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Can a denied disability claim be appealed?

Can a denied disability claim be appealed?

Even people who are not collecting Social Security disability benefits — or may never, depending on what happens to them in their life — know how important these benefits are to someone living with a disability. Not only can these benefits be used to pay for everyday expenses such as groceries, but they can be used to help pay for medical treatments as well. For many, they provide a financial safety net that might not have been possible if their claim had not been approved.

Unfortunately, even the Social Security Administration admits that not every claim is approved upon initial review. Contrary to what most people think, even legitimate claims can be denied because of application errors, missing medical documents or application reviewers who are not paying close enough attention. It’s because of this that some people need to go through the appeals process in order to access their benefits.

How does SSA define disability?

SSA defines a disability as a physical or mental impairment — or combination of the two — that lasts for a least one year, or results in death, and prevents a person from working.

In an effort to speed up processing of applications, the SSA has developed a list of diseases and medical conditions that immediately qualify for benefits. This list is known as Compassionate Allowances. Any condition referenced on this list meets the SSA definition of disability, which increases an application’s chances of being approved upon initial review.

Information you will need for your appeal

As we pointed out above, some legitimate claims are denied because they are missing necessary information. To avoid this issue, the SSA suggests following a checklist that includes all of the important pieces of information that you will need in order to make your appeal an effective one. Be sure to include testimonials from friends, family and doctors regarding your condition, including information about clinical visits and any treatments you have needed for your condition.

It’s also important to remember that there is a time limit on appeals. According to SSA, an appeal must be made within 60 days after receiving your denial letter. Depending on why your claim was denied, an appeal can be made in writing or on the SSA website.

How does the appeals process work?

There are four levels to the appeals process:

  • Reconsideration
  • Hearing with administrative law judge
  • Appeals Council review
  • Federal Court review

During the reconsideration stage, your application will undergo a full review and you will be given a decision. If you do not agree with the reconsideration, you have the right to request a hearing with an administrative law judge.

The judge, who was not party to your initial claim nor the reconsideration, will hear the facts of your case, including new information, and make a decision about your claim. If you disagree with this decision, then you may decide to appeal to the Appeals Council for review.

Depending on how the Appeals Council decides, you may want to file a civil lawsuit with a federal court that would then look at your case and also make a decision.

Do I need representation?

Though it’s possible to go through the appeals process without the help of legal representation, you do have the right to seek the help of a lawyer. Because of the complexity of the law, an attorney can help answer all of your questions, prepare your claim and even correct an mistakes that could lead to further denial of benefits.