can be won when the evidence has been gathered and properly considered. And appeals can provide a path to winning, whereas simply filing a new disability claim can be synonymous to spinning one's wheels. Nonetheless, many applicants do this.
Filing a new claim instead of filing a disability appeal
In just about every instance, it makes more sense for a disability claimant to appeal their case rather than filing a new disability claim (the exception to this rule is when their case has been denied on a technicality, such as too much monthly income or assets, and then only if this issue has changed since the initial filing). This is because, each time a claim is appealed its chances of approval increase.
All disability appeals, both SSD and SSI, are evaluated in the same state agency that makes disability determinations on the initial claim for the federal social security administration. This agency is called disability determination services (DDS) in most states, although its name may vary slightly from state to state.
Given the fact that the same agency renders a decision in the appeal as in the initial claim, some applicants may wonder if appealing their claim is a waste of time, or if a case really has any better chance of being approved upon appeal if the same agency is considering the same facts.
The answer to this question is that, yes, it is almost always in a claimant’s best interest to file an appeal with social security. First of all, about 15 percent of all claims that were denied the first time they were considered, will be approved upon review. The first appeal to DDS, or request for reconsideration, is also an opportunity to introduce any new medical evidence in support of the claim that was not available or was for whatever reason omitted when the application was first filed.
Okay, so that still leaves about 85 percent of applicants who are denied disability benefits even after they have appealed the decision. However, an appeal, even if it is denied, is still useful in that it helps to move the case forward to the second level of appeal, which is to request a hearing before an administrative disability judge.
At this level, a case stands its greatest chance of winning—about half of all disability claims are approved when they are heard before a judge, and more than half are approved when the claimant has legal representation, either a disability lawyer or non-attorney advocate.
Factors that affect the chances of winning
If you are older, or if your past work history includes jobs that required physical exertion or certain repetitive movements (as in the case of carpal tunnel syndrome), you stand an even better chance of being approved for benefits upon reconsideration appeal or at a disability hearing.
However, anyone who suffers with a disabling medical condition, be it physical or mental, can win disability benefits. That is, provided they can supply medical records to document that they have been diagnosed with the condition by a medical professional, have sought treatment, and are still experiencing symptoms that prevent them from earning enough to make a living.
To sum it up, the chances of winning a disability appeal are, like those of winning an initial claim, directly related to the quality of medical evidence provided to the examiner or judge making the determination, and the expertise with which this evidence is presented. That is why it is highly recommended that disability claimants retain legal counsel if they are planning to appear before an administrative judge, or even sooner if they are having difficulty gathering the information needed to support their claim.
What is the Social Security Disability SSI list of impairments?
Can you work while getting or applying for Disability?
How Often Does Social Security Approve Disability The First Time You Apply?
Tips for getting Social Security Disability or SSI benefits approved
What medical conditions will get you approved for disability?
What kind of Mental Problems Qualify for Disability?
Receiving a Disability Award Letter
Conditions Social Security will recognize as a disability
Previously answered questions regarding SSD and SSI
Applying for disability in your state
Most popular topics on SSDRC.com
Social Security Disability SSI Questions
The listings, list of disabling impairments
Can a mental illness qualify you for disability?
Disability Lawyers prevent unnecessary denials
How much Social Security Disability SSI back pay?
How to apply for disability for a child or children
Filing a Social Security Disability SSI application
Filing for disability - when to file
How to apply for disability - where to apply
Qualifications for disability benefits
How to Prove you are disabled and Win your Disability Benefits
Qualifying for Disability - The Process
How to get disability for depression
Getting disability for fibromyalgia
SSI disability for children with ADHD
What is the Application Process for Social Security Disability and SSI?
Common Mistakes to avoid after being denied for Disability
Social Security Disability SSI Exam tips
More Social Security Disability SSI Questions
Social Security Disability SSI definitions
What makes you eligible for Social Security Disability or SSI?
New and featured pages on SSDRC.com
Who can help me file for disability?
How can I win Social Security Disability benefits?
How do you Win Benefits under Social Security Disability or SSI?
What kind of cases win disability benefits?
How Likely are You to Win Your Disability Case?
Winning a Social Security Disability Appeal or SSI Appeal
What Will a Disability Lawyer Do to Win a Social Security Case?
What are the chances of winning a Social Security Disability Benefits hearing?
Preparing for a Disability Hearing to Win Social Security or SSI Benefits
Winning Social Security Disability Benefits For Mental Disorders
Why does Social Security take five months of benefits when you are awarded?
If you apply for disability in Indiana
Will I qualify for disability Benefits in Indiana?
Getting a Disability Lawyer in Indiana
These pages answer some of the most basic questions for individuals who are considering filing a claim.
Can you get temporary Social Security Disability or SSI benefits?
Permanent Social Security Disability
What is the difference between Social Security Disability and SSI?
Who is eligible for SSI disability?
Can I Be Eligible For SSI And Social Security Disability At The Same Time?
What makes a person eligible to receive disability benefits?
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?
For the sake of clarity, SSDRC.com is not the Social Security Administration, nor is it associated or affiliated with SSA. This site is a personal, private website that is published, edited, and maintained by former caseworker and former disability claims examiner, Tim Moore, who was interviewed by the New York Times on the topic of Social Security Disability and SSI benefits in an article entitled "The Disability Mess" and also by the Los Angeles Times on the subject of political attempts to weaken the Social Security Disability system.
The goal of the site is to provide information about how Social Security Disability and SSI work, the idea being that qualified information may help claimants pursue their claims and appeals, potentially avoiding time-consuming mistakes. If you find the information on this site helpful and believe it would be helpful to others, feel free to share links to its homepage or other pages on website resource pages, blogs, or social media. Copying of this material, however, is prohibited.
To learn more about the author, please visit the SSDRC.com homepage and view the "about this site" link near the bottom of the page.