What Appealing A Denied SSDI Claim Looks Like

If you take nothing else away from reading this page, understand this: a denied claim for Social Security Disability Insurance (SSDI) benefits is not the end of the road. In fact, it’s the beginning – and a common beginning at that. Nearly 70% of initial claims for SSDI benefits are denied.

Initiating the appeals process after a disability claim denial can be challenging. However, with careful preparation and the right guidance, you can fight for the benefits you need.

The Two Most Important Things To Do Right Now

After a Social Security Disability (SSD) denial, you need to act fast. First, write down your 60-day deadline to file an appeal. If you miss this deadline, you might have to start your application all over again. Contacting a lawyer right away can help, since they can guide you through the appeal process and meet these deadlines. They make sure you file all the paperwork correctly and on time, which boosts your chances of winning the appeal.

Next, figure out why the Social Security Administration (SSA) denied your claim. Many people face denial because of common issues, and knowing these can help you fix them. Facing these issues directly can help you turn the denial around:

• Lack of evidence: One of the common reasons for claim denial is that the SSA says that they do not have the medical evidence they need for their claim. It does not mean your claim is weak; it means the evidence was not presented in the exact way the SSA requires. I know what they’re looking for, and my first step is to analyze your file and get the specific medical records and doctors’ opinions needed to prove your case.
• Failure to meet eligibility criteria: To qualify for SSDI, applicants must meet specific eligibility criteria, including having a disability that prevents substantial gainful activity and having enough work credits. If you receive this kind of technical denial, I can help you show why you do qualify for these important benefits.
• Incomplete documentation: Submitting a complete application is crucial. Missing forms, incomplete information or errors in the documentation can lead to a denial. I can handle the paperwork for you, reviewing your application and your evidence to make sure it is compelling and complete.

By finding out the exact reasons for your denial, you can work with your lawyer to gather more medical records and build a stronger case for your appeal.

Doing these steps quickly not only improves your chances of getting the support you need but also reduces the stress and uncertainty of the appeals process.

The Four Stages Of An SSDI Appeal: How I Fight For You

There are four different stages in responding to a notice of denial. Success at any of these means your claim has been approved and you do not need to move to the next step.

1. Request For Reconsideration

In this initial stage of the appeal, you simply request that your application be reviewed again, this time by Disability Determination Services (DDS). It will be reviewed by a medical consultant and an examiner who were not part of the initial review. Only 5% to 10% of claims that are reviewed at this stage are approved.

My strategy at this stage: Resolving these issues is about more than just refiling your application. At The Law Offices of Cory A. DeLellis, I carefully analyze your denial, gather medical records and work with your health care providers to specifically address the SSA’s objections. This helps me not only appeal their decision but also helps build the case if you need to request a hearing.

2. Request For A Hearing

If your request for reconsideration results in a denied claim, the next step is to request a hearing before an administrative law judge (ALJ). This request must be submitted within 60 days of receipt of the denial. ALJ hearings are usually held in small conference rooms, though some are held via video conference. The judge, an attorney who works for the SSA, will ask the injured party about their medical condition and treatment.

If you have hired an attorney, he or she can speak to the judge on your behalf at this hearing and ask questions of you that you have been prepared to answer. There may also be medical professionals who serve as expert witnesses. The judge will ask these witnesses questions and your lawyer may ask questions of them as well.

The judge typically rules on your claim within four weeks, and you receive that notice by mail. If the judge approves your claim – and this occurs more than 50% of the time at this stage – you will begin to receive benefits.

My strategy at this stage: This stage is crucial, and your success depends on being prepared for the hearing. This is also where my legal experience can provide critical support. I will:

• Prepare you thoroughly for the judge’s questions, ensuring you feel confident and ready.
• Represent you at the hearing, passionately arguing your case with skill and dedication.
• Challenge the SSA’s expert witnesses, emphasizing the unique limitations of your condition.
• Present the strong medical evidence I’ve been gathering since your reconsideration, showcasing the strength of your case.

3. Appeals Council

If you lose your disability hearing, you can request to have the appeals council review your case. This also must be done within 60 days of receiving notice of losing your hearing. The appeals council does not review all cases it receives, and it will not be reviewing the merits of your claim.

Rather, it reviews the ALJ hearing to determine if there was an abuse of discretion, if the ALJ decision is not supported by evidence or if actions by the ALJ raise a policy or procedural concern. The appeals council stage does not result in many reversals of denials. Instead, it is mostly a bridge to the fourth stage of appeal.

My strategy at this stage: The appeals council does not review the medical facts of your claim. Instead, this stage involves a highly technical legal argument. I handle this complex legal brief for you. I will document and present the ALJ’s errors and preserve your right to appeal to the next and final level.

4. Federal Court Review

The final stage in the appeals process is filing a lawsuit in U.S. District Court. These cases are heard without a jury. Federal judges are supposed to review the case only for legal errors, but they frequently rule on factual aspects of the case as well. Here again, the rate of reversal at this level is low. However, they do send back a high percentage of cases to SSA for further review.

My strategy at this stage: Filing a lawsuit in federal court is complex. As a result, few attorneys handle cases at the federal level. However, at The Law Offices of Cory A. DeLellis, I am prepared to take your case to the highest level. I will write and file the detailed legal briefs required to challenge the SSA’s decision and fight for you at every step.

Put An Experienced Lawyer In Your Corner

Having a disability attorney who is familiar with the appeal process on your side is an important advantage. Statistics show that those who enlist the help of an attorney when appealing a denied disability claim have a higher chance of being successful.

Call me at 619-567-4462 or use my online contact form to schedule a free consultation. I only get paid if I help you obtain benefits.