If you suffer from a serious medical condition and cannot work enough to support yourself, Social Security Disability benefits can be a crucial resource. These benefits allow workers with life-threatening or long-term disabling conditions to receive money to help them pay for things like living expenses and medical bills when they cannot work.
Unfortunately, the Social Security Administration denies most initial claims, and many appealed claims are denied yet again. Knowing this can potentially make it less surprising to learn that the SSA denied your claim, but it doesn’t make it any less frustrating. If your claim is denied, it is important not to lose hope or assume you do not qualify for benefits. There is an appeals process in place.
Steps to appeal
There are four levels of appeal regarding disability benefits. At all stages of appeal, it is important to meet filing deadlines (typically 60 days after a denial) and continue to see your medical provider to document your symptoms.
1. Reconsideration – You have 60 days to file for reconsideration if your claim is denied. At this step, a new person will reevaluate your application. If you have new evidence to support your claim, this person can take it into account.
2. Administrative Law Judge Hearing – If reconsideration doesn’t result in a favorable outcome, you can request an ALJ hearing. Again, you have 60 days to request this hearing after your reconsideration is denied. You will likely attend this hearing (in person or via video conference) where you may provide additional information or clarification. There may also be experts called in to testify.
3. Appeals Council review – If an ALJ hearing is not successful, you can request a review by the Appeals Council. This Council will decide whether to review your case. If it chooses to review your case, the Council will either make a decision or send the case back to an ALJ.
4. Filing a federal court claim – If you do not agree with the Council’s decision, the final option for appeals is to file a federal lawsuit. Based on the details of your case, a federal judge may or may not reverse the SSA’s decision.
Keep going to the doctor
The process is rarely quick: from the time you first apply for reconsideration, you often must wait at six to 12 months to receive a decision, and sometimes longer. About 80 percent of the time, people are denied twice – and must then wait another 12 to 18 months after the reconsideration is denied before they can get a hearing.
At this point, many people get frustrated and give up on the process. No matter how frustrated you are, it’s essential to keep going to the doctor during these waiting periods. You can ruin your claim entirely if you don’t go to the doctor during these waiting period, even if you meet every deadline.
It’s important to work with your medical provides to document all symptoms and any abnormalities in your health. Even if your doctor says there is nothing more they can do for you, you still need to follow up with them and get regular physical exams throughout the process.
Know your legal options
This appeals process can feel overwhelming and extremely frustrating, especially for someone who is already coping with serious health issues and trying to figure out how to pay for the things they need without being able to work. Many times, you will be asked to provide the same information repeatedly. As such, working with an attorney can be wise if the SSA denies your claim. With legal guidance, you can focus on your health without abandoning your efforts to pursue critical financial benefits.