As a former disability examiner who has worked on Social Security Disability and SSI cases, and as someone who has been involved in the representation of disability claimants, I have been able to take notice of the mistakes many claimants make after they receive a denial notification from the social security administration (SSA). Here is a short list of three common mistakes on claims.
1. Some claimants do not pursue their claim by filing an appeal after their case has been denied. In effect, they accept their denial notice as the final word on their claim. This is nearly always a mistake.
Why? Because, statistically speaking, pursuing the claim through the appeals process will stand a fairly high chance of eventually being approved. Filing the first appeal will get the case processed as a request for reconsideration. Reconsiderations are almost always denied…however, after a claim is denied at the reconsideration level, a claimant will be allowed to file a request for a disability hearing.
Assuming that the case has received proper preparation at this level, and that the claimant has chosen a good disability representative (the representative can be a disability lawyer or a non-attorney representative) to appear before the administrative law judge, the chances of winning will be good.
This fact is consistently borne out by federal statistics which indicate that, nationally, more than sixty percent of all represented claimants will be awarded disability benefits following a hearing.
2. Some claimants choose to file a new claim instead of filing an appeal. This happens fairly frequently and the result is fairly predictable. The case simply gets denied again on the new claim. For the outcome to be any different, of course, would not even be logical, though, since a new claim will be handled by the same agency (DDS, or disability determination services) that made the decision on the first claim.
Why do some claimants continue to a new claim instead of submitting an appeal? Or even file new claims over and over instead of utilizing their appeal rights? In some cases, it may be due to confusion on the claimant’s part. In the past, of course, this was understandable. The Social Security Administration has been forced, on more than one occasion, to change the wording of its denial notices since they mistakenly gave claimants the impression they should file a new application instead of appealing.
Filing new disability applications over and over, of course, is not a good strategy. By contrast, those who file appeals will eventually get their case decided by a federal judge and the odds of being approved (as was stated earlier) will be substantially higher.
Why are the odds better at a hearing? There are several reasons. The first is that adminstrative law judges give more credence to the opinion of a claimant’s doctor, or treating physician.
Secondly, since the hearing is the only step in which the decision-maker meets the claimant, it may be easier for the judge to be subjectively influenced by the claimant’s symptoms, appearance, and testimony.
Thirdly, the attention paid to both a claimant’s exertional and nonexertional limitations is more detailed, as is the attention paid to the claimant’s prospects–or lack of prospects–for being able to switch to other types of work. Finally, a fourth reason is that, at a hearing, a compelling theory of the case and argument for approval can be advanced by the claimant and/or their disability representative.
3. Some claimants intend to appeal, but miss the appeal deadline. This also happens frequently. Why? In some cases, it may be that the claimant is unsure of what to do next as a result of anxiety or depression following the denial of their initial claim. In other cases, however, it may be that the claimant is seeking to have a disability attorney file their appeal for them and the fact that they have not located an attorney yet is holding up the filing of their appeal paperwork.
Of course, there is nothing wrong with having one’s representative file the appeal. That is, after all, part of the representative’s job. But unrepresented claimants who are having difficulty finding representation should probably get their appeal sent in as soon as possible to avoid missing the deadline. Missing an appeal deadline will result in having to start over with a new claim and will amount to a considerable loss of time, sometimes amounting to months.
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These pages answer some of the most basic questions for individuals who are considering filing a claim.