If your social security disability claim has been denied, you’re not alone. In fact, an average of two-thirds of benefits applicants are initially denied.
If your claim for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) is denied, you may think there is nothing else you can do. Or you may even resubmit the same disability claim—only to be denied a second time. The fact is that a denial is neither a reason to give up nor to file the same claim twice, as neither of those actions is going to get you the benefits you deserve.
Instead, those whose claims are initially denied must appeal the decision within 60 days.
Levels of appeal include:
- Reconsideration by another reviewer
- A hearing before an Administrative Law Judge (ALJ)
- Review of your claim by the Appeals Council
- Appealing in federal court
The Social Security Administration (SSA) has a built-in appeals system that allows you to go through multiple stages of reconsideration. This will ensure that your claim is not denied by mistake, and if your circumstances can be used to prove you qualify, you may be able to overturn a decision that went against you.
The right Social Security disability lawyer can help you navigate your appeals. They will advocate for you and be able to build the best strategy toward winning your benefits.
Why Was My Social Security Disability Claim Denied?
There are a variety of reasons your claim may be initially denied, ranging from technical to medical. The SSA will typically send you a letter when you are denied detailing the specific reasons, which commonly include:
Insufficient medical evidence.
The SSA has strict definitions of what meets its standard of disability. Conditions must either meet specific criteria outlined by the Social Security disability Blue Book, or you must otherwise be able to prove your disability prevents you from working in the U.S. economy and earning an income. Types of medical evidence include doctors’ notes and letters, test results, imaging, or records of medications and therapies.
Earning an income above a certain level, or other employment-related reasons.
To qualify for benefits, you must not earn above the Substantial Gainful Activity (SGA) level, which is $1,310 per month per individual for 2021. SSDI and SSI also each have their own employment-related qualifications you must meet.
Missed deadlines, incorrect or incomplete paperwork, or other mistakes.
The SSA may request for you to submit certain paperwork, information, or records, and meet certain deadlines during the process. This should be explained to you by the person handling your case. If you don’t meet these deadlines and requirements, this can lead to a denial of benefits.
Your claim may also be denied if a technical error occurs during the review process. Talk to a disability attorney for more information about reasons your claim might have been denied.
My Social Security Disability Claim Was Denied. What Are My Options?
There are multiple levels of appeal that your SSDI or SSI claim can go through if you are initially denied. At each of these stages, the right attorney can guide you through the process and advocate on your behalf. Qualified legal representation can ultimately increase the chance that you’ll receive your benefits on appeal.
If your claim is initially denied, your chances of winning benefits during this stage are still fairly slim. As mentioned above, you may be denied on a technicality or error in reviewing your claim. If this happens, it is one of the reasons the decision may be reversed during a reconsideration. The evidence of your original claim, plus any new evidence, will be reviewed by a different person.
An attorney can help during reconsideration by reviewing what kinds of errors could have been made and what kinds of new evidence would be required at this stage to win benefits.
An ALJ Hearing
Statistically, your best chance of having a denial reversed is during a hearing before an Administrative Law Judge. During your hearing, you will have an opportunity to present new medical evidence and will be questioned by a judge along with other potential witnesses, such as medical and vocational experts.
An attorney can help you prepare for your hearing, as well as play an active role as your advocate during the hearing. For instance, your attorney can cross-examine you and other witnesses to prove that your disability prevents you from working. An attorney can be crucial during this hearing, as they may have a nuanced understanding of these court systems, judges, and legal expectations that will give you the best possible chance for a positive outcome.
Hearings during COVID-19
While it can normally take months--or even years--to have a hearing, this process has been somewhat accelerated during COVID-19 due to the use of virtual hearings, which are being scheduled more rapidly. Thus, it is crucial to consult an attorney sooner, rather than later, to get prepared.
Other Stages of Appeal
You may request that the Appeals Council review a decision made by an ALJ. However, the Council may reject the request if they feel the judge’s decision was correct. They may also decide either to make a decision themselves or to send your claim back to an ALJ to be decided. Beyond this, you may file a lawsuit in federal district court.
While an attorney can help you during each stage of appeal, your ALJ hearing is really your best opportunity to reverse a denial and win your benefits. However, you don’t have to wait until your hearing to consult an attorney.
The earlier in the process you seek legal counsel, the better. This is because your attorney will be able to become familiar with the facts of your case sooner and help you optimize your chances at each stage—as well as understand the reasons decisions are made in your case.
In many cases, you won’t pay any up-front attorney’s fees for Social Security claims. Instead, you will pay a federally regulated portion of your first disability check (back pay) only if you win your case.
If your Social Security Disability claim has been denied, or you’re thinking about filing and don’t know where to start, Affleck and Gordon can help. We’ve been helping people in Georgia just like you for over 40 years. Sign up for a free case evaluation here, or call us at (404) 990-3945.