SSDI Claim Denied? Don’t Lose Hope — Here’s What to Do If You’ve Been Denied Disability Benefits
Fighting for disability benefits is a long, arduous process that takes an emotional toll — particularly when your disability claim is denied.
But being denied for disability benefits doesn’t mean that you’ve run out of options.
At Fields Law, we have helped thousands of clients nationwide strengthen their case and ultimately receive the benefits they deserve.
In today’s blog, we’ll discuss some of the most common reasons why most people get denied for disability, what you can do when your disability claim is denied, and how an experienced disability law firm like Fields Law can help you fight for your rights.
Understanding Why Your Disability Claim Was Denied
The Social Security Administration (SSA) receives millions of initial disability claims each year for both Social Security Disability Income (SSDI) and Supplemental Security Income (SSI).
Of those initial claims, approximately 72% of them are denied on the first application.
With so many incoming claims in a single year, the numbers show that receiving a social security disability denial is not only common, it’s a likely outcome for many.
But why do most people get denied for disability? These are the primary reasons:
- Lack of Medical Evidence: The SSA requires extensive medical evidence to prove a claim. This includes doctors notes, treatment history, specialist reports and objective tests (like X-rays, MRIs, and lab work). Lacking sufficient, well-documented medical evidence in any of these areas is often a primary reason for being denied SSDI or SSI disability.
- Insufficient Documentation: In the same vein as lacking medical evidence, missing or incomplete forms, or even errors in the required documentation are another likely culprit for being denied Social Security disability.
- Failure to Follow Treatment: If the evidence shows that you have neglected to follow recommended treatment procedures, you are likely to be denied disability.
- Unimpaired Ability to Work: To be considered disabled, you must be unable to perform substantial gainful activity (SGA). The SSA sets a threshold for how much you can earn and still be considered disabled. If you are still able to perform some form of work, and are earning more than the threshold, you are likely to be denied for disability benefits.
- Technical Ineligibility: To qualify for SSDI benefits, you must have worked enough in your lifetime to earn the appropriate credit requirements. If you have not met this eligibility criteria, your SSDI claim will be denied.
- Number of Applications Received: With the SSA receiving millions of applications per year, the review process is rigorous. Applications with errors, missing information, or other technical ineligibilities are often denied efficiently, so that the SSA can prioritize complete applications.
What to Do If You’ve Been Denied Disability? Beginning the Appeals Process
While many Social Security disability claims are initially denied, the chances of approval increase with the appeals process.
If you’ve recently received a letter of denial from the SSA, read it carefully. The administration will typically cite their reasons for Social Security disability denial.
Understanding why you’ve initially been denied disability is a crucial first step for mounting a successful appeal.
Both SSDI and SSI appeals follow the same structured approach to appeals. There are three levels of appeals within the Social Security Administration, as well as a final option to appeal in federal court. It’s vital to understand each stage, its deadlines, and the actions you must take.
This is where the help of an experienced disability law firm such as Fields Law becomes invaluable. Here is a breakdown of the appeals process and its levels:
1. Reconsideration – The First Appeal
Whether your SSDI claim was denied or your SSI disability was denied, the first step in the appeals process is filing a Request for Reconsideration. In this stage, your entire claim is reviewed by a new disability examiner and medical consultant who were not involved in your initial application.
To improve your odds in this stage, here’s what to do:
- Submit New Medical Evidence: If you have any new test results, medical records, or doctors’ opinions that weren’t included in your initial application, or documentation showing a worsening of your condition, this is your time to provide it.
- Address Denial Reasons: The SSA will offer their reasons in your denial letter. It’s imperative that you address these directly, such as providing missing information, or correcting errors.
- State Why You Believe the Decision is Wrong: Clearly articulate why you feel the initial decision was wrong, and explain how your medical condition prevents you from working.
It’s important to bear in mind that you must submit your appeal within the appropriate timeline — typically within 60 days of receiving your Social Security disability denial letter.
It can take anywhere from three to six months for a decision to be made on your appeal. Many claims are still denied after the first appeal, but reconsideration is the first of several appeals available, so don’t lose hope even if your first appeal is denied.
2. Hearing Before an Administrative Law Judge – The Second Appeal
If your reconsideration SSDI/SSI claim is denied, the next chance to appeal is by requesting a hearing from an Administrative Law Judge (ALJ).
