Appeal Council Office of Disability Adjudication and Review

Summary

Approximately 67% of Social Security Inability applications are denied the first time
Applications can exist denied for medical reasons or non-medical reasons
Having an experienced disability chaser can greatly increment your chances of winning your appeal
Social Security Disability chaser fees are express by law
Chaser fees are 25% of your past-due benefits, non to exceed $6000
Your attorney will non be paid unless they win you benefits

Finding out that yous take been denied for Social Security Disability Insurance (SSDI) tin can exist devastating. If a disability is preventing yous from maintaining gainful employment, you lot are probable to need the blazon of financial aid that SSDI tin provide. That'due south why having your SSDI claim denied can be such a scary prospect. Here, we tell you why you lot are not alone – and why almost applicants have their SSDI claim denied the first fourth dimension around. Nosotros tell you how to file an appeal, and how hiring an chaser can provide yous with your all-time chance of success. Finally, because we know how financially-challenging this process tin be, we get into the specifics of how much an SSDI entreatment chaser will cost, and why hiring an attorney at this stage in the process is well worth information technology.

You're non alone: Virtually appeals are denied

If you practical for SSDI and have been denied, you lot may experience like giving upwards. Simply don't allow your denial cease yous from moving forrard! Here is an interesting statistic: About of the people who use for SSDI are denied, in 2012 the approval rate at the outset stage was 33%. Only, most of the people who appeal their deprival eventually win their instance! Therefore, if your SSDI application has been denied, you should attempt to consider this denial as but the first step in a long procedure, rather than thinking of information technology as the terminate of the road.

Why are most appeals denied?

Well-nigh SSDI applications are denied because the SSA determines that the applicant'south disability is non severe enough or long-lasting enough for that person to authorize for benefits. For example, permit'southward say yous were in a car wreck and bankrupt a number of bones, and those injuries prevent you lot from working. The SSA could deny your claim because near of your injuries would heal in less than 12 months, and any injuries which DID remain after 12 months would non prevent you from working. Or, let's say that you were you sustained injuries which definitely would last over 12 months. The SSA could Still deny your claim if they adamant that those long-lasting injuries were not astringent enough to continue y'all from working. Almost SSDI denials are for one of these reasons – a inability which is either not astringent enough or not long-lasting plenty to prevent the bidder from participating in substantial gainful activity (SGA).

The primal to proving that your disability is severe and kept yous from working is extensive medical treatment that shows y'all could not work over the 12 month period and ongoing.

Some applicants receive what is called a technical denial, or a denial for non-medical reasons. That means that the SSA has determined that the applicant did not meet the work credit requirements to qualify for SSDI – that person's application would accept been denied before the SSA even considered whether that person was disabled. We discuss appealing both medical and technical denials beneath.

Your SSDI application has been denied – what practise you do now?

First, it is important to note that if your SSDI application is denied, you should NOT re-use. Re-applying simply starts the process all again. And unless you've had a major alter in circumstances, it is likely that your awarding will simply be denied all over again. Rather than re-apply, y'all should ALWAYS appeal your denial. You have 60 days from the receipt of your deprival letter to entreatment the SSA'south decision.

As far as how to entreatment, your deprival letter of the alphabet will contain the instructions for the appeals process. Generally, you contact your local SSA office and let them know that you will exist appealing the conclusion, and they will tell yous what you lot need to practise next. For almost applicants, the first pace in the appeals process is something called a Request for Reconsideration.

Asking for Reconsideration

In about states, the first stride in an appeal is called a Asking for Reconsideration, while some states skip this step. California is among united states of america which does not require the request for reconsideration, but this is true of the Los Angeles North and Los Angeles West branches only. Therefore, even the majority of Californians would need to seek a request for reconsideration. Approximately 10-fifteen% of appeals are granted during a request for reconsideration. If you do have to file a request for reconsideration and it is denied, or if yous alive in a land where y'all didn't have to file one in the first identify, and then your side by side footstep is to request a hearing before an administrative law guess.

