How To Appeal Social Security Disability Benefits Denial

Share on facebook
Share on twitter
Share on linkedin
Share on reddit

It is quite common to be denied for Social Security disability benefits when you first apply for them. This is because of the complications and challenges associated with Social Security Disability Insurance (SSDI) and the fact that many do not have the help that they need to get the benefits that they deserve. In fact, many will be denied for small mistakes on the application or failing to attach important documents. This is common and frequently expected, and there is an avenue to appeal the decision against you. The wisest course of action, if you have been denied SSDI benefits, is to contact Surface Law Firm in Greenville, SC for a free consultation to learn more about your rights and the steps ahead of you.

Why Were My SSDI Benefits Denied?

If your SSDI benefits were denied, it could be for a variety of different reasons. With the right SSDI attorney, many of those reasons could be overcome with an appeal. Consider some of the following common reasons for denial of SSDI benefits:

  • You do not qualify for SSDI because you have not earned enough work credits.
  • You earn too much money through substantial gainful activity (SGA).
  • You are not disabled, according to the Social Security Administration’s definition.
  • You do not have a severe enough disability to last one year or lead to death.
  • You did not provide sufficient evidence of your disability.
  • You did not attend or refused to attend a consultative examination (CE) of disability.
  • Important information or documentation was missing from your application.
  • You are believed to have lied on the application.
  • You failed to follow through with necessary treatments or physical therapy.
  • Your disability is affected by your substance or alcohol abuse.
  • You have been found guilty of a felony and are in prison.
  • Your injury occurred while you were committing a felony you have been found guilty of.
  • You cannot be located for communication with the SSA.

Typically, the biggest obstacle that you will face in your quest to receive benefits is in providing adequate proof of the disability. Thus, it is common and necessary to use the appeals process. Being denied initially is a frequent occurrence, and you will have to deal with the administrative process if you wish to get the benefits that you need.

Four Levels of Appeals for SSA

If you have never attempted to apply for social security benefits, then you may be quite confused by the application and appeals process. The first thing to know is that there are four levels of appeals for SSA. These include the request for reconsideration, an Administrative Law Judge (ALJ) Hearing, an Appeals Council, and a Federal Court Review. On denial of your application, you will receive a formal informational letter regarding the appeals process. However, this can still be confusing. An experienced lawyer can help you to understand the process and successfully complete it.

Request For Reconsideration

The first level of appealing for SSA is the request for reconsideration. This is where the Disability Determination Services will perform a full review of your claim. These will not be the same people who have already viewed and denied your claim. You have the opportunity to submit new evidence, and this can make all the difference if you were denied for a lack of proof. This is also when you may be able to meet with an SSA rep to discuss your disability and needs. About 15% of claims that request reconsideration will be approved.

Administrative Law Judge Hearing

If you are not approved after requesting reconsideration, your next step is the Administrative Law Judge Hearing. This is much like going to court, and you would be wise to have an attorney on your side during this step. You will be presenting evidence and testimony to a judge who will question you, and you will have the opportunity to question witnesses and experts. An attorney in this situation is invaluable, as your lawyer will have the experience and expertise that you lack in gathering evidence, witnesses, expert testimony, etc, to prove that you deserve disability benefits.

At this level of appeal, your chance of approval will be greater, with some noting that more than 50% of appeals are approved at this stage. Do not give up hope when your case is denied, even if is denied again at reconsideration. There is still a chance, and if you work with an attorney, that chance is even greater, to prove your need to a judge.

Social Security’s Appeals Council

If you go through the ALJ Hearing stage and are still denied for benefits, you still have more options. The next step is to ask for a review by the Social Security’s Appeals Council. This is the council that will view requests and only review cases that are not determined to be already correctly addressed. You may get a decision from the council, or they may send you back for another ALJ review. You also have the opportunity to submit any new evidence that you may have.

At this point, you may be months into your injury and it may have grown worse. You can submit evidence of this as well. You may also have evidence that you’ve completed treatment and have not seen improvement.  You will not have to attend a council hearing at this point unless the council sends it back down for review with the ALJ.

Federal Court Review

If you are still denied or if the Appeals Court will not review your case, you still have one remaining path to take. You can file a lawsuit in the federal district court, where a judge will review your application and the whole appeals process that you have been through. The judge will check for legal errors in the case and for any factual mistakes.

While it can be stressful and can take a lot of time and money to appeal your case in court, it is an option worth considering. To evaluate whether or not this is the right choice for your case, contact a knowledgeable SSDI attorney to discuss your application and appeals process.

Consult With an SSDE Appeals Lawyer in Greenville

The best thing that you can do if your application for Social Security disability benefits is denied is to seek a free consultation with an SSDE appeals lawyer in Greenville, SC. Surface Law Firm is here to help with the experience and expertise that you need on your side for the best chance of getting your application for disability approved.