If you were denied Social Security disability benefits, don’t give up. Applying for Social Security disability benefits can be complex and arduous. More than half of all applicants are given an initial denial of disability benefits. Instead of giving up or re-applying, you should file an appeal with the Social Security Administration (SSA) as soon as possible. You must file the appeal within 60 days of the date on the denial notice.
There are a number of common mistakes that first time Social Security disability applicants make. Be sure to avoid some of these common errors:
When you apply for Social Security disability, the Social Security Administration will consider your payroll taxes and monthly income. To be considered for disability benefits, you must make less than the Substantial Gainful Activity (SGA) level established by the SSA. This amount is re-adjusted every year.
The Social Security Administration will not consider you disabled if you can engage in activity where you earn more than the SGA limit. In 2018, for instance, the monthly limit for individuals who are legally blind was $1,970. The SGA level for those who are not blind was $1,180. In contrast, the monthly SGA limit in 1975 for those who were either blind or not was $200.
One of the most common reasons for denial is not following your doctor’s treatment plan. It’s important to comply with the treatment plan your doctor prescribed for you. Those who deviate from that plan are at a much higher risk being denied disability benefits. Also, you should not routinely fail to show up for scheduled medical exams. The SSA may conclude that it is your lack of cooperation with your healthcare professional, rather than your disability, that prevents you from working.
Claims are often denied if the application had insufficient treatment records, missing paperwork, errors, or omissions. The SSA expects you to complete the application and provide all the required paperwork as instructed. You should make sure the proper medical records are released when requested. It isn’t sufficient to start keeping medical records after you apply for disability. The SSA needs to see a detailed medical history. Work with your doctor(s) to obtain typed notes containing your medical complaints, results of examinations, treatment regimens, and other applicable details. It is important to carefully follow all instructions on document submission. Photocopies are acceptable for many documents, but the SSA requires particular documents in their original form, like your birth certificate.
In order to collect disability benefits from the SSA, you must have previously worked and paid into the Social Security system. The SSA uses a measurement based on the number of work credits you’ve earned, combined with other factors such as age and how recently you earned your work credits, to determine whether you qualify for disability. The Benefits Planner page on the Social Security Administration website will give you more in-depth information on working credits needed to qualify.
If you’ve had your disability benefits application denied, don’t be discouraged. There is a system for you to appeal your benefits denial.
In most states, the first step in the appeals process is reconsideration. Reconsideration is not scheduled as a hearing, since it usually does not involve the applicant being present. Reconsideration is an administrative review that occurs before an ALJ hearing. During reconsideration, a second disability claims examiner will review your application file and determine whether a different decision is warranted. The following states have eliminated reconsideration as part of the appeals process:
If your reconsideration appeal is unsuccessful, the next step is the ALJ hearing where your case goes before an administrative law judge (ALJ). For states where reconsideration has been eliminated, the ALJ hearing is the first step in the appeals process. Statistically, the ALJ hearing is where you have the highest likelihood of winning your disability benefits appeal. Your case goes before a judge, who will take another look at your file and any newly submitted medical evidence. Numerous reliable sources note that while reconsiderations are denied at an even higher rate than initial applications, approvals at the ALJ hearing level is somewhere between nearly half to more than half of all cases heard.
Should the ALJ rule against you, you can appeal the decision to the Appeals Council. This Council will examine your case and determine whether there were legal errors in the judge’s decision. The Appeals Council can either reverse the judge’s decision and approve your appeal, remand the case back to the ALJ for a second hearing, or issue another denial of your claim.
Should the Appeals Council reject your appeal, your last resort is to file suit in federal court. If this is unsuccessful, you will need to re-apply for disability benefits.
In order to avoid much of this hassle, it can be beneficial to speak with a disability lawyer early in the application process. Unlike attorneys who specialize in other areas, disability lawyers do not charge up-front fees or require a retainer. Most disability lawyers will only collect a contingency fee, meaning they will only get paid if you win your case. Their payment comes out of a portion of the “back pay” awarded to you by the Social Security Administration. LawInfo provides you free access to a directory of excellent, Lead Counsel-rated disability lawyers.
This article is intended to be helpful and informative. But even common legal matters can become complex and stressful. A qualified social security disability lawyer can address your particular legal needs, explain the law, and represent you in court. Take the first step now and contact a local social security disability attorney to discuss your specific legal situation.