Know Your Options for A Denied Social Security Disability Claim
Every year, over 2.5 million Americans apply for Social Security Disability. Given that huge number, the Social Security Administration (SSA) is a bureaucratic mess.
If denied Social Security Disability, you don’t have time to wait for the pencil pushers to process your appeal. You need that money as soon as possible, or else you wouldn’t apply in the first place.
Did you recently receive your denial letter in the mail? You know how you feel. Angered, worried, confused, and desperate are all correct emotions. You have to attempt an even keel.
While that’s easier said than done considering your current financial situation, you do have options. Learn more about your next course of action.
What Are the Eligibility Requirements for Social Security Disability Insurance (SSDI)?
If you’re denied SSDI benefits, you’re familiar with the eligibility requirements. Even if you’re familiar, it’s good to have a refresher. Let’s review them before moving on to an action plan.
To qualify for SSDI, you must show gainful employment before you became disabled. If unemployed before your disability, odds are you won’t receive SSDI.
The good news is, gainful employment is a broad concept. There’s no income threshold or other means test associated with benefits. Volunteer work is, in many cases, considered employment.
To qualify, your state’s Disability Determination Service (DDS) must determine whether your disability is severe enough to warrant payments.
While your disability can be mental or physical, it must be complete. Partial disabilities do not meet the eligibility requirements.
Federal Listing of Impairments
To be eligible, your disability must fall on the Federal Listing of Impairments. While the list is broad, there are some disabilities not on the list.
If your disability is not included in the federal list, your state’s DDS must determine if it is similar to an included one to reward payment.
Unable to Work
Unable to work is a broad term. Here’s what it means in terms of SSDI eligibility.
You must prove you’re unable to do the work you once did. This means if you worked in a floor tile factory, you can no longer physically or mentally perform the tasks necessary.
Unable to work also means your disability prevents you from working any other kind of job that provides a stable income for you and your family. If you’re over 50, this burden of proof may not be necessary.
You’re Denied, Now What?
When you receive your SSDI denial letter, know that you’re not alone. The application process comes with a high denial rate. 62% of claims receive a denial.
If you believe you meet the federal disability standards, you have three courses of action available to you.
Accept the Denial
This is the easiest and least beneficial course of action. Once you’re denied, you give up and move on with your life and attempt to find whatever work you can do.
Denial is a course of inaction. Most people don’t apply for SSDI out of a lark or in the hopes of free money. That’s not why you applied.
You need financial help because you’re unable to work. The fact that the DDS doesn’t see it that way feels hurtful, but you shouldn’t give up.
Reapplying is the level up from accepting the denial. You are free to accept the denial and put together a new application to restart the process with a fresh claim.
While this may seem like the best course of action if you don’t want to get involved in any legal proceedings, understand that your second application will have the same denial rate as your first application.
Filing an appeal to your SSDI is the next level of action. An appeal does not mean guaranteed success.
If you intend to appeal your denial, it’s best to seek legal counsel. While it’s not necessary at any step of the appeal process, a disability lawyer like those at heardandsmith.com gives you the best chance for success.
Why You Should Appeal
An appeal is a scary proposition. You don’t want to drag out a lengthy appeal that might end up with another denial. Life would be easier if your first claim were approved and that was it.
Life and government don’t often work that way. While you have the choice to do nothing or reapply, an appeal is often the best course of action after your first denial.
Why? Because an appeal protects your benefits. Reapplying for benefits may mean forfeiture of retroactive payments from your disabled date.
Let’s say you stopped working due to a disability on October 1, 2018. After visiting your doctors, you decide to apply for SSDI benefits in October of 2019, a full 12 months without an income.
You received your denial on March 1, 2020. An approval would’ve meant you could receive weekly benefits starting on October 1, 2018. Retroactive payments due come in the form of a lump sum payment.
If you appeal, you protect your ability to receive benefits from the time you became disabled and your approval.
How the Appeal Process Works
If you believe you were unfairly denied, you’ll want to file a Social Security Disability appeal. You do this to protect potential retroactive disability payments.
Before you file your appeal, you need to lawyer up. Legal counsel for the appeals process gives you the best chance for success.
What about payment? Most disability lawyers work on a contingency basis. That means they do not receive payment until you receive your settlement.
Request for Reconsideration
Once you receive your initial denial, you have 60 days to complete and file an official Request for Reconsideration of your claim.
Filing for this reconsideration request means you submit to a new medical evaluation. During this time, you can also submit any new medical records to your state’s DDS.
This includes any new treatments or procedures performed since your previous evaluation.
If you haven’t received any new treatments since your last medical evaluation, you are likely to be denied during this reconsideration phase.
Request a Hearing
This is where your expert attorney will pay off. If you’re denied at the Reconsideration phase, you can request a hearing with an Administrative Law Judge.
Your hearing request with an Administrative Law Judge may take 12-16 months to reach court. Be prepared for a wait.
Thanks to Covid-19 restrictions, you may receive a telephone hearing rather than an in-person hearing. While convenient, a telephone hearing has different rules than an in-person hearing.
Each party must call into the hearing from a separate location. That means you will be separate from your attorney.
You do have the legal option to deny a telephone hearing. Considering ongoing Covid-19 complications, that may stretch your time frame.
The good news? Those who receive a hearing with an ALJ win 50% of the time.
The bad news? Those who receive a hearing with an ALJ lose 50% of the time. If you’ve lost your appeal at this stage, don’t worry.
Your lawyer will request an appeals council review within 60 days of your ALJ denial.
When you send your case to an appeals council, your case isn’t reviewed. The council reviews the judge’s decision and determines whether the decision falls within the parameters of disability law.
This feels like a long, arduous process. It’s hard to keep faith when you’ve been denied up to three times. You have to trust your lawyer and keep in mind you’re fighting for your quality of life.
You deserve a decent life.
The truth is, a vast majority of appeals that go before an Appeal Council aren’t overturned. At this point, you may feel like all hope is lost. There is one more course of action in the appeals process.
You and your attorney have the option to file a civil complaint with the U.S. District Court. Though not many cases make it to a federal court, if you find yourself denied thus far, this is where you turn.
Though few cases make it to Federal court doesn’t mean you shouldn’t try. Many of these cases involve deserving parties with enough temerity to see the process through.
Denied Social Security Disability?
Don’t worry. There are steps you can take to get the payments and settlement you deserve.
If you’re denied Social Security Disability, you have three options. You can do nothing, reapply, or file an appeal. If you plan on appealing your denial, make sure you seek the counsel of an expert attorney.
You want the law on your side. You need help fighting through the bureaucratic red tape to get the payment you deserve. The best way to do this is to appeal your SSDI denial.
Are you interested in more law advice? Check out the rest of our blog.