Appealing a Denial for Social Security Disability Benefits

Jun 20, 2016

Appealing a Denial for Social Security Disability Benefits

The truth is that many people are denied Social Security disability benefits when they first apply. Social Security Disability Insurance (SSDI) is complicated, and without the right help, you could run yourself in circles trying to figure it out. Seemingly small and meaningless mistakes on an application can mean you do not receive the assistance you deserve. Maybe you made a mistake on the paperwork, or maybe you forgot to attach necessary documentation. Whatever the issue, you are one of many people who need to appeal the decision. If you have been denied SSDI benefits, contact the Charlotte NC SSDI attorneys at Ted A. Greve & Associates P.A. to learn about your rights.

Common Reasons SSDI Benefits Are Denied

There are many reasons why an application for assistance can be denied. Many of them can be overcome upon appeal with the help of an experienced SSDI attorney.

Denials are commonly based on:

  • You have not earned enough work credits to qualify for SSDI;
  • You earn too much money through substantial gainful activity (SGA);
  • You do not meet the Social Security Administration’s definition of disabled;
  • Your disability is not severe enough to last one year or lead to your death;
  • The SSA claims you lack sufficient evidence of your disability;
  • You refuse to attend a consultative examination (CE) of your disability;
  • You left off information or necessary documents on your application;
  • The SSA claims you lied on your application;
  • You did not follow through with physical therapy or necessary treatments;
  • Substance or alcohol abuse contributed to your disability;
  • You are in prison after being found guilty of a felony;
  • You were injured in the commission of a felony you were later found guilty of committing; or
  • The SSA cannot find you or communicate with you.

The greatest challenges to receiving benefits are offering the necessary amount of proof of your disability and using the appeals process when necessary. An initial denial is common and the only way to receive the benefits you need is to continue through the administrative process.

Levels of SSA Appeals

For those who have never experienced applying for social security benefits before, the application and appeals process is probably confusing. The appeals process, in particular, can be hard to manage because there are four levels of appeals:

  • A request for reconsideration;
  • An Administrative Law Judge (ALJ) Hearing;
  • An Appeals Council; and
  • A Federal Court Review.

When your application is denied, a formal letter will inform you how to appeal. Even with this information, it best to have an experienced attorney guide you through the exact procedures.

Reconsideration

When you ask the SSA to reconsider your application, the Disability Determination Services performs an entire review of your claim. The people reviewing your application will be different than the people who initially looked at it and denied it. You can submit new evidence as this time, which can be extremely helpful if the reason for your denial was a lack of proof of your disability or the extent of your disability. You might also be able to meet with a SSA representative to discuss why you need benefits.

It is estimated that up to 15 percent of claims that ask for reconsideration are approved.

ALJ Hearing

If your request is reconsidered and denied, you can move on to an Administrative Law Judge Hearing. Even if you have not used a lawyer up to this point, you still have the right to a legal representative and you should exercise this right. An ALJ hearing is like going to court. You will need to present evidence and testimony regarding your disability. The judge will question you, and you or your attorney can question witnesses and experts. An SSDI attorney is helpful in this situation because they can guide you through what the hearing will be like. They can help you gather the evidence, witnesses, and expert testimony you need to prove your disability. An attorney has the legal know-how to ask the right questions to demonstrate the extent of your disability and need for SSDI benefits.

While this may seem time-consuming, your chance of being approved increases at this level of appeal. Some figures state more than half of the appeals that get to the ALJ level are approved here. While it is hard to find exact numbers, it is clear that you should not give up hope if your request for benefits is initially denied or even denied on reconsideration. There is hope that you can prove to a judge that you need this benefits.

Appeals Council

If your application for benefits is denied at the ALJ hearing, you can ask for a review by the Social Security’s Appeals Council. The council looks at all requests and denies to review cases it believes were determined correctly by the previous hearing. If the council reviews your case, it will make a decision or send it back to an ALJ for another review.

When you appeal to the council, you can send any new evidence you have. This is important because at this point, you may have been suffering from your injury for months. The extent and duration of your injury at this time can prove that you are disabled and will be so for more than 12 months. You may also be able to show that you have undergone your medical treatment or rehabilitation and that it has not improved your condition. If your condition has worsened, you can also provide evidence of this.

You do not need to attend a council hearing at this level of appeal, though you may attend an ALJ hearing if the council sends it back down for review.

Federal Court

If the Appeals Council refuses to review your case or denies your request for benefits, your final option is to file a lawsuit in the federal district court. If you take your case to court, a judge will review your application and appeals process. He or she will specifically look for any legal errors in your case, but he or she might also look for factual mistakes or questions as well.

Taking your appeal to court can be time-consuming and expensive. Speak with an experienced SSDI attorney to determine if this is the right option for you.

A Charlotte SSDI Appeals Lawyer Can Help

If you have been denied Social Security disability benefits, call the experienced Charlotte NC SSDI benefits attorneys at Ted A. Greve & Associates P.A. right away. No matter where you are in the appeals process – they can help. Attorney Ted A. Greve has more than 20 years of experience fighting for people like you, and he brings with him a large legal team to support your case.