Steps to Take If Your SSDI Claim Is Denied

Article summary: When your SSDI claim is denied you have 60 days to file an appeal. There are four levels of appeal, starting with a Request for Reconsideration. Using a disability advocate is the safest way to ensure your decision is reversed at the reconsideration stage as they know how to present compelling information in a timely manner adhering to the right process. Following the appeal process and providing detailed medical evidence is the best way to avoid moving to the next level of appeal.

Table of Contents

• Introduction
• Contact a Disability Advocate
• Request for Consideration
• Follow the Appeal Process Without Error
• Provide Detailed Medical Evidence
• Moving to the Next Level of Appeal

The process to apply for Social Security Disability insurance (SSDI) is stressful and time-consuming. If your application is denied you have a right to appeal. In fact, anyone who is denied social security disability insurance should always appeal, as a staggering two-thirds of the applications processed are denied the first time. The only way to approach your claim denial is to speak to a disability advocate. They will take every possible step to ensure your appeal is not denied. Here we look at the steps to take if your SSDI applications are denied following the Social Security Disability Insurance (SSDI) appeals process.

Contact a Disability Advocate

This is a very important first step as it avoids going through the appeals process only to be denied again. Disability advocates understand why most claims are denied and can quickly put together an appeals case to ensure you receive the SSDI benefits you deserve. You must contact them as soon as possible as you only have 60 days to file an appeal. This starts from the date listed on the denial letter.

Your disability advocate can quickly prepare the appeal, so you don’t miss the deadline. Although missing the deadline doesn’t automatically mean you can’t appeal your denial, it does make the appeal process more difficult. You may have to start from scratch and refile your claim all over again. Filing the appeal prior to the 60 days helps avoid wasted time that keeps you from receiving your benefits.  A reconsideration appeal might be decided as quickly as eight weeks. However, if you miss your deadline the new application for disability can take another six months, or more.

Request for Reconsideration

There are four levels of appeal for the SSDI appeals process beginning with a Request for Reconsideration. Each level adds more time to the appeals process, which delays receipt of your benefits. Therefore, you’ll need support from a disability advocate who can find evidence to prove you have a legitimate disability. Your disability advocate will make the Request for Reconsideration online so your case can be reviewed by a different team.

Your advocate will ensure the information required is presented with the correct elements of the original evidence you submitted, in hand with new evidence they collect to help increase the odds your appeal will be approved. Your disability advocate will also look at the reason for denial to determine the type of Reconsideration appeal required. There are two possibilities:

1. Non-Medical Reconsideration: A non-medical determination letter means your denial is based on the non-medical information you provided. As a result, your advocate will review the information to determine where the issue lies such as your income, possible overpayments, your current living arrangements, your age, or resources available to you.
2. Medical Reconsideration: A medical reconsideration addresses denials related to your medical condition. In this case, your advocate will thoroughly investigate your condition, to prove it is a qualifying condition. They will then collect further evidence to prove your disability directly impacts your employability.

Your disability advocate knows how to prepare a compelling argument proving your disability does qualify and that you are eligible for SSDI.

Follow the Appeal Process Without Error

Your appeal is your chance to include every detail about your case. Therefore, you want to follow the appeal process to a T. Errors or missed information are the most common reason cases are denied. You don’t want the same mistakes to cause your appeal to be denied as well. Although you can take further steps if your Request for Consideration is denied, your best bet is to follow the proper process from the start including:

• A properly filled out Form SSA-561 which is your formal Request for Reconsideration (This is most often completed, online).
• A complete Reconsideration Disability Report, SSA 3441) with new information to support your claim in hand with all the original medical information you sent with your original claim  (This form is also most often filed online)
• Proper Authorization to Disclose Information to the SSA makes it easy for the SSA to access your health information to confirm your evidence is authentic.

Your disability advocate will ensure your documents and forms are completed without error so you can win your appeal.

Provide Detailed Medical Evidence

Once the field office verifies your non-medical eligibility requirements, they send your application to the Disability Determination Services (DDS) team. Their job is to evaluate your actual disability. They decide whether or not your condition qualifies for SSDI benefits. If they find your application fails to show you meet the disability standards, they send your file back to the field office. Appeals are reviewed by a different team at the DDS. You want to ensure every detail of your medical condition is collected and included.

Your disability advocate specializes in finding factual medical evidence to support your claim your disability is eligible for benefits. Their job is to make sure the DDS overrules the original determination and put your claim through for approval. If you fail to provide the information required, you will have no choice but to take your appeal to a Disability Hearing before an Administrative Law Judge. Therefore, providing compelling supplementary evidence is key to winning your case.

Moving to the Next Level of Appeal

As mentioned above, the process to review your appeal at the first level of reconsideration can be decided in as little as eight weeks. This process takes as long as 16 weeks if you fail to send enough supplementary evidence, as the review team has to investigate and follow up with your medical professionals. If your reconsideration is denied, you will have to go to the next level of appeal. There are three more levels if your case is denied at the reconsideration process:

1. Disability Hearing by an Administrative Law Judge
2. Appeals Council Review
3. Federal District Court Review

The more levels you go through the less chance there is your claim will be approved. That is why it is so important to start off on the right foot with a disability advocate in your corner.

Our team of experienced advocates can collect the necessary medical documents and test results for your Request for Reconsideration to increase the possibility of winning your appeal. Speak to our team for a free consultation today.