Appeal Your SSDI Denial: How to Appeal After Your Social Security Disability Denial

Being approved for SSDI can be a herculean task, and denials are common. If the SSA sends you a denial letter in the mail, don’t give up! Just 1 in 5 claimants (20%) get approved the first time they apply. If you were denied SSDI benefits, here’s everything you need to know about how to appeal an SSDI denial and try again to win your case.

Appealing a Disability Denial: Key Takeaways

• Initial SSDI approval rates for disability benefits are low, with only 20% of applicants succeeding on their initial attempt.
• Hiring a lawyer greatly enhances the likelihood of success during the SSDI appeal process.
• The appeals process is broken up into three key steps: Reconsideration, the ALJ hearing, and an Appeals Council review.
• Submit supplementary evidence during the Reconsideration phase to strengthen your case.
• The Administrative Law Judge (ALJ) hearing is a critical stage where presenting a thorough case is crucial.
• Consider filing a federal lawsuit as a last resort if previous appeals are unsuccessful.
• Interim benefits may be available during the appeal process if there’s a prolonged wait for an ALJ hearing.
• Successful appeals result in receiving SSDI benefits, potentially including back pay.

Step 1: Get Professional Help Filing Your SSDI Appeal

Even if you’re denied SSDI benefits, all hope is not lost. You may still win benefits if you appeal within 60 days. However, most people who win benefits at their appeals hearing have a lawyer.

We strongly suggest having a lawyer file your disability appeal (or at least consult one before getting started on your own). You’ll pay nothing to talk privately with a lawyer and get specific advice that applies to your situation. Plus, a lawyer can easily spot mistakes on your application and explain why the SSA denied your claim. Click here to find an experienced lawyer to answer your questions now for free.

Hiring a lawyer who specializes in the disability application process can greatly improve your chances of being approved when you appeal your SSDI ruling. Applicants with lawyers are 3.3 times more likely to be approved for benefits compared to those without, according to the US General Accounting Office.

Here are a few skills a disability lawyer can bring to the table to assist with your SSDI appeal:

• Guidance navigation the application and appeals process
• Help identifying weaknesses in your disability benefits case
• Ongoing case management and communication
• Legal experience with the appeals process and an understanding of how to appeal effectively
• Insight on the perspective of judges

Enlisting the expertise of a disability lawyer significantly enhances your prospects of success during the SSDI appeal process. Their specialized knowledge, insight into the appeals system, and ability to pinpoint crucial aspects of your case can be invaluable. By seeking professional assistance, you not only increase your chances of approval but also gain peace of mind knowing that your appeal is being handled with precision and expertise.

Step 2: Submit Your Appeal (Request for Reconsideration) Within 60 Days

Once you’ve been issued a negative verdict on your SSDI application, you have 60 days to submit an appeal. Fill out and submit Form SSA-561 to the SSA as soon as you know you’ve been denied to start this process.

What is Reconsideration?

This portion of the SSDI appeals process is known as Reconsideration and involves a second review of all the information you submitted with your initial application by a new SSA disability examiner. In addition, you can also submit supplementary evidence and documentation to help prove your disability, so if your initial application was missing information or filled out incorrectly, now is your chance to rectify this.

Note: If you cannot get an appointment with your local Social Security office, you can also submit it by mail. If a lawyer filed your initial claim, there’s nothing else for you to do. Your attorney will handle all the appeals paperwork needed for reconsideration.

What Happens If Your Reconsideration Appeal is Rejected?

Only an additional 13% of applicants are typically approved during the Reconsideration process. Instead, once you’ve submitted your Reconsideration appeal, it’s time to start preparing for your ALJ hearing.

Step 3: Request an Administrative Law Judge (ALJ) Hearing

Just like Step 2, you have 60 days to request your ALJ hearing (do this as soon as possible!). The SSA’s Office of Disability Adjudication and Review (ODAR) usually schedules your appeal hearing 7-18 months after receiving your request. At this stage, most people who win disability benefits have a lawyer (and 81% of people at hearings do).

What is an ALJ Hearing?

The Administrative Law Judge (ALJ) hearing is a critical stage in the Social Security Disability Insurance (SSDI) appeal process. During the hearing, you’ll have the opportunity to present your case directly to the ALJ, who is responsible for making a final decision on your disability claim.

How Does the ALJ Hearing Work?

The ALJ will typically begin by confirming personal details such as your name, address, and education level before delving into your work history over the past 15 years. They’ll inquire about your past and present employment, including any volunteer work or jobs that may not have been reported for taxation purposes.

Following the discussion on work history, the Administrative Law Judge will explore the impact of your impairments on your daily life. They’ll ask you to describe a typical day, including your daily activities and any challenges you face due to your disabilities. It’s essential to be thorough and honest in your responses, as this information helps the ALJ assess the severity of your impairments and their effect on your ability to work.

Additionally, the ALJ may ask about medications you’re taking and any other relevant details that can aid in their decision-making process. Throughout the hearing for your Social Security Disability benefits, your attorney, if you have one, will provide guidance and support to ensure your case is presented effectively.

