What If I’m Denied?
Denial of Your Claim
It is very common for a Social Security Disability Insurance (SSDI) claim to be denied following the initial application. Within 60 days of the date of the written Determination that denies your claim, you must contact the Social Security Administration (SSA) and make a Request for Reconsideration of the denial. You can make the Request for Reconsideration in several different ways:
- Contact your SSA District Office by telephone or in writing and specifically make the Request for Reconsideration;
- Call the SSA Toll Free telephone number (800) 772-1213 and make the Request for Reconsideration; or
- Make the Request for Reconsideration online at the SSA website: https://secure.ssa.gov/apps6z/iAppeals/ap001.jsp SSA changes their website regularly so if this link does not work, go to the SSA Homepage at: www.ssa.gov and look for a link to the appeals process.
At the Reconsideration level, your claim will be examined by a Disability Determination Services (DDS) caseworker who will review your application and the evidence. A determination will be made as to whether or not your claim was properly denied. In the vast majority of cases, your claim will be denied again at this stage of the process.
If your case is approved, you will start receiving your disability checks each month in addition to any Social Security Disability payments to which you were entitled up to that point in time.
If you are denied SSDI benefits following the Request for Reconsideration, the next step is to make a Request for Hearing before an Administrative Law Judge (ALJ). You again will have 60 days from the date of the written Reconsideration decision to make the Request for Hearing.
It is at the hearing step that an attorney from Malters, Shepherd and Von Holtum could be of most benefit to you. We would be happy to meet with you to discuss your case and consider representing you in your Request for Hearing. Mark Shepherd of our firm has assisted people with Social Security Disability claims for 30 years.
Unfortunately, the road to a Social Security hearing will likely take more than one year. Our firm can assist you to develop evidence which can lead to a favorable decision for you.
Once the hearing is scheduled, you will meet with your attorney to prepare for the hearing. You will attend the hearing with your attorney and any other witnesses who you and your attorney believe can be helpful to your case. An Administrative Law Judge (ALJ) will hear your case and will likely arrange to have a vocational expert testify at your hearing. Following the hearing, the ALJ will issue a written decision.
What should I do if my application is denied?
There are four different levels of appeal. They are:
- Request for Reconsideration. Following the initial denial, you will ask for a reconsideration of the decision by someone different than who first denied your claim. You must make the Request within 60 days of the initial written denial of your application. The new worker will make the decision as to whether or not the initial decision was improper. This review rarely results in the reversal of the initial decision.
- Request for Hearing. This level of the process involves a formal hearing in front of an Administrative Law Judge. The Request must be made within 60 days of the written Reconsideration denial.
- Request for Review by the SSA Appeals Council. This level involves a review of the decision of the ALJ. New evidence is generally not allowed and there is no in-person appearance made by you or your attorney. Typically, the Appeals Council does not change the decision of the ALJ.
- Federal Court Appeal. The final step in the process is an appeal of the denial to U.S. Federal District Court. Very few claimants are able to have their cases examined at this level. Your chances of a positive outcome are only somewhat better than at the previous level.
Reconsideration of Social Security Disability
You will need these forms to request a Reconsideration:
- Form SSA-561-U2: Request for Reconsideration http://www.ssa.gov/online/ssa-561.pdf
- Form SSA-3441-F6: Reconsideration Disability Report http://www.ssa.gov/online/ssa-3441.pdf (this form may also be completed online—https://secure.ssa.gov/apps6z/iAppeals/ap001.jsp
- Form SSA-827: Authorization for Source to Source Release Information to the SSA http://www.ssa.gov/online/ssa-827.pdf
If you have filed your initial application and received a Social Security Disability denial, a notice regarding your right to appeal will be sent to you. Our Social Security Disability lawyer or the local Social Security office can assist in getting your Reconsideration started.
A Reconsideration is a thorough review of your Social Security claim. A Disability Determination Services (DDS) office will examine your claim. The original documentation and additional evidence will be reviewed by a medical consultant and examiner that were not involved in the decision regarding your initial Social Security Disability application. Our Social Security Disability lawyer can assist you by gathering additional evidence for the DDS and by helping you navigate your appeal.
You will receive a denial notice and explanation should your reconsideration for Social Security appeal be denied. The next step if you wish to appeal is requesting a hearing before an Administrative Law Judge.
You will need these forms if you wish to request a hearing before an Administrative Law Judge (ALJ):
- Form HA-501-U5: Request for Hearing by ALJ http://www.ssa.gov/online/ha-501.pdf
- Form HA-4486: Claimant’s Statement When Request for Hearing is Filed and the Issue is Disability http://www.disability-links.com/forms/ss4486f.pdf
- Form SSA-827: Authorization for Source to Release Information to the Social Security Administration http://www.ssa.gov/online/ssa-827.pdf
You are allowed 60 days after receipt of your denial of your Social Security appeals reconsideration to request a hearing before an ALJ. SSA allows five extra days for mailing time, making a total of 65 days to file a Social Security appeal to an ALJ.
A hearing will be scheduled before an ALJ who is employed by the Social Security Administration. The hearing is formal and will result in the ALJ making an independent evaluation of your application and decision on your claim.
Those present at the hearing will include the ALJ, an administrative assistant responsible for recording the proceeding, the claimant (you), your attorney and any witnesses that you present at the hearing. The ALJ may examine medical or vocational experts at the hearing. There is no attorney on the opposing side that will claim that you are not eligible for benefits.
SSA Appeals Council
You will need this form if you wish to request an appeal to the Appeals Council:
- SSA Form HA-520-U5: Request for Review of Decision/Order of Administrative Law Judge http://www.socialsecurity.gov/online/ha-520.pdf
The last step in the administrative Social Security Appeal process is an appeal to the Security Appeals Council (AC). This AC appeal needs to be requested within 60 days. The AC may send your case back to the ALJ if it feels that additional evidence is necessary or it may retain your case to be examined. The AC will review existing records and any supplemental evidence to your claim. It is quite difficult to be successful at this level and it can take one year or longer for the AC to examine your Social Security appeal.
Federal District Court
A lawsuit can be filed in Federal District Court if the AC refuses to review your disability claim or denies your claim. The complaint must be filed within 60 days of receipt of the notice from the AC. A federal Magistrate and Judge will review your case at this level.
INJURED? DISABLED? GET ACTION!
We can help you through the appeals process for your Minnesota, South Dakota and Iowa Social Security Disability claims. Contact us to get started on resolving your Social Security Disability claim. Remember, consultations with prospective clients on Social Security Disability cases are free of charge.