Hearing before an administrative law guess (ALJ)

So, your request for reconsideration has been denied, or you did not have to file a asking for afterthought. Either way, your next stride is to asking a hearing earlier an administrative police approximate (ALJ). You must asking your ALJ hearing within lx days of receiving your deprival alphabetic character. An authoritative law judge is an attorney who works for the SSA, specifically in a department chosen the Function of Disability Adjudication and Review. This ways that the majority of what these ALJs do is hear disability appeals.

What happens during the ALJ hearing is that the judge takes a fresh look at your case, starting at the beginning. You become to commencement your argument over again, this time in person. The ALJ will make a decision after reviewing all of your evidence (including any new bear witness that you lot've submitted since the time of your original denial) and after questioning you about your inability. (If you aren't very confident most speaking in forepart of a estimate, and so it is probably a skillful thought to hire an attorney who tin walk you through the process and help you to do your testimony.)

The ALJ volition likewise likely enlist the assist of a vocational expert. A vocational good is someone who knows various jobs and the skills it takes to do them. Most people who appeal their SSDI denials were originally denied benefits because the SSA determined that there were other jobs available to the bidder which would permit him to participate in substantial gainful activity, or SGA. Therefore, the vocational expert will exist at that place to inform the judge which jobs he believes that you are capable of doing and why. Again, having an attorney at this stage is helpful because he or she could argue against the vocational skillful if you disagree with his findings.

The ALJ may also wish to consult a medical practiced for assistance with understanding your claimed disability. Again, it is helpful to have an chaser to assist you if you expect that y'all may disagree with the medical practiced'south findings.

In terms of probability, the hearing in front of the ALJ is your all-time chance to win your SSDI instance and it is highly recommended that yous have an attorney for the hearing due to the complex legal questions and issue and dealing with the vocational expert.

The average time to wait between the original application and the hearing date may be xviii months to 2 years. This is why applying as shortly every bit possible for SSDI benefit is so critical.

The Appeals Council

Even if you lot are not among the 52% of cases whose appeals are granted by the ALJ, you have another avenue in your appeal procedure – the Appeals Council. Substantially, if your appeal is denied by the ALJ, yous can request that the Appeals Council hear your case. The important word here is request. You are not entitled to a review by the Appeals Council. In fact, they will but hear your case if it meets sure conditions; specifically, in that location must take been a flaw in the ALJ's review of your case. Note that cases brought before the Appeals Council are but won 2-3% of the time and people go a new hearing 18% of the time. Technically, the only reason for pursuing this option is that y'all must do so before being allowed to pursue your case in federal courtroom, which would be the side by side footstep in your appeals procedure.

Federal Court

If your disability claim is denied and you lot accept exhausted your appeals options with with SSA, your next footstep is to take your case to the U.S. District Courtroom. The good news is that at least one-third of disability cases taken to federal court are won past the bidder. The bad news is that this is an arduous procedure. Federal court cases can take years and are extremely expensive. Therefore, while federal court is an pick, it is in your best interest to do everything possible to win your appeal prior to reaching that phase.

How an entreatment is different from your original application?

If you lot've already submitted your original SSDI application and been denied, you lot may be wondering how and why you need to arroyo your entreatment so as to alter your cease result. If your disability situation hasn't changed since your original application, why volition things be unlike this fourth dimension effectually? The simplest answer is that the appeals process is handled less systematically than was your original application.

Commencement, let's starting time with the request for afterthought, assuming that yous need to accept this step. A reconsideration is a complete review of your claim, and it is carried out past a medical consultant and examiner who were not a office of the conclusion to deny your original application. In other words, a request for reconsideration is similar a practice-over with new parties on the decision-making end.

As far as the piece of work on your finish is concerned, a asking for reconsideration is non all that different from your original application. Just assuming your request for afterthought is denied, then this is where the appeals process starts to vary greatly from your original application process.

