If you have applied for Social Security Disability Insurance benefits and received a denial letter, you might feel discouraged and hopeless. However, Southern Californians should know that a denied claim is not the end of the road. It is the beginning.
Nearly 70% of initial claims for SSDI benefits are denied. This means that most applicants have to go through the appeal process to get their benefits.
The appeal process consists of four levels. The first is called Reconsideration, and this is essentially, a second look by another official who did not participate in the first application process. You can submit new evidence or information to support your claim.
This is a hearing before an administrative law judge who will listen to your testimony and review your evidence. You can also have witnesses or experts testify on your behalf.
Appeals Council and federal court
The final appeal level is either the Appeals Council or federal court. The council can send your case back to the ALJ, dismiss your review request or grant/deny your claim. Though, if the council refused to review your claim or you do not agree with their decision, you can file a lawsuit in a federal district court and ask a judge to review it.
Common reasons for denials
You need to prove that you have a severe impairment that prevents you from working for at least 12 months or results in death. You need to provide medical records, test results, treatment notes and opinions from your doctors that support your claim.
You need to show that you are following your doctor’s orders and taking the prescribed medications or therapies for your condition. If you fail to do so without a good reason, your claim may be denied.
You need to work long enough and recently enough to qualify for SSDI benefits. You need to have earned a certain number of work credits based on your age and earnings. If you do not meet the work requirements, your claim may be denied.
You need to cooperate with the Social Security Administration and provide them with any information they request. You also need to attend any scheduled appointments or examinations. If you do not comply with SSA requests, your claim may be denied.
Complex and time-consuming
The appeal process can be complex and time-consuming. It requires Southern Californians to gather and present the necessary evidence, prepare for the hearing and represent themselves at every level of the appeal.