Appealing Your Social Security Application Denial

If your application for Social Security benefits has been denied, you are not alone. In fact, roughly two-thirds of all initial Social Security applications are denied. The important thing to remember is a denial does not mean you cannot eventually win.

What is the difference between SSI and Social Security Disability (SSDI)?

Both provide cash assistance for people who are disabled but there are differences:

Social Security Disability (SSD or SSDI):

Funded through payroll taxes, people who receive SSDI have worked and paid FICA and Social Security taxes to meet the required amount of work credits, and are younger than 65 years.

Supplemental Security Income (SSI):

A need-based program that provides financial help for people who don’t work or have a low-income, and are 65 years or older, blind, or disabled.

Why was I denied Social Security benefits?

Here are some reasons your SSI or SSDI benefits may be denied:

  • Your income is too high to qualify
  • Your disability isn’t severe enough
  • You did not follow your doctor’s prescribed therapy
  • Your disability is a result of using drugs or alcohol
  • You have been convicted of a crime

The Social Security appeals process starts after you receive your denial notice.

If you were denied SSI or SSDI, read your denial notice very carefully because it will contain detailed instructions on what you must do next.

The Request for Reconsideration is the first level of an appeal.

Generally, you must act quickly to request a reconsideration of your claim as soon as possible, but no later than 60 days from the date of your denial notice. It’s imperative that the social security administration receives your paper work within this time frame for your case to be reviewed a second time.

The reconsideration determination usually takes about 120 days. Don’t be discouraged if your reconsideration results in a second denial. This process is somewhat redundant as, essentially, someone from the same agency is reviewing your claim, again. Roughly 9 out of 10 reconsideration requests result a second denial.

An Administrative Law Judge has the power to overturn your denial.

If your claim is denied after reconsideration, you can request a hearing before an Administrative Law Judge (ALJ). You must do this as soon as possible, but no later than 60 days from the date of your reconsideration decision.

How long will it take for my Social Security hearing to be scheduled?

On average, it will be a little over a year before you get a hearing before an ALJ.

At what stage of the appeal should I hire a Social Security attorney to help with my claim?

While you are not required to hire an attorney, an experienced disability attorney will greatly improve your chances of winning. Statistics show that disability claimants who are represented by an attorney at the ALJ hearing are twice as likely to be approved.

If the judge denies your claim, the Appeal’s Council may reconsider your case.

If after your hearing the ALJ denies your claim, you have the right to appeal your claim to the Social Security’s Appeals Council, which can take as long as 18-24 months to decide. The Appeals Council can either remand your case back to the ALJ, which happens in roughly 1 out of 4 cases, or they can overturn the ALJ’s decision, which happens in a mere 3% of cases.

If you are denied again, the Federal District Court can overturn the Appeal’s Council.

Ultimately, if your claim is still denied at this level, or the Council decides not to review your case, you can file an appeal in Federal Court. This appeal, filed as a civil action, can be confusing and complicated when done without the help of an attorney, and it could take up to one year for the judges to reach a decision.

If you have questions about your Social Security application, contact one of our experienced Social Security attorneys today for a free consultation.

As social security disability attorneys, we represent people who have been denied SSI and SSDI. We are familiar with what is required by Social Security regulations to prove a disability and will pursue all options available to help our clients secure the benefits they need. If you have any questions please contact Gottlieb, Johnston, Beam, and Dal Ponte, P.L.L.