What Happens If You Receive a Negative Ruling at Your ALJ Hearing?

The hearing stage is where your appeal is most likely to be successful. However, if you still receive a rejection, you can appeal your SSDI denial further to an Appeals Council review.

Important: Wait times for appeal hearings can vary according to which state you live in. Find yours on our interactive hearing wait times map of the U.S. (current as of December 2022).

Step 4: If You’re Denied Again, Request an Appeals Council Review

You have another 60 days to dispute the judge’s ruling if you don’t win SSD benefits at this stage. But if you miss this filing deadline, the SSA will automatically dismiss your case. You’re only likely to win SSD benefits at this appeals stage if:

• The judge cut your ALJ hearing short or made an obviously flawed ruling. The Appeals Council may review your claim, dismiss it or reverse the ALJ’s decision.
• Your SSD case implies broad policy or procedural issue changes. If an expert testified at your ALJ hearing or you’re the first person to develop a new impairment, then this applies to you.

Step 5: File a Federal Lawsuit Against the Social Security Administration

Your last appeal option involves suing the SSA. This is expensive and time-consuming (i.e., you may wait 2-9 years for your court date). Only choose Step 5 if you believe the SSA made legal errors during the application and claim review process. Most lawyers aren’t willing to represent these cases on contingency, or sue the SSA at all.

Work With a Disability Lawyer For Your SSDI Appeal

Navigating the SSDI appeal process can be daunting, but it’s not a journey you have to undertake alone. If you’ve faced a denial of benefits, don’t lose hope. Seeking professional assistance from a disability lawyer significantly increases your chances of success.

So if you find yourself trying to appeal an SSDI ruling, don’t hesitate to reach out to a disability lawyer for assistance. With their expertise and support, you can navigate the appeals process with confidence, knowing that you’re giving yourself the best possible chance of securing the benefits you deserve.

Appealing a Disability Denial: Frequently Asked Questions (FAQ)

1. What is SSDI?

SSDI stands for Social Security Disability Insurance. It’s a federal insurance program designed to provide income support to individuals who are unable to work due to a qualifying disability.

2. Why was my SSDI claim denied?

There could be several reasons for a denial, including insufficient medical evidence, failure to meet the SSA’s definition of disability, incomplete application, or not meeting the work credit requirements.

3. What should I do if my SSDI claim is denied?

If your claim is denied, you have the right to appeal the decision. It’s crucial to act promptly as there are strict deadlines for filing an appeal.

4. How do I appeal an SSDI denial?

The appeals process typically involves several stages:

• Reconsideration: You can request a reconsideration of your claim by the Social Security Administration (SSA). This involves a review of your initial application by someone who was not involved in the initial decision.
• Administrative Law Judge (ALJ) Hearing: If your claim is denied upon reconsideration, you can request a hearing before an ALJ. You’ll have the opportunity to present evidence and testimony supporting your disability claim.
• Appeals Council Review: If the ALJ denies your claim, you can request a review by the SSA’s Appeals Council.
• Federal Court Review: If all administrative avenues are exhausted and your claim is still denied, you can file a lawsuit in federal court.

5. How long does the appeals process take?

The duration of the appeals process can vary widely depending on factors such as the complexity of your case, the backlog of appeals in your area, and the stage at which your claim is approved or denied. It’s not uncommon for the process to take several months to several years.

6. Do I need a lawyer to appeal my SSDI denial?

While it’s not required to have legal representation, many applicants find it beneficial to hire a disability lawyer or advocate, especially when navigating the appeals process. A lawyer can help ensure that your rights are protected, gather necessary evidence, and present a strong case on your behalf.

7. What evidence do I need to support my appeal?

You’ll need to provide medical evidence that supports your disability claim, including doctor’s reports, test results, treatment records, and statements from healthcare providers. Additionally, any relevant work history, vocational assessments, or personal statements detailing the impact of your disability on your ability to work can strengthen your case.

8. Can I continue to receive benefits while my appeal is pending?

In some cases, you may be eligible for interim benefits while your appeal is pending. These benefits are typically available if you’ve been waiting for a hearing before an ALJ for more than a year.

9. What happens if my appeal is successful?

If your appeal is successful, you’ll start receiving SSDI benefits. Additionally, you may be entitled to back pay, which includes retroactive benefits dating back to when you first applied for SSDI.

10. What if my appeal is denied at every stage?

If your appeal is denied at every stage of the process, you still have the option to pursue legal action by filing a lawsuit in federal court. It’s advisable to consult with an attorney experienced in SSDI appeals to assess your options.

11. Should I reapply or appeal if my SSDI claim is denied?

It’s generally recommended to appeal rather than reapply if your SSDI claim is denied. Reapplying restarts the process from the beginning, which may result in unnecessary delays and potential loss of back pay. By appealing, you have the opportunity to present additional evidence, address any deficiencies in your initial application, and have your case reviewed by a different decision-maker. However, every case is unique, and it’s advisable to consult with a disability lawyer or advocate to determine the best course of action based on the specifics of your situation.