The biggest modify comes in the adjacent pace in the appeals process: the ALJ hearing. That's because an ALJ hearing is simply that: a hearing. No more than hiding behind newspaper documents – this is an in-person discussion of your argument, a formal proceeding where evidence is presented and arguments are made. The fact that the ALJ hearing is then different from your original application process is the reason why hiring an attorney is so important at this stage. Hearings, arguments, presenting evidence: all of these steps tin can be very confusing, and scary, for the boilerplate applicant. Only an attorney knows how to nowadays your instance to the ALJ and to give y'all the best chances of winning your appeal.

What do you need to do to win your entreatment?

If you've already applied for SSDI and have been denied, and so the get-go thing you lot need to practise in social club to have a dissimilar consequence this fourth dimension around is to figure out why you were denied in the first place. Find out what the SSA thinks you did wrong, and this fourth dimension practice it right. The first step is to decide what blazon of deprival you received.

Technical denials

As nosotros pointed out in our discussion of SSDI eligibility and requirements, the first step the SSA will take in reviewing your application is determining whether y'all meet the non-medical requirements for SSDI. By non-medical, nosotros mean the questions as to whether you lot earned enough work credits (and earned them recently enough) for your awarding to be considered. Think that if the SSA determines that you practice not meet the not-medical requirements, and so the outcome of whether you are disabled will not even be considered.

A technical deprival is a denial based upon the non-medical portion of your SSDI application. You will know whether your application denial was a technical denial considering it will say and then in the denial letter that you receive from the SSA. Some of the reasons for a technical denial are that you made also much money to qualify (meaning that you were found to be able to participate in substantial gainful activity, or SGA), or maybe the SSA determined that you didn't work (and pay into the SSA via FICA withholdings) long plenty to qualify for SSDI.

Generally speaking, nearly technical denials cannot be appealed. In other words, if you didn't earn enough work credits to qualify for SSDI, then there is nil that you lot can do to change that. Technical denials can be appealed, however, if the SSA fabricated a mistake in calculating your work credits. An appeal of a technical denial is handled just like an appeal for medical reasons, and the instructions for filing an appeal will be listed on your deprival letter (and discussed on this website).

Medical denials

While technical denials do occur, the majority of SSDI applications which are denied are due to medical reasons. That would include denials based upon a decision that your medical condition is not severe, as well as deciding that your condition does not prevent you from participating in SGA. Every bit we said to a higher place, a lot of the time the denial is due to lack of medical information. Sometimes Social Security did non become all of the records or they demand medical opinion evidence from your treating doctors and those reports never made it to the person reviewing your claim.

Overcoming a medical deprival

The all-time fashion to overcome a medical denial is to provide the SSA with as much medical information as possible, so that an informed decision can exist made on your example. You need to focus on the fact that your inability prevents you from working (specifically, from performing whatever substantial gainful activity). Remember that information technology isn't plenty to show that you can no longer perform your old chore – you also need to be able to show that your inability prevents yous from performing whatever other chore for which you would otherwise be qualified.

Should you hire an chaser to handle your SSDI appeal?

If you've been reading our clarification of the SSDI appeals procedure, then our answer to this question should come as no surprise. Should you hire a lawyer to handle your SSDI appeal? Definitely. And this isn't just a sales pitch: hiring a lawyer is undoubtedly in your all-time involvement, and it gives you lot the best chance at winning your SSDI appeal.

While an chaser can help you lot use for SSDI the first time around, the truth is that most people who hire a lawyer do so at the appeals stage. That'due south because the work involved in the appeals process – hearings, practiced witnesses, arguments before a judge – are activities that are much more familiar to an attorney than to the average layperson. Plus, if nothing else, an attorney is someone who tin put a fresh, experienced set of eyes on your case, letting you lot know what you're missing and what yous can await throughout the process.

An chaser can relieve the stress of the appeals procedure

Now, there is something very of import to consider at this indicate. Statistically, ALJ's grant approximately 52% of the appeals that they hear. Call back almost that – that ways that 52% of the time, someone who was denied SSDI the first time effectually will exist granted SSDI if they appeal. That is a powerful statistic, and it shows why highly-seasoned a denial should be an easy determination to make. Sadly, nonetheless, most SSDI applicants who are denied the get-go time around will Non file an appeal, despite their increased chances of having their application granted during the appeals procedure. This decision non to appeal could exist considering people don't realize that they CAN appeal, or empathise why they should.