The second appeal is critical, and offers a significantly improved chance of approval. Individuals with legal representation from an experienced disability attorney like Fields Law are often two to three times more likely to win approval at this stage, than those who proceed without representation.
The hearing is presided over by the ALJ, an independent judge uninvolved in your previous denials. During the hearing, you may testify yourself, present new evidence, and even have witnesses speak on your behalf.
The ALJ will want to know about how your medical condition affects your ability to work, your daily activities as well as your work history.
Largely due to backlogs in the system, this stage can take a significant amount of time to work through, ranging from one to one and a half years.
3. Appeals Council Review – The Third Appeal
If you are denied social security disability by the ALJ, you may request a review by the SSA’s Appeals Council.
The Appeals Council won’t hold any new hearings or review any new evidence without a compelling reason to do so. Instead, they will review the ALJ’s decision to ensure it complies with SSA procedures and regulations, and then exercise one of three options:
- Uphold the ALJ’s decision to deny your disability benefits
- Reverse the ALJ’s decision and grant you benefits
- Send your case back to the same or another ALJ for a new hearing, with specific instructions.
The approval rate at this stage is significantly lower than during the second appeal, but it is still possible to win approval here. This stage can take anywhere from six months to a year to complete.
4. Federal Court Review – The Fourth and Final Appeal
What to do if you’re denied disability in each of the SSA’s three appeals stages? The fourth and final chance for an appeal is to file a civil lawsuit in a U.S. District Court.
Taking things to this level is a complex legal process that requires the guidance of an experienced disability attorney. Winning approval here will be difficult, but not impossible.
If a federal court reviews the SSA’s decision and determines the administration did not follow the proper legal procedures, or if their decision was not supported by the evidence, the court may remand the case back to the SSA, giving you another chance to have your case reviewed.
How a Qualified Disability Attorney Can Help You Appeal a Social Security Disability Denial
Being denied Social Security disability can leave you feeling helpless and alone, but with help from an experienced disability attorney, you can enter the appeal process with confidence.
When your SSDI claim or SSI disability is denied, enlisting the help of an attorney can improve your chance of a successful appeal by:
- Guiding You Through the Appeals Process: The SSA’s rules and regulations are complex, but a qualified disability attorney will have an intricate understanding of the system. They will be able to help you navigate the appeals process efficiently and with confidence.
- Strengthening Your Application/Appeal: Whether you’re making an initial claim, or filing an appeal, a disability attorney will be able to help you gather the crucial medical records, documents, and doctors’ statements needed to build an effective case.
- Meeting Strict Deadlines: There is a 60-day window from the time you receive a denial letter for you to submit an appeal at any stage of the appeal process. An attorney will ensure that all required paperwork is completed and filed correctly on time.
- Preparing You for Your Hearing: When your appeal heads to a hearing with an ALJ, an attorney will prepare you for the types of questions you will face. They will also prepare you to effectively communicate the impact of your disability to the judge. An attorney can also question witnesses, challenge unfavorable testimony from medical experts, and present a compelling argument on your behalf.
- Maximizing Your Chances of Approval: Claimants who retain legal representation have a significantly greater chance of being approved than those who try to navigate the system on their own. An attorney will fight relentlessly for your rights and ensure that your case receives fair consideration.
At Fields Law, we have helped thousands of clients nationwide over the past 20 years gain the Social Security benefits they deserve.
Whether you’re filing an initial claim or looking to file an appeal after being denied for disability benefits, we can help.
We offer a free case review to all new clients, and we always stand behind our win-win guarantee — you won’t pay us anything until we win your case.
Your Disability Claim Has Been Denied — Now What? Contacting Fields Law Today Is Your Next Move
Don’t waste another minute wondering what to do if you’ve been denied disability benefits.
Fields Law offers nationwide representation for disability claims. We’re here to help you fight for your rights, and get the benefits you deserve.
. It costs nothing to get your questions answered today. Our representation is always backed with our Win-Win Guarantee® – we only get paid if you get paid.
*DISCLAIMER*
This blog post provides general information regarding appealing disability denials. Individual cases will vary significantly. For personalized guidance on your specific situation, it is essential to consult with a legal expert licensed in your state.
