Do you live in Florida? Do you struggle with a disability that has caused you to be unable to work? Have you filed a disability benefits claim and had it denied? If you answered yes to each of these questions, you may be feeling very frustrated and overwhelmed right now. That’s understandable. It can be tremendously stressful to be unable to work and pay your bills. You may feel strongly that you had a valid claim for benefits, and you may not understand why your claim was denied.
If you feel this way, you’re not alone. In fact, in many states, more than half of disability claims are denied on the first attempt. The good news is that an initial denial does not mean that you’ll never receive benefits. There is an appeals process available. Let’s take a closer look at that process together.
Why Was Your Claim Denied?
Before looking at the stages of the appeals process, it can be helpful to understand why claims are commonly denied. Often, it is not because your claim truly has no merit or because you don’t need or deserve disability benefits. Some of the common reasons for denial include:
- Insufficient Medical Evidence: When reviewing a claim, the Social Security Administration must determine if a particular condition is a disability. In making this determination, the SSA will consult its listing of impairments, more commonly known as the Blue Book. Sometimes, an applicant has a condition that is not specifically included in the Blue Book. In other cases, a condition may be listed, but sufficient medical evidence regarding that condition has not been submitted.
- Earning Too Much Income: As you probably know, the Social Security Administration intends for disability benefits to be provided to those who are unable to work. If you are still able to earn sufficient income in some way, the Social Security Administration may deny your application for benefits.
- Your disability is short-term: It is definitely possible to have a condition that is severe, but resolves fairly quickly. In this case, if a condition has lasted less than a year, the Social Security Administration may deny a benefits application.
- Technical Errors: Sometimes, an application may be denied for mere technical reasons. There may be missing signatures, an incomplete employment history, or failure to provide other required documentation.
These are only a few of the more common reasons that benefits are denied. Obviously, every claim is different, and consulting with an attorney regarding your particular denial is always advised.
A Look at the Appeals Process
- Filing a request for reconsideration: This first stage of the process includes reviewing the reasons that your claim was denied and having another SSA official review your claim and issue a new decision if warranted. You may want to submit additional medical documentation or other evidence to support your arguments.
- ALJ hearing: If your request for reconsideration is denied, you will have sixty days from the date of denial to request a hearing before an administrative law judge if desired. These hearings can be held in person, by telephone, or video. The ALJ will review your claim, including the reasons that the request for reconsideration was denied, as well as any additional evidence that you present. After doing so, the ALJ will issue an opinion affirming or denying the reconsideration request.
- Appeals council review: If the ALJ denies your claim, you have sixty days from the date of denial to request a review before the appeals council. The appeals council will review the decision of the ALJ and any additional evidence and arguments you present and issue a decision affirming or denying the ALJ’s opinion.
- Filing an appeal in federal court: The final stage of the appeals process is requesting review in federal court. This process can be expensive, time-consuming, and complicated. Only certain types of claims reach this stage, and consulting with an attorney regarding whether you want to pursue an appeal at this level is advised.
In many cases, pursuing an appeal can be effective. Finding an attorney who can review your claim and advise you about the appeals process can be very helpful. At Disability Experts, we’re here for you.
Call Disability Experts Today
At Disability Experts, we know that our clients who struggle with disabilities face many challenges. That’s why we’re here to help. Our talented and experienced legal team knows and understands every aspect of the claims process, and we are here to put that knowledge to work for you. We’ll always pursue the best legal strategies on your behalf, and we will keep you informed and involved in your claim every step of the way. If you’re ready to get started, give us a call today. We look forward to speaking with you soon.
Sources
- Social Security Appeals Process: https://www.ssa.gov/apply/appeal-decision-we-made
- Social Security Disability Benefit Overview: https://www.ssa.gov/pubs/EN-05-10029.pdf