Social Security Disability Insurance (SSDI) provides monthly payments to people who can no longer work due to a disability. When people find out about this program, they are filled with hope. Receiving SSDI benefits can give back a person’s independence and allow them to once again financially support themselves.
However, this hope and optimism can be destroyed in a moment should your claim be denied by the Social Security Administration (SSA). When this happens, you may be tempted to give up. This is a mistake. You are not out of options, but swift action is needed.
Let’s take a look at what you should do in the event that your SSDI claim is denied.
Understand Why Your Claim Was Denied
First, you need to understand why your claim is denied. This should be clearly explained in your denial notice. Possible reasons for denial include:
Insufficient Work Credits
Eligibility for SSDI benefits requires a substantial work history. This is measured with work credits. If you do not have enough, you will not be approved. If this was your reason for denial, double check to ensure that your work credits were calculated correctly.
Too Much Income
There is an income limit for those on SSDI. If you are denied for making too much money, you should double check the calculations and ensure that all proper deductions were applied.
Insufficient Medical Evidence
This is one of the most common reasons for denial. If you are denied for this, it means that the SSA does not feel that there is sufficient evidence to prove that you have a qualifying disability. If this is why you are denied, you must collect more medical evidence.
As you can see, understanding why you were denied can help you know how best to proceed.
Review Your Medical Evidence
If you were denied for insufficient medical evidence, you need to review the medical records you supplied with your application.
You need to carefully examine your medical records and determine whether or not they accurately reflect the severity of the condition.
You should also consider whether important diagnoses, test results, treatments, or symptoms were missing.
Full medical documentation is necessary to show how the condition affects your ability to perform work-related activities.
Consider Whether Additional Evidence Is Available
After reviewing the evidence you already have, you should try to collect more to fill in any gaps. This includes:
- Recent medical records
- Diagnostic test results
- Treatment histories
- Statements from treating providers
- Documentation regarding functional limitations
Remember, the more evidence you have, the better. You want the medical evidence to show the extent of your disability and the limitations it places on you.
Learn About the Appeals Process
To get your benefits, you will need to appeal the denial. You should be aware that this can be a long and complicated process. It consists of 4 levels, which are:
- Reconsideration: A complete review of your file by a new claims examiner who did not take part in the original decision. This stage takes about 3 to 8 months. You can update or add new medical evidence during this time.
- Administrative Law Judge (ALJ) Hearing: An in-person, phone, or video hearing where you can present testimony, witnesses, and new evidence to a judge. This stage takes about 9 to 18 months. Approval rates are typically highest at this stage.
- Appeals Council Review: A review of the judge’s decision to check for legal or procedural errors. This stage takes about 6 to 18 months. The council can approve the case, deny review, or send it back to the judge for a new hearing.
- Federal District Court Action: This is filing a formal civil lawsuit against the Social Security Administration in a U.S. District Court. It can take several years.
Should your claim be approved at any stage, you will not have to proceed to the next level of appeal.
Pay Attention to Appeal Deadlines
You have 60 days to appeal the initial denial. This clock starts ticking as soon as you receive the letter informing you of the denial.
Furthermore, if you are denied at subsequent appeal levels, you will once again have 60 days to take action. It is vital that you do not miss these deadlines. Doing so will result in you having to start the entire process over from the beginning.
Consider Legal Help
If you have received a denial of your benefits, it is wise to hire an experienced disability attorney. They understand the intricacies of the appeals process.
They will guide you through the entire process, as well as help you gather crucial evidence.
Having legal help can give you the best chance of receiving the benefits you are entitled to.
