WHEN SOCIAL SECURITY SAYS "NO" AND DENIES YOUR CLAIM

Unfortunately, Social Security will deny about 7 out of 10 applications for disability.  However, there are appeals available and should be used.  Here is the required path for appeals.

 Note:  You are only allowed 60 days to file an appeal.

 1.  Appeal and ask for Reconsideration.  This is the first appeal.  It asks the Disability Determination Service (DDS) to re-examine your application and reconsider their decision.  They will usually deny the claim again but this opens up further avenues of appeal.

 2.  Appeal and ask for a Hearing.  At the hearing, an administrative law judge (ALJ) will hear your appeal, listen to your testimony and review all the evidence. Both the claimant and his/her attorney will appear before the judge for this hearing. The judge will give you a new decision.  This is actually the best chance of winning your benefits.  

 3.  If the ALJ denies your claim, appeal and ask for a review by the Appeals Council. The claimant does not get to appear for this appeal. This Council is a group of judges headquartered in Falls Church, Virginia.  It's their job to see whether the administrative law judge made an error at your hearing.  If the Council finds an error was made, it will likely send your case back to the ALJ for a new hearing.  This is called a remand. 

 4.  If the Appeals Council does not provide a favorable result, the next step is an appeal to a federal district court (FDC).  A judge or magistrate there will review your case to see if errors were made and, if so, will issue a remedy. The claimant does not appear for this proceeding.  Your attorney will submit a written appeal brief and usually will not appear before the judge.  Only about 1 percent of cases reach the federal district court level.   

 These are the 4 steps in the appeal process and they must be taken in order.  You can't skip Step 2 and go straight to Step 4, for example.

 Nearly everyone on Social Security disability today had to appeal a denied claim.  Very few claimants get their claim approved at the first step, the application level.  The important thing is to appeal, not to give up.  Those who eventually get their benefits are the ones who refuse to give up and stick with the process for the long haul.  This usually involves staying with the appeal process through the hearing before an administrative law judge.  A few cases must be appealed beyond that level.

Comments

Post a Comment

Popular posts from this blog

HOW TO GET READY FOR YOUR HEARING

Image
Most disability applications are rejected at first.  The first appeal, called "Reconsideration" usually does not get a favorable response, either.  When these two steps have failed, as they usually do, it's time for a hearing with an administrative law judge, your the next step. How do you prepare for that hearing?  Realize that the hearing before the judge is the best opportunity you will ever have to get your benefits approved.  So, it's important to make a good appearance and present yourself well. Some suggestions: 1.  First and foremost, be absolutely certain that all of your medical records have been submitted well in advance of the hearing.  You can review your electronic folder by contacting the Social Security Office of Hearings Operations which has jurisdiction over your appeal. They should have received a medical record from each doctor, hospital, emergency room, counselor and other medical providers that you have seen within the relev...
Read more

DOES SOCIAL SECURITY PAY SHORT TERM BENEFITS?

Social Security Disability Insurance (SSDI for short) is a long term disability program sponsored by the US government.  It is paid for by payroll deductions, called FICA tax. What is meant by long term?  It means a medical condition which has lasted, or is expected to last at least 12 straight months OR to end in death. Impairments lasting less than 12 straight months are not covered under SSDI. Do you have to wait 12 months to apply?  No.  This is a mistake.  The medical condition you are claiming needs to the type of condition which normally lasts 12 months or more.  You do not need to wait 12 months to apply. For example, if you break your leg and your doctor advises you to be off work for 3 months, this is not covered under SSDI.  However, if a person has a heart attack and the doctor says he can't work for at least a year or more, it would be a covered condition. Is it easy to get approved?  Frankly, no.  It is difficult. So...
Read more

DISABILITY AND BACK DISORDERS

Back trouble is a generic term for many musculoskeletal impairments that cause pain in the back, shoulders, hips or legs.    Back and spinal issues are the single largest cause of disability in the United States.   Social Security, however, will not pay a benefit simply because of complaints of back pain, even if the doctor has recorded long term complains of pain. It's necessary to determine the cause of back pain in order to get benefits approved.  This usually requires objective tests which may include X-rays, MRIs or CT scans for imaging of the spine. These imaging studies may show degenerative disc disease.  Specifically, studies may reveal narrowing of the spinal canal, osteophyte complex (bone spurs), bulging or herniated discs or other problems. After demonstrating the cause of the pain, Social Security will try to determine how pain affects your ability to function.  How does pain limit your ability to sit, stand, stoop, reach, ...
Read more