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The vast majority of applications for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) get denied when initially submitted. Most people have to go through at least one level of appeal to get the benefits they deserve.
It can help if you know when to talk to a Social Security disability lawyer. A Texas disability attorney can advocate for you and navigate through the appeals process on your behalf.
When Your Disability Benefits Application Gets Denied or Reduced
Since the Social Security Administration (SSA) denies most initial applications, you might want to plan on having to submit at least one appeal. The regulations for the appeals process are complex and strict. For example, you only have 60 days from when you get the notice of the SSA’s decision to request an appeal. If you miss that deadline, you will get stuck with the decision.
An adverse decision can be a denial of your application for benefits or an award that is less than you think it should be. In either situation, your remedy is to file an appeal.
The Social Security Disability Benefits Appeals Process
There are four levels of appeals from an adverse decision on your application for Social Security disability benefits:
- Reconsideration. In a reconsideration appeal, your file moves on to someone else, not the person who made the original adverse decision. The individual who performs the reconsideration reviews everything in your claim file and any additional evidence you submitted after your original application got denied or reduced. You can request a reconsideration of a medical issue or a non-medical issue.
- Hearing with an administrative law judge (ALJ). After the reconsideration, you still might not be happy with the determinations made in your case. You can request that an administrative law judge hold a hearing about your benefits claim. The ALJ will be new to the case and will review your file and the arguments you raise in the appeal.
- Review by the Appeals Council. If the ALJ dismisses your case or makes a ruling with which you disagree, your remedy is to file a request for review by the Appeals Council. The Appeals Council can refuse to review your case if the two previous levels of appeal followed the law and regulations correctly. If the Appeals Council grants you a review, they can send the case to an ALJ, or the Council itself could perform the review.
- Filing a lawsuit in federal court. After exhausting all of the administrative remedies through the Social Security Administration, an applicant can file a lawsuit in federal court seeking a favorable determination on the relevant issues.
The rules are different for each stage of the appeals process. If you do not jump through all of the hoops correctly, the SSA or court can dismiss your case on procedural grounds without addressing the substantive issues of your eligibility for disability benefits.
Working with a Social Security Disability Lawyer from the Beginning of the Claim Process
Often, the SSA denies applications for disability benefits because people submit incomplete forms or do not provide enough evidence for the SSA to approve the request for benefits. When you work with a lawyer from the beginning, your application is more likely to include the information the SSA needs to make a decision.
Avoiding months of delays can make a significant difference in your financial health. The SSA does provide payment of back benefits when an applicant finally gets an award of disability benefits, but having to wait until your case makes its way through one or more appeals can create a financial hardship for you and your family. A Texas disability attorney might be able to help you avoid unnecessary delays. Contact our office today.