If you suffer a disability and are unable to work but the Social Security Administration (SSA) has denied you disability benefits, you can file an appeal.
You have the right to appeal any decision Social Security makes about whether you believe you are entitled to Social Security Disability Benefits (SSDI) or Supplemental Security Income (SSI) payments. Typically you have 60 days after you receive the denial letter from the SSA to file your appeal or request consideration.
If you miss the 60 day deadline without a good reason, the ALJ may dismiss your appeal which means you may no longer be eligible for the next step in the appeal process.
How to File Your Appeal for Disability Benefits
As long as the 60 day deadline has not been reached you may file an appeal or request a “reconsideration” You can do so by following the instructions in your denial letter or by appealing online.
What to Have When Filing Your Appeal
You, or your disability attorney if you have one, may request a hearing by filing in writing, submitting your hearing request online by or by downloading the forms you need and sending them to us by mail, or writing us a letter or asking us to assist you in completing your request by calling your local field office.
You should include as much new medical evidence as you can to support your appeal.
This includes new medical test results confirming your medical condition, an updated letter from your physician and results of a Residual Functional Capacity (RFC) test performed by your physician. You should also submit a letter with your appeal.
Update Your Medical Records
When filing an appeal, if you have seen a new doctor or had any more tests done you should submit this info with your appeal. This provides more information for the appeal which may help you win disability benefits.
Using an RFC with Your Appeal
Your RFC is extremely important because the Social Security Administration doesn't just award benefits on the basis of a disability diagnosis alone, but rather on the ability of the disabled person to perform work-related activities necessary for undertaking gainful employment.
Before the SSA decides whether a disability applicant has a true disability that prevents work, the agency ascertains what types of activities and tasks the applicant can still do. If you are lodging an appeal having an RFC that confirms you have limited ability to move or have a mental disability may help you win the appeal.
Get a Doctor’s Support with Your Appeal
Typically, a statement provided by a doctor with whom you have had a long term relationship will be given strong weighting by the SSA when you file an appeal particularly if the doctor’s statement is supported by the medical evidence in the doctor's records and any other medical records provided by other healthcare providers who have been part of your diagnosis and treatment.
Why Claims Are Denied
When you receive your disability benefits denial letter from the SSA you should ensure you understand why your disability claim was denied in the first place. There are 5 main reasons for being denied disability benefits are described below:
1. Insufficient Medical Evidence
If you wish to qualify for disability benefits you will need to provide hard proof that you are unable to work which means providing medical records that show your disability stops you from working.
The medical records kept by your physicians are the most important in determining the success of your claim for Social Security Disability benefits. This should include your medical files that show the time you have taken off work due to your disability.
2. A Prior Denial
Often a claim will be denied if the SSA reviewer sees you have been denied benefits from a previous application. You have a higher chance of winning disability benefits if you lodge an appeal from a denial through the Social Security disability benefits appeal process rather than filing a new claim.
3. Your Income
If you are eligible to receive other government benefits this could affect your monthly SSDI benefit. This could include the following:
- public disability benefit;
- worker’s compensation;
- pension that is based on work that’s not covered by social security which may include a government or overseas government pension.
If you are working when you file an application for disability benefits and your earnings exceed $940 per month your claim may be denied.
4. Failing to Follow Treatment
If you do not follow the treatment prescribed by your physician the SSA will quite likely deny your claim. This is because SSA examiner won’t be able to determine accurately whether your medical condition does prevent you from going to work.
5. Failing to Cooperate
If you do not provide the requested documentation or do not turn up to any medical examinations, your claim will be denied. Therefore it is important to stay in contact with the SSA officer responsible for your case and provide any requested documentation when you are asked to do so.
A lawyer can help file the appeal. However, don’t leave contacting a lawyer for too long as you are only given 60 days from receiving the denial letter to lodge an appeal.
Once you have contacted an attorney you can expect to get a free case evaluation when the attorney will assess your chances of winning an appeal. You have more chances of winning a social security appeal if an attorney works on your behalf during the social security disability benefits appeal process.
