Do You Need to Appeal an SSD Claim Denial?
Millions of people apply for Social Security Disability benefits every year, but approximately 70% of applicants are denied by the SSA at the initial application level. Despite working and paying into the Social Security program through mandatory wage withholdings, countless disabled workers are left struggling to pay for their monthly expenses. Many are unable to obtain the medical care they need. For some, putting food on the table is nearly impossible.
If your application for Social Security disability benefits was denied by the SSA, there is hope. Klain & Associates has helped thousands of disabled people throughout the United States appeal adverse decisions...and win. Give us a call and find out how we can help you, too.
Social Security Disability Appeals Process
The appeals process for SSDI and Supplemental Security Income (SSI) is divided into four levels.
Request for Reconsideration
The first step in the SSDI or SSI appeals process is to apply for reconsideration. Although your chance of winning benefits at this level is slim (only about 10 to 15 percent of applicants obtain approval at the reconsideration level), you must take this step if you wish to appeal your claim.
Many applicants are turned down at reconsideration because the same information is reviewed and the same rules and guidelines are used to make the disability determination at this level. In fact, the only real difference between the reconsideration-level appeal and the initial application is that the claim is reviewed by a different disability examiner.
Administrative Law Judge Hearing
If your claim is denied at the reconsideration level, the next step is to request a hearing with an Administrative Law Judge (ALJ). This is perhaps the most important step in the disability appeals process. It is also the level in which most applicants are approved.
Higher approval rates at the ALJ hearing level are likely the result of several factors.
• Claimants are typically able to speak directly with the judge and their attorneys are able to present their arguments in more detail.
• Claimants are more likely to be represented by an SSDI attorney or trained advocate.
• SSDI attorneys can cross-examine vocational experts and medical experts at the hearing.
SSA Appeals Council
If the adverse decision is upheld at the ALJ hearing level, do not give up hope. The next step is to request that the Appeals Council review your case. The Appeals Council has the discretion to uphold the denial, grant you disability benefits, return your case to the ALJ for reconsideration if mistakes are found, or dismiss your case.
The Council may also dismiss your case without review unless one of the following is discovered.
• An error of law or an abuse of discretion
• There is no substantial evidence to support the ALJ decision
• The ALJ did not follow the correct procedures or went against policy
Your chance of winning disability benefits at this level is only about 2% to 3%. However, most people use this level as a stepping stone to proceed to the next level - which is to sue the SSA in federal court.
Federal Court Review
If you are not already working with an attorney or representative, you’ll certainly need to get legal help before you proceed to the Federal Court Review. When you file a lawsuit against the SSA in U.S. District Court, a federal judge will hear your case without a jury. Although only legal errors are supposed to be reviewed, many judges review the facts of the case as well.
While only a small number of cases are overturned at this level, about half are sent back to the SSA for reconsideration. If a treating doctor's opinion, pain and other symptoms, or assessments of abilities from treating doctors were not considered when your claim was denied, you have a good chance of approval at this level. However, only about 1% of disability cases ever see federal court.
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Navigating the rules, regulations and confusing terms when claiming Social Security Disability can be difficult. Our nationwide network of attorneys and advocates work with people at all levels of the SSI and SSDI claims processes. Let our team put your mind at ease and help you achieve success.