Just the main reason why most people don't appeal their SSDI denials is considering the application procedure was so much work the first time effectually that they only don't want to become through it all over again. Being disabled and unable to earn a living can put a strain on a person's finances, their family, and their overall well-being. It makes sense that they wouldn't desire to cause themselves whatever additional stress. But this is one of the ways in which hiring an attorney can assistance an SSDI applicant: by condign the disabled person's partner, and to aid him as he goes through this hard process.

How much will an attorney charge to handle an SSDI appeal?

If you're considering hiring an chaser to handle your SSDI entreatment, chances are that yous are curious as to how much an attorney will accuse you. But what about people don't realize is that SSDI cases are a special area of the constabulary in which attorneys practice non charge hourly rates or demand large retainers. Instead, the amount that an attorney charges for an SSDI case is ready by law, meaning that all attorneys charge a fee that is calculated the same style.

How is the attorney fee calculated?

The method for calculating an chaser'due south fee for an SSDI case is actually pretty simple: the chaser collects 25% of your past-due benefits, non to exceed $6000. What that means is that your attorney but makes money if you win, and he does non get paid UNTIL you win. Most of the time the SSA simply takes the attorney's fee out of your by-due benefits and pays you the rest, significant that y'all never actually have to give your attorney his fee personally.

An attorney can as well request additional costs from you for things like postage, copying, etc. These expenses are to be expected, given that the attorney will be making many requests for medical records and other evidence. Commonly these fees run in the $200 range but are often less. Some attorneys enquire for these fees upwardly forepart, and others let you pay the fees once your instance has been won. If this result is important to you, so before y'all hire a lawyer you should clarify whether he volition look any money from you lot up forepart.

Why the attorney fee laws benefit you lot?

This question is actually pretty uncomplicated. Commencement, the fact that all attorneys are required by law to follow the same fee calculation means that you practise not accept to store around for the all-time rate. You can choose an attorney based upon other, more important factors such as his or her skills and whether yous feel a bond with this person. 2d, the fact that the attorney does not get paid unless and until you win means that the attorney has every reason in the earth to piece of work as hard for you as possible.

Just the most important way in which the chaser fee setup tin be a do good to you is related to something chosen a disability onset appointment. Every bit we've said, the attorney only receives a share in your past-due benefits, not your future benefits. And your by-due benefits are what will be paid to you in a lump sum past the SSA if you win your appeal. And then, obviously, both yous and your attorney desire those past-due benefits to be as high equally possible.

While you lot may think that your past-due benefit amount is something over which you have no control, the truth is that an chaser can take actions to aid to increase that number. He or she does this past arguing for every bit early of a disability onset date every bit possible. In other words, the earlier your onset date, the longer you have been disabled and the larger your backpay award.

The bottom line is that an attorney non merely tin increase your chances of winning your appeal by using his expertise, but he tin also help you lot through the process past relieving the stress of having to practise all of the piece of work yourself. On superlative of that, y'all will only have to pay the chaser if you win, and his payment volition come out of your lump-sum bank check automatically. Finally, he can help to make that lump-sum cheque as large as possible, which benefits both of you.

If you are yet on the contend when it comes to hiring an attorney, we encourage y'all to read the following link, "A candid discussion of attorneys' fees and why an attorney is worth the money."

Determination

While having your SSDI application denied can be disheartening, you lot should not surrender. As long equally you educate yourself every bit to the reason the SSA denied your awarding and accost that upshot head on (hopefully with the assist of an attorney), the appeals process will give you lot another shot to argue your case. And while an SSDI appeal may be complicated, it is well worth the efforts, given the potential benefit if your application is granted.

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Source: https://www.rivercityattorneys.com/ssdi-appeals/