My Disability Claim Was Denied: What Now?

If you file for social security disability benefits or Supplemental Security Income (SSI) and your claim is denied, you may have questions about how you can proceed.

Here some of the next steps you can take and some of the options you still have available to you.

Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) are available to those who have suffered a long-term or permanent disability that keeps them from working. The process begins once you file a claim, along with documentation of the disability, and can be time-consuming. If, after completing the process, your claim is denied, what can you do? Approximately 70% of disability claims are denied on the first filing, but there’s a process to appeal that decision. You might want to consider hiring an experienced attorney to help you complete the appeal process.

How Long Does it Take To Get Denied or Approved for Disability?

Typically, initial claims of disability take between 30 and 90 days to process. If your claim is approved, you should expect the entire wait time to be 90 days or less. If your claim is denied, you need to go through the appeals process, which will add more time to your wait. A significant factor in the speed of the claim process is your medical evidence. If you don’t include enough or proper medical evidence, the Social Security Administration (SSA) might request additional information or simply deny the claim.

Why Was a Disability Claim Denied?

If you wish to appeal the decision, it’s important to understand why your initial claim was denied. You should have received a letter in the mail explaining why your claim was denied and outlining the appeal process. The many reasons a claim might get denied include:

• Substantial Gainful Activity (SGA): If you are earning more than the allotted monthly amount, you’ll be denied. The SGA changes annually and follows the federal regulations outlined in the Social Security Act. The national average wage index helps set the SGA.
• Lack of medical evidence: To claim disability, you need to complete a lot of documentation to provide medical proof. Check out the SSA’s Blue Book to find your medical condition and the list of documents, tests, and treatments required for your disability.
• Not following a treatment plan: If you haven’t been following your doctor’s orders for a treatment plan, you might be denied. If you’re unable to follow your treatment plan for a valid reason, explain that in detail in the appeal.
• Ignoring requests: The SSA might ask for additional information. If you’re not responding to the organization’s requests for additional information, you’ll be denied.

Once you know why your claim has been denied, you can start working on the appeal process. You have 60 days from the day you receive the denial notice to appeal your claim.

Can I Refile the Disability Claim?

Do not simply start the process over again by refiling the same claim for disability. The appeal process might be time-consuming, but it allows you to add more information and explanations to a claim that already exists. If you simply refile the same claim, you will likely be denied again. Ultimately, you’ll end up filing an appeal even after refiling.

What Is the Appeal Process for a Denied Disability Claim?

If you receive a letter stating that your disability claim has been denied, do not stop there and do not reapply. Instead, plan to go through the appeal process to try to overturn the decision. Only 30% of applicants get approved on the first attempt, yet more than 50% of those who complete the appeal process are eventually approved. To appeal, follow these steps:

• Plan to resubmit the claim with any additional information or documentation that will further explain your disability. Look through the SSA’s Blue Book to ensure you have all necessary medical evidence.
• Consider having your doctor complete a Residual Function Capacity (RFC) form. This form helps describe your condition and how it affects your ability to work.
• Be prepared to attend a disability hearing where a judge will listen to your explanation, consider any new evidence, and render a decision.

Having an experienced attorney by your side for the appeals process can make a difference in the outcome of your appeal. An attorney can organize your information and documentation in a manner that often speeds up the appeal process and dramatically improves your chances of a positive outcome.

What if My Appeal Is Denied?

If your appeal for disability is denied, you’ll have to file a new application or go to federal court. If you don’t appeal, you can no longer try to receive benefits under your current claim. If you decide to appeal, you cannot open a new application until the appeal process is complete. Your initial claim can be denied twice: once as the initial denial and the second if your appeal is rejected. If you’ve been denied a second time, you still have the right to refile a second application.

To have your claim overturned, you’ll need to prove that the Administrative Law Judge (ALJ) decided denial of benefits without considering your medical records correctly. The Appeals Council (AC) then reconsiders the case. If the AC believes the ADJ made an incorrect decision, the case with either be remanded or sent back to the ADJ, or the AC will decide the case. If you’re denied again, you can file a civil complaint with your state’s U.S. District Court.

Do I Need an Attorney for a Disability Claim Appeal?

While you don’t need an attorney to file an appeal with the Social Security Administration, you might consider hiring one to help strengthen your case. Having an experienced attorney on your side increases the chances of approval and often speeds up the timeline on your case. Your representation knows how to review your case and develop the required evidence for your particular disability claim.

Reach out to the knowledgeable team at Goodman Acker today for a free consultation to determine how best to approach your case. We’re available by phone at 248-965-5205, or you can complete our online form, and a member of our team will get back to you. Know your rights when it comes to a denied disability claim.

Call Goodman Acker P.C. today at (248) 793-2010 to discuss the details of your case.