What’s next after your first SSI & SSDI application is denied?

by Brad Myler

The next step after receiving an SSI & SSDI application denial is to put in an appeal. Do not make the error of reapplying, as winning an appeal is not that uncommon. While appealing is as simple as filling in an online form, using an attorney greatly increases the chances of success, as they are better able to gather and present evidence in support of the claim.

Medical or Technical?

We know if Social Security denies a claim, it’s because of one of the following two reasons, medical or technical. Denials on technical grounds are less common, and in some cases, such an insufficient amount of earned social security credits, appeals are not an option, otherwise it is worthwhile contacting Social Security in order to appeal the decision. Putting in an appeal is possible and is a recommended option for a medical denial. See https://www.trajectordisability.com/ for a comprehensive list of Social Security’s medical requirements for many common medical conditions.

While not required, representation by a disability attorney during the appeals process increases the chances of winning a case. Attorneys are knowledgeable about what pieces of evidence a case should have to win and are able to request additional medical tests, as needed. Experienced attorneys and law firms, especially, are even more beneficial as most are familiar with the ALJ social security administrative law judges through hearings, giving them an advantage in playing up strengths in a case.

Appeal Period

Applicants must place an appeal within 60 days of receiving a SSDI or SSI application denial letter. There are four successive appeal levels starting with reconsideration, hearing by an administrative law judge, review by the appeals council and, finally, a federal court review.

Reconsideration Level

Chances of success at the reconsideration level are historically low and Social Security denies more than three-quarters of all applications. During a reconsideration review, a different disability claims examiner along with a medical consultant assesses the application and any new supporting medical evidence.

Administrative Law Judge

Upon failing a reconsideration review, a hearing by an administrative law judge is the next step in the appeals process, and is where most successful appeals occur. Using legal representation at a hearing improves the chances of winning. Disability attorneys are more knowledgeable about what evidence can properly support an application and are better able to highlight the strengths in a case.

Hearings by an administrative law judge take a considerable amount of time to schedule. Applicants need to be prepared to wait roughly nine to twelve months, or longer. Although, hearings can be scheduled earlier if the applicant is under severe financial strain and is unable to pay for medications or medical care or is in danger of loosing their home. The hearing office will sometimes expedite a case and grant an on-the-record review in which the hearing office reviews the case before the hearing date. The hearing office only grants these in exceptional circumstances such as a worsening of the claimant’s medical condition.

Disability Appeals Council

The next step up on the appeals ladder is going in front of the Disability Appeals Council Review. The Appeals Council Review will recommend another hearing with an administrative law judge, award disability benefits, or deny the appeal.

Civil Complaint

The final stage in the appeals process is to file a civil complaint with the United States District Court.

New Claim

After all four levels of the appeals process are exhausted, the only other available course of action is to put in a